Li Lingsheng, Sloan Danetta H, Mehta Ambereen K, Willis Gordon, Weaver Meaghann S, Berger Ann C
University of Oklahoma College of Medicine, Oklahoma, OK, USA.
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Ann Palliat Med. 2017 Jul;6(3):211-219. doi: 10.21037/apm.2017.05.03. Epub 2017 Jun 3.
It is important to identify, from the patients' perspectives, the different factors that contribute toward psycho-social-spiritual healing.
This was a qualitative study that took place at a large research center, an underserved clinic, and a community hospital. We used a needs assessment questionnaire and open-ended questions to assess the constituents of psycho-social-spiritual healing: (I) how previous life experiences affected patients' present situations in dealing with their illnesses; (II) barriers to palliative care, and (III) benefits of palliative care.
Of a total of 30 participants from 3 different study sites, 24 (80%) were receiving inpatient or outpatient palliative care at a research center. Thirteen (43%) participants were female, 10 (33%) were Black/African American, and 16 (53%) reported being on disability. While the initial shock of the diagnosis made participants feel unprepared for their illnesses, many looked to role models, previous work experiences, and spiritual as well as religious support as sources of strength and coping mechanisms. Barriers to palliative care were identified as either external (lack of proper resources) or internal (symptom barriers and perceived self-limitations). The feeling of "being seen/being heard" was perceived by many participants as the most beneficial aspect of palliative care.
The needs assessment questionnaire and open-ended questions presented in this study may be used in clinical settings to better help patients achieve psycho-social-spiritual healing through palliative care and to help clinicians learn about the person behind the patient.
从患者的角度识别有助于心理-社会-精神康复的不同因素非常重要。
这是一项定性研究，在一个大型研究中心、一家服务不足的诊所和一家社区医院进行。我们使用需求评估问卷和开放式问题来评估心理-社会-精神康复的组成部分：（I）以往的生活经历如何影响患者当前应对疾病的情况；（II）姑息治疗的障碍，以及（III）姑息治疗的益处。
来自3个不同研究地点的30名参与者中，有24名（80%）在一个研究中心接受住院或门诊姑息治疗。13名（43%）参与者为女性，10名（33%）为黑人/非裔美国人，16名（53%）报告有残疾。虽然诊断带来的最初冲击让参与者对自己的疾病感到毫无准备，但许多人将榜样、以往的工作经历以及精神和宗教支持视为力量来源和应对机制。姑息治疗的障碍被确定为外部（缺乏适当资源）或内部（症状障碍和自我认知限制）。许多参与者认为“被关注/被倾听”的感觉是姑息治疗最有益的方面。
本研究中提出的需求评估问卷和开放式问题可用于临床环境，以更好地帮助患者通过姑息治疗实现心理-社会-精神康复，并帮助临床医生了解患者背后的个体。
