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生命的意义、死亡的呈现及其与心理困扰的关联。

Meaning of life, representation of death, and their association with psychological distress.

机构信息

Department of Philosophy, Sociology, Education, and Applied Psychology,University of Padua,Padua,Italy.

Department of Health,Local Health Authorities 8,Asolo,Italy.

出版信息

Palliat Support Care. 2018 Oct;16(5):511-519. doi: 10.1017/S1478951517000669. Epub 2017 Aug 9.

Abstract

OBJECTIVE

This paper presents a two-phase cross-sectional study aimed at examining the possible mitigating role of perceived meaning of life and representation of death on psychological distress, anxiety, and depression.

METHOD

The first phase involved 219 healthy participants, while the second encompassed 30 cancer patients. Each participant completed the Personal Meaning Profile (PMP), the Testoni Death Representation Scale (TDRS), the Hospital Anxiety and Depression Scale (HADS), and the Distress Thermometer (DT). The primary analyses comprised (1) correlation analyses between the overall scores of each of the instruments and (2) path analysis to assess the indirect effect of the PMP on DT score through anxiety and depression as determined by the HADS.

RESULTS

The path analysis showed that the PMP was inversely correlated with depression and anxiety, which, in turn, mediated the effect on distress. Inverse correlations were found between several dimensions of the PMP, the DT, and the HADS-Anxiety and HADS-Depression subscales, in both healthy participants and cancer patients. Religious orientation (faith in God) was related to a stronger sense of meaning in life and the ontological representation of death as a passage, rather than annihilation.

SIGNIFICANCE OF RESULTS

Our findings support the hypothesis that participants who represent death as a passage and have a strong perception of the meaning of life tend to report lower levels of distress, anxiety, and depression. We recommend that perceived meaning of life and representation of death be more specifically examined in the cancer and palliative care settings.

摘要

目的

本研究采用两阶段横断面设计,旨在探讨生活意义感和死亡呈现方式对心理困扰、焦虑和抑郁的可能缓解作用。

方法

第一阶段纳入 219 名健康参与者,第二阶段纳入 30 名癌症患者。每位参与者完成个人意义问卷(PMP)、托诺尼死亡呈现量表(TDRS)、医院焦虑抑郁量表(HADS)和痛苦温度计(DT)。主要分析包括(1)各量表总分之间的相关性分析,(2)路径分析,以评估 HADS 确定的焦虑和抑郁对 DT 评分的 PMP 间接效应。

结果

路径分析显示,PMP 与抑郁和焦虑呈负相关,而焦虑和抑郁又在一定程度上影响了心理困扰。在健康参与者和癌症患者中,PMP 的几个维度、DT 和 HADS-焦虑和 HADS-抑郁子量表之间均存在负相关。宗教取向(对上帝的信仰)与生活意义感更强和将死亡视为通道而不是毁灭的本体论呈现方式有关。

结果意义

我们的研究结果支持这样一种假设,即那些将死亡视为通道、对生活意义感较强的参与者往往报告的心理困扰、焦虑和抑郁水平较低。我们建议在癌症和姑息治疗环境中更具体地研究生活意义感和死亡呈现方式。

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