Department of Neurology, INRCA-IRCCS National Institute of Health and Science on Aging, Ancona, Italy.
Palliative Care Unit, "San Carlo" Hospital, Potenza, Italy.
Support Care Cancer. 2018 Aug;26(8):2633-2640. doi: 10.1007/s00520-018-4107-3. Epub 2018 Feb 19.
This study focuses on the spiritual well-being (SWB) of the family caregivers of cancer patients, examining the relationship with personality traits and quality of life (QoL) in palliative and curative care settings.
All participants (n = 199) underwent the following self-report questionnaires: the Structural Analysis of Social Behavior (SASB)-Form A, the SWB Index, and the Medical Outcomes Study Short Form (SF-36). SWB scores were dichotomized at a cutoff corresponding to the 75th percentile.
Student's t test or by χ squared tests to compare high and low SWB and multivariate linear regression to estimate relations between SWB, SASB clusters (Cl), and QoL dimensions.
Caregivers with high SWB reported significantly better scores than low SWB caregivers in the following SF-36 subscales: bodily pain (p = 0.035), vitality (p < 0.001), social activities (p < 0.001), mental health subscales (p < 0.001), and standardized mental component (p < 0.001) in the SASB Cl2 (p < 0.005), SASB Cl7 (p = 0.007), and SASB Cl8 (p < 0.001). Multivariate linear regression was performed with vitality, standardized mental component, SASB Cl2, SASB Cl7, and SASB Cl8. Greater SWB is associated with greater vitality (p < 0.001), mental standardized component (p < 0.001), and SASB Cl2 (p < 0.001), but lower SASB Cl7 (p < 0.05) and SASB Cl8 (p < 0.05); palliative care is associated with greater SASB Cl8 (p < 0.05) and lower standardized mental component compared with the caregivers in active care.
This study points out that caregivers who experience low SWB have a poorer QoL and more problematic intrapsychic aspects of personality, such as low self-acceptance of their own emotions, are self-refusing and unable to be in contact with their own feelings. This suggests that spirituality could be a source of strength and a potential avenue for therapeutic intervention.
本研究聚焦于癌症患者家庭照顾者的精神幸福感（SWB），探讨其在姑息治疗和治愈性护理环境中与人格特质和生活质量（QoL）的关系。
所有参与者（n=199）接受了以下自评问卷：结构分析社会行为（SASB）-A 型、幸福感指数（SWB 指数）和医疗结局研究短表（SF-36）。SWB 评分以第 75 百分位对应的截定点进行二分。
采用学生 t 检验或卡方检验比较高 SWB 和低 SWB 组，采用多元线性回归估计 SWB、SASB 群集（Cl）和 QoL 维度之间的关系。
SWB 较高的照顾者在以下 SF-36 子量表中的得分显著高于 SWB 较低的照顾者：躯体疼痛（p=0.035）、活力（p<0.001）、社会活动（p<0.001）、心理健康子量表（p<0.001）和标准化心理成分（p<0.001），在 SASB Cl2（p<0.005）、SASB Cl7（p=0.007）和 SASB Cl8（p<0.001）中。进行了活力、标准化心理成分、SASB Cl2、SASB Cl7 和 SASB Cl8 的多元线性回归。更高的 SWB 与更高的活力（p<0.001）、标准化心理成分（p<0.001）和 SASB Cl2（p<0.001）相关，而与 SASB Cl7（p<0.05）和 SASB Cl8（p<0.05）较低相关；与积极护理中的照顾者相比，姑息治疗与更高的 SASB Cl8（p<0.05）和较低的标准化心理成分相关。
本研究指出，体验低 SWB 的照顾者的生活质量较差，人格的内在心理方面更具问题，例如低自我接纳自己的情绪、自我拒绝和无法接触自己的感受。这表明灵性可能是力量的源泉，也是治疗干预的潜在途径。
