Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Anesthesiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Division of Palliative Medicine, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Interdepartmental Division of Critical Care, Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada.
J Pain Symptom Manage. 2018 Jul;56(1):122-145. doi: 10.1016/j.jpainsymman.2018.03.009. Epub 2018 Mar 14.
Spiritual distress contributes to patients' and families' experiences of care.
To map the literature on how seriously ill patients and their family members experience spiritual distress within inpatient settings.
Our scoping review included four databases using search terms "existential" or "spiritual" combined with "angst," "anxiety," "distress," "stress," or "anguish." We included original research describing experiences of spiritual distress among adult patients or family members within inpatient settings and instrument validation studies. Each study was screened in duplicate for inclusion, and the data from included articles were extracted. Themes were identified, and data were synthesized.
Within the 37 articles meeting inclusion criteria, we identified six themes: conceptualizing spiritual distress (n = 2), diagnosis and prevalence (n = 7), assessment instrument development (n = 5), experiences (n = 12), associated variables (n = 12), and barriers and facilitators to clinical support (n = 5). The majority of studies focused on patients; two studies focused on family caregivers. The most common clinical settings were oncology (n = 19) and advanced disease (n = 19). Terminology to describe spiritual distress varied among studies. The prevalence of at least moderate spiritual distress in patients was 10%-63%. Spiritual distress was experienced in relation to self and others. Associated variables included demographic, physical, cognitive, and psychological factors. Barriers and facilitators were described.
Patients' and families' experiences of spiritual distress in the inpatient setting are multifaceted. Important gaps in the literature include a narrow spectrum of populations, limited consideration of family caregivers, and inconsistent terminology. Research addressing these gaps may improve conceptual clarity and help clinicians better identify spiritual distress.
精神困扰是患者和家属护理体验的一部分。
绘制关于重病患者及其家属在住院环境中经历精神困扰的文献图谱。
我们的范围综述包括四个数据库，使用“存在主义”或“精神”加上“焦虑”、“焦虑”、“痛苦”、“压力”或“痛苦”等搜索词。我们纳入了描述成年患者或其家属在住院环境中经历精神困扰的原始研究和仪器验证研究。每项研究均由两人进行重复筛选，纳入文章的数据被提取出来。确定了主题，并对数据进行了综合。
在符合纳入标准的 37 篇文章中，我们确定了六个主题：概念化精神困扰（n=2）、诊断和流行率（n=7）、评估工具的开发（n=5）、体验（n=12）、相关变量（n=12）和临床支持的障碍和促进因素（n=5）。大多数研究侧重于患者；两项研究侧重于家庭照顾者。最常见的临床科室是肿瘤科（n=19）和晚期疾病科（n=19）。描述精神困扰的术语在研究中各不相同。患者中至少有中度精神困扰的流行率为 10%-63%。精神困扰与自我和他人有关。相关变量包括人口统计学、身体、认知和心理因素。描述了障碍和促进因素。
患者和家属在住院环境中经历的精神困扰是多方面的。文献中的重要空白包括人群范围狭窄、对家庭照顾者的考虑有限以及术语不一致。解决这些空白的研究可能会提高概念的清晰度，并帮助临床医生更好地识别精神困扰。
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