Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York.
Department of Psychology, Fordham University, Bronx, New York.
Psychooncology. 2018 Nov;27(11):2573-2580. doi: 10.1002/pon.4821. Epub 2018 Jul 27.
The study aims to examine the prevalence and common themes of unfinished business (UB) and its associations with distress among advanced cancer patients.
A total of 223 patients from a larger randomized controlled trial of Individual Meaning-Centered Psychotherapy (IMCP) completed self-report questionnaires that assessed UB and UB-related distress, hopelessness, desire for hastened death, anxiety and depression, quality of life, spiritual well-being, and purpose/meaning. Unfinished business themes were identified by qualitative analysis of open-ended data.
A total of 161 (72%) patients reported the presence of UB. The mean UB-related distress score was 7.01 (SD = 2.1) out of 10. Results of independent t tests showed that patients with UB reported significantly higher levels of anxiety and lower levels of existential transcendence than patients without UB. Linear regression equations indicated that UB-related distress significantly predicted hopelessness (F = 9.54, P < 0.05, R = 0.058), anxiety (F = 4.31, P < 0.05, R = 0.027), personal meaning (F = 6.18, P < 0.05, R = 0.043), and existential transcendence (F = 6.7, P < 0.05, R = 0.053). Ten UB themes emerged from open-ended responses; UB themes were not associated with UB-related distress or psychological adjustment.
Unfinished business was both prevalent and distressing in our sample. Findings underscore the need to develop and implement interventions designed to help patients resolve or find solace with UB.
本研究旨在探讨晚期癌症患者未竟事务（UB）的发生率和常见主题及其与痛苦的关系。
共有 223 名来自更大规模的个体意义中心心理治疗（IMCP）随机对照试验的患者完成了自我报告问卷，这些问卷评估了 UB 和 UB 相关的痛苦、绝望、加速死亡的愿望、焦虑和抑郁、生活质量、精神幸福感和目的/意义。通过对开放式数据的定性分析确定 UB 主题。
共有 161 名（72%）患者报告存在 UB。UB 相关痛苦评分的平均值为 10 分中的 7.01（SD=2.1）。独立 t 检验的结果表明，有 UB 的患者报告的焦虑水平明显高于没有 UB 的患者，而存在的超越感明显低于没有 UB 的患者。线性回归方程表明，UB 相关的痛苦显著预测了绝望（F=9.54，P<0.05，R=0.058）、焦虑（F=4.31，P<0.05，R=0.027）、个人意义（F=6.18，P<0.05，R=0.043）和存在超越感（F=6.7，P<0.05，R=0.053）。从开放式回答中出现了 10 个 UB 主题；UB 主题与 UB 相关的痛苦或心理调整无关。
在我们的样本中，未竟事务既普遍又令人痛苦。研究结果强调需要开发和实施干预措施，以帮助患者解决或找到 UB 的慰藉。
