Department of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Marburg, Germany.
Curr Opin Psychiatry. 2018 Sep;31(5):389-395. doi: 10.1097/YCO.0000000000000441.
To provide an update on recent studies about psychological interventions in palliative (mainly cancer) care with a focus on physical, psychological, spiritual, and social aspects.
Some promising psychological interventions for physical challenges, such as fatigue, pain, dyspnea, and insomnia do exist, but further research is needed. Regarding psychological aspects, current reviews showed small to large effects in the reduction of depression and anxiety symptoms through cognitive behavioral-based interventions, mindfulness-based interventions, and meaning-based interventions. Meaning-based or dignity-based approaches were also used for targeting spiritual aspects or existential distress. Social aspects that play a crucial role in palliative care are addressed by social support interventions, end-of-life discussions, and advanced careplanning. All of these psychological interventions must meet the specific requirements of palliative care, namely abbreviated session time and flexibility concerning locality of interventions, a minimized questionnaire burden and a high attrition rate caused by patients' poor physical conditions or deaths.
There is substantial research on psychological interventions in palliative care that shows promising results, but sample sizes were often small. Due to its high relevance for this growing patient group, there is a strong need for ongoing/further research.
提供关于姑息治疗（主要是癌症）中心理干预的最新研究，重点关注身体、心理、精神和社会方面。
一些针对身体挑战的有前途的心理干预措施，如疲劳、疼痛、呼吸困难和失眠确实存在，但需要进一步研究。在心理方面，目前的综述表明，通过认知行为干预、正念干预和意义干预，抑郁和焦虑症状的减轻效果从小到大都有。基于意义或尊严的方法也被用于针对精神方面或存在困境。在姑息治疗中发挥关键作用的社会方面，可以通过社会支持干预、临终讨论和预先护理计划来解决。所有这些心理干预措施都必须满足姑息治疗的特定要求，即缩短疗程时间和干预地点的灵活性、最小化问卷负担以及因患者身体状况不佳或死亡而导致的高退出率。
姑息治疗中有大量关于心理干预的研究，结果显示出有希望的结果，但样本量通常较小。由于它与这个不断增长的患者群体密切相关，因此迫切需要进行持续/进一步的研究。
