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丧亲期间家庭照顾者对临终梦想和愿景的看法:一种混合方法研究

Family Caregiver Perspectives on End-of-Life Dreams and Visions during Bereavement: A Mixed Methods Approach.

作者信息

Grant Pei C, Depner Rachel M, Levy Kathryn, LaFever Sarah M, Tenzek Kelly E, Wright Scott T, Kerr Christopher W

机构信息

Palliative Care Institute-Department of Research, Center for Hospice and Palliative Care, Cheektowaga, New York.

Department of Counseling, School and Educational Psychology, University at Buffalo, The State University of New York, Buffalo, New York.

出版信息

J Palliat Med. 2020 Jan;23(1):48-53. doi: 10.1089/jpm.2019.0093. Epub 2019 Jul 9.

Abstract

End-of-life dreams and visions (ELDVs) are prevalent experiences that provide comfort and meaning to dying individuals. Limited research has examined the impact of ELDVs on the bereaved. This study aimed to explore differences in self-reported grief for people whose loved ones shared ELDVs and those who did not, and to describe the role of ELDVs in the grieving process. Mixed-methods cross-sectional survey. A total of 228 bereaved family caregivers (FCGs) of patients who died while under the care of a comprehensive hospice program were recruited. Demographics and ELDV prevalence were collected. Bereavement was assessed using the Core Bereavement Items (CBI) a validated measure. Impact on grief was also evaluated using an tool. Comfort from dreams significantly related to total CBI score ( = 0.224,  = 0.047) as well as the images and thoughts ( = 0.258,  = 0.025) and acute separation subscales ( = 0.224,  = 0.047). Comfort from dreams had a positive relationship with accepting the reality of loss ( = -0.511,  < 0.001), working through the pain of grief ( = -0.556,  < 0.001), adjusting to the new environment ( = -0.405,  = 0.001), and continuing bonds ( = -0.538,  < 0.001). CBI scores were not significantly different between caregivers who reported loved ones with ELDVs and others. Open-ended responses were thematically analyzed resulting in three emergent themes: , , and . ELDVs' impact extends beyond those experiencing them to bereaved loved ones. Bereaved FCGs report that comforting ELDVs experienced by their dying loved ones influenced their grief process in terms of the Worden's tasks of mourning.

摘要

临终梦境与幻象(ELDVs)是普遍存在的体验,能为濒死个体带来慰藉和意义。针对ELDVs对丧亲者影响的研究有限。本研究旨在探讨所爱之人有过ELDVs的人与没有过的人在自我报告的悲伤方面的差异,并描述ELDVs在悲伤过程中的作用。混合方法横断面调查。共招募了228名在综合临终关怀项目照料下死亡患者的丧亲家庭照料者(FCGs)。收集了人口统计学数据和ELDV的流行情况。使用经过验证的核心丧亲项目(CBI)评估丧亲情况。还使用一种工具评估对悲伤的影响。来自梦境的慰藉与CBI总分显著相关(r = 0.224,p = 0.047),以及与意象和想法(r = 0.258,p = 0.025)和急性分离分量表(r = 0.224,p = 0.047)。来自梦境的慰藉与接受丧失现实(r = -0.511,p < 0.001)、排解悲伤之痛(r = -0.556,p < 0.001)、适应新环境(r = -0.405,p = 0.001)以及持续联系(r = -0.538,p < 0.001)呈正相关。报告所爱之人有ELDVs的照料者与其他照料者的CBI得分无显著差异。对开放式回答进行了主题分析,得出三个新出现的主题: , ,和 。ELDVs的影响不仅限于经历者,还延伸到丧亲的爱人。丧亲的FCGs报告说,他们濒死的爱人所经历的慰藉性ELDVs在沃登哀悼任务方面影响了他们的悲伤过程。

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