单一的一个问题，关于在姑息治疗期间家庭成员的安全感，能否预测他们在丧亲期间的幸福感？在持续护理期间和患者去世一年后进行的纵向研究。
Can a single question about family members' sense of security during palliative care predict their well-being during bereavement? A longitudinal study during ongoing care and one year after the patient's death.
机构信息
Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
Department of Advanced Home Care and Department of Medical and Health Sciences, Linköping University, Norrköping, Sweden.
出版信息
BMC Palliat Care. 2019 Jul 25;18(1):63. doi: 10.1186/s12904-019-0446-1.
BACKGROUND
It has been recognised that more evidence about important aspects of family members' sense of security during palliative care is needed. The objectives of the study was: i) to discover what variables are associated with family members feeling secure during palliative care; ii) to develop a model of family members' sense of security during palliative care, and iii) to evaluate if family members' sense of security during ongoing palliative care predicts well-being during bereavement.
METHODS
Between September 2009 and October 2010, 227 family members (of patients admitted to six Swedish palliative home care units) participated in the study (participation rate 75%) during ongoing care and 158 participated also 1 year after the patient's death (70%). They answered a single question regarding the family members' sense of security during the palliative care period. The question was constructed and validated by the researchers. Data were also collected using other questions and validated instruments and analysed stepwise with Generalized Linear Models (ordinal multinomial distribution and logit link).
RESULTS
Sixteen variables were positively related to family members' sense of security during ongoing palliative care. The five variables with the highest importance were selected into the model (listed in decreasing importance): Family members' mastery; nervousness and stress; self-efficacy; patient having gynaecological cancer; family members' perceived quality of life. Moreover, the family members' sense of security during ongoing palliative care predicted ten variables indicating their well-being 1 year after the patient's death, e.g. psychological well-being, complicated grief symptoms, health related quality of life.
CONCLUSIONS
The findings reveal possibilities to identify family members at risk of negative adjustment to bereavement in clinical practice and may help to develop interventions to support family members during ongoing palliative care.
背景
人们已经认识到，在姑息治疗中，需要更多关于家庭成员安全感的重要方面的证据。本研究的目的是：i）发现哪些变量与家庭成员在姑息治疗中的安全感相关；ii）构建一个姑息治疗中家庭成员安全感模型，iii）评估在持续姑息治疗期间家庭成员的安全感是否能很好地预测丧亲后的幸福感。
方法
在 2009 年 9 月至 2010 年 10 月期间，227 名（来自瑞典 6 个姑息治疗家庭护理病房的患者的家属）在持续治疗期间参与了研究（参与率为 75%），158 名在患者去世后 1 年也参与了研究（70%）。他们回答了一个关于在姑息治疗期间家庭成员安全感的单一问题。这个问题是由研究人员构建和验证的。还使用其他问题和验证工具收集了数据，并使用逐步广义线性模型（有序多项分布和对数链接）进行了分析。
结果
16 个变量与姑息治疗期间家庭成员的安全感呈正相关。选择进入模型的五个最重要的变量（按重要性递减顺序列出）：家庭成员的掌握能力；紧张和压力；自我效能感；患者患有妇科癌症；家庭成员感知的生活质量。此外，在姑息治疗期间家庭成员的安全感预测了 10 个变量，这些变量表明患者去世 1 年后他们的幸福感，例如心理健康、复杂悲伤症状、健康相关生活质量。
结论
这些发现揭示了在临床实践中识别有负面丧亲适应风险的家庭成员的可能性，并可能有助于开发在持续姑息治疗期间支持家庭成员的干预措施。
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