灵性照护能减轻专门照顾姑息治疗患者的家庭成员的负担。
Spirituality alleviates the burden on family members caring for patients receiving palliative care exclusively.
机构信息
Department of Psychology, Hospital da Luz, São Paulo, Brazil.
Division of Nephrology and Molecular Medicine, Department of Medicine, University of São Paulo School of Medicine, São Paulo, Brazil.
出版信息
BMC Palliat Care. 2020 Jun 3;19(1):77. doi: 10.1186/s12904-020-00585-2.
BACKGROUND
Spirituality can give meaning to life, providing support and guidance in complex situations. Despite its importance in palliative care, the role of spirituality for family caregivers of patients under exclusive palliative care has not received enough attention in the literature. We aimed to address the correlation between spirituality and the emotional burden of family members of patients under exclusive palliative care.
METHODS
This transversal study was conducted in a tertiary private teaching hospital, in São Paulo, Brazil. The study comprised family members of patients receiving palliative care exclusively. Only one caregiver who cared for the patient for at least 2 months was invited to participate. Family members answered the following questionnaires: WHOQOL spirituality, religiousness and personal beliefs (SRPB), Zarit Burden Interview (ZBI) and Self-Reporting Questionnaire (SRQ-20). They were excluded if patients were residing in a Long Stay Institution. Continuous variables were expressed by median and quartiles and analyzed with the Kruskal-Wallis test with Muller-Dunn post-test adjusted by Bonferroni or with the Mann-Whitney test for two groups. We used multivariable linear regression to identify independent predictors of caregiver burden.
RESULTS
A total of 178 family members were interviewed in a median of 8 [4-13.25] days after patient admission. Almost 40% of families presented high score of burden. Faith and Meaning in Life were the facets that scored the highest, with a median of 4.50 [4.00-5.00] for both facets. There was an inverse correlation between Zarit score and all of the WHOQOL-SRPB facets, indicating that the lower the spirituality, the greater the emotional burden. Inner peace was the strongest protective factor associated with burden.
CONCLUSIONS
Psycho-socio-spiritual interaction can improve the coping ability of family caregivers of patients under exclusive palliative care, addressing a critical gap in the provision of holistic palliative care services.
背景
灵性可以赋予生活意义，在复杂情况下提供支持和指导。尽管在姑息治疗中很重要，但专门接受姑息治疗的患者的家属的灵性作用在文献中并没有得到足够的关注。我们旨在探讨灵性与专门接受姑息治疗的患者家属的情绪负担之间的相关性。
方法
这是一项在巴西圣保罗的一家三级私立教学医院进行的横断面研究。该研究包括接受姑息治疗的患者的家属。只邀请了至少照顾患者 2 个月的一名照顾者参加。家属回答了以下问卷：世界卫生组织生活质量-灵性、宗教和个人信仰（SRPB）、Zarit 负担访谈（ZBI）和自我报告问卷（SRQ-20）。如果患者居住在长期住院机构中，则将其排除在外。连续变量用中位数和四分位数表示，并通过 Kruskal-Wallis 检验与 Muller-Dunn 事后检验进行分析，事后检验采用 Bonferroni 调整或两组间的 Mann-Whitney 检验。我们使用多变量线性回归来确定照顾者负担的独立预测因素。
结果
在患者入院后中位数为 8 [4-13.25] 天内，共对 178 名家属进行了访谈。近 40%的家庭存在高负担评分。信仰和生活意义是得分最高的方面，两个方面的中位数均为 4.50 [4.00-5.00]。Zarit 评分与 WHOQOL-SRPB 的所有方面呈负相关，这表明灵性越低，情绪负担越大。内心平静是与负担最相关的最强保护因素。
结论
心理-社会-精神相互作用可以提高专门接受姑息治疗的患者的家属的应对能力，从而解决整体姑息治疗服务中存在的一个关键差距。
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