Bernard Mathieu, Berchtold André, Strasser Florian, Gamondi Claudia, Borasio Gian Domenico
Palliative and Supportive Care Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
Institute of Social Sciences & NCCR LIVES, University of Lausanne, Lausanne, Switzerland.
BMJ Support Palliat Care. 2024 Dec 19;14(e3):e2537-e2545. doi: 10.1136/bmjspcare-2020-002211.
Meaning in life (MIL) represent a key topic in palliative care. The aims of this study were to explore (1) the differences in perceived MIL and in the meaning-relevant life areas between a representative sample of the Swiss population and palliative care patients, and (2) to what extent MIL can be considered as a significant predictor of quality of life (QOL).
A cross-sectional study was conducted separately for the patients (face-to-face interviews) and the general population (telephone survey). MIL was measured with the Schedule for Meaning in Life Evaluation (SMILE) and QOL with a single-item visual analogue scale (0-10). Sociodemographic variables were controlled for in the analyses.
206 patients and 1015 participants from the Swiss population completed the protocol. Results indicated high MIL scores in both populations even if the difference was significant (patients 81.9 vs general population 87, p<0.001). Patients were more likely to cite 'family' (OR=1.78), 'social relations' (OR=1.9), 'spirituality and religion' (OR=3.93), 'social commitment' (OR=1.94) and 'growth' (OR=2.07), and less likely to cite 'finances' (OR=0.15) and 'health' (OR=0.21) as MIL-relevant areas. The SMILE scores and MIL areas explained 21.8% of the QOL variance for the patients and 15.1% for the representative sample.
Our data emphasise the importance of MIL as a contributor to QOL in both populations. It highlights the importance of the life areas contributing to MIL, especially social interactions for both populations, and spirituality and areas related to growth in palliative care patients.
生活意义（MIL）是姑息治疗中的一个关键主题。本研究的目的是探讨：（1）瑞士人群的代表性样本与姑息治疗患者在感知到的生活意义以及与意义相关的生活领域方面的差异；（2）生活意义在多大程度上可被视为生活质量（QOL）的重要预测指标。
分别对患者（面对面访谈）和普通人群（电话调查）进行了一项横断面研究。采用生活意义评估量表（SMILE）测量生活意义，用单项目视觉模拟量表（0 - 10）测量生活质量。分析中对社会人口统计学变量进行了控制。
206名患者和1015名瑞士人群参与者完成了该方案。结果表明，尽管差异显著（患者81.9分，普通人群87分，p<0.001），但两组人群的生活意义得分都很高。患者更有可能将“家庭”（比值比=1.78）、“社会关系”（比值比=1.9）、“精神与宗教”（比值比=3.93）、“社会承诺”（比值比=1.94）和“成长”（比值比=2.07）列为与生活意义相关的领域，而将 “财务”（比值比=0.15）和“健康”（比值比=0.21）列为与生活意义相关领域的可能性较小。生活意义评估量表得分和生活意义领域解释了患者生活质量变异的21.8%，以及代表性样本生活质量变异的15.1%。
我们的数据强调了生活意义作为影响两组人群生活质量因素的重要性。它突出了对生活意义有贡献的生活领域的重要性，特别是对两组人群而言的社会互动，以及对姑息治疗患者而言的精神层面和与成长相关的领域。
