Department of Clinical Health Psychology (Kredentser) and Department of Psychiatry (Chochinov), Max Rady College of Medicine, University of Manitoba, Winnipeg.
Am J Psychother. 2020 Dec 1;73(4):137-143. doi: 10.1176/appi.psychotherapy.20190048. Epub 2020 Oct 22.
Dignity has gained increasing attention as a vital component of quality of life and quality of end-of-life care. This article reviews psychological, spiritual, existential, and physical issues facing patients at the end of life as well as practical considerations in providing therapy for this population. The authors reviewed several evidence-based treatments for enhancing end-of-life experience and mitigating suffering, including a primary focus on dignity therapy and an additional review of meaning-centered psychotherapy, acceptance and commitment therapy, and cognitive-behavioral therapy. Each of these therapies has an emerging evidence base, but they have not been compared to each other in trials. Thus, the choice of psychotherapy for patients at the end of life will reflect patient characteristics, therapist orientation and expertise with various approaches, and feasibility within the care context. Future research is needed to directly compare the efficacy and feasibility of these interventions to determine optimal care delivery.
尊严作为生活质量和临终关怀质量的重要组成部分，越来越受到关注。本文综述了生命末期患者面临的心理、精神、存在和身体问题，以及为这一人群提供治疗的实际考虑。作者回顾了几种基于证据的治疗方法，以增强临终体验和减轻痛苦，包括对尊严疗法的重点关注，以及对意义中心心理疗法、接受和承诺疗法和认知行为疗法的额外回顾。这些疗法中的每一种都有一个新兴的证据基础，但它们在试验中没有相互比较。因此，临终患者的心理治疗选择将反映患者的特点、治疗师对各种方法的取向和专业知识，以及在护理环境中的可行性。需要进一步的研究来直接比较这些干预措施的疗效和可行性，以确定最佳的护理提供方式。
