Department of Obstetrics and Gynaecology, Parklane Clinic, Johannesburg, South Africa.
Department of Obstetrics and Gynaecology, University of Witwatersrand, Johannesburg, South Africa.
Climacteric. 2022 Jun;25(3):215-219. doi: 10.1080/13697137.2021.1948995. Epub 2021 Jul 19.
Thoughts of death and dying will prevail constantly in the minds of women with gynecologic cancer. Invariably, there is the hope that, when the end comes, there will be 'a good death'. End-of-life decisions, with particular emphasis on what the patient and her family constitute 'a good death' to be, will be influenced by emotional, psychological, mental, physical, spiritual and religious backgrounds. It is important to allow patients to resolve their despair by communicating their innermost thoughts. Spirituality and religious belief are important components that may play major roles in enabling patients to obtain peace and require the participation of all members of the health-care team managing the cases. Clinicians should appreciate the patient's concerns, beliefs, fears, spiritual and religious needs and be sensitive to comments that may indicate spiritual distress. Active listening and supportive dialogue may help patients work through existential issues and find peace. Patients who are in spiritual distress should be referred to certified and trained spiritual care professionals, chaplains, counselors and clergy.
患有妇科癌症的女性常常会不断地思考死亡和临终的问题。她们总是希望在生命结束时能够“有尊严地离去”。临终决策,特别是患者及其家属对“有尊严地离去”的定义,会受到情感、心理、精神、身体和宗教背景的影响。重要的是,要允许患者通过沟通内心的想法来排解绝望。灵性和宗教信仰是重要的组成部分,它们可能在帮助患者获得内心平静方面发挥重要作用,并需要负责治疗的医疗团队全体成员的参与。临床医生应该理解患者的担忧、信仰、恐惧、精神和宗教需求,并对可能表明精神困扰的言论保持敏感。积极倾听和支持性对话可以帮助患者解决存在主义问题并找到内心的平静。有精神困扰的患者应转介给经过认证和培训的精神关怀专业人员、牧师、顾问和神职人员。