Department of Psychiatry and Psychotherapy I, University of Ulm, Ulm, Germany.
Zentrum für Psychiatrie Südwürttemberg, Weingartshofer Strasse 2, 88214, Ravensburg, Germany.
BMC Palliat Care. 2021 Aug 8;20(1):125. doi: 10.1186/s12904-021-00818-y.
Based on the concept of "Daseinsverabschiedung", an anthropological theory of "Anticipated Farewell to Existence" (AFE) was suggested on the basis of six grounding dimensions: selfhood, interpersonality, temporality, corporeality, worldliness, and transcendence, which are activated in a genuine manner facing death. The purpose of the study is to quantitatively compare the extent of confrontation with death between dying people in palliative care and those in other stages of life by means of the Anticipated Farewell to Existence Questionnaire" (AFEQT), based on these dimensions.
The sample (N = 485) consists of dying individuals in palliative wards and hospices (n = 121); old people living in nursing homes not suffering from a mortal disease (n = 62); young adults (n = 152), and middle-aged adults (n = 150). The design is cross-sectional and analytical. The relevance of anticipated farewell to existence was measured by means of the AFEQT. The internal consistency of the AFEQT was assessed using Cronbach's alpha and convergent validity by means of dimensions of the Life Attitude Profile-Revised (LAP-R). Differences between groups and associations with control variables were estimated by means of multiple regression models, including propensity scores.
Cronbach's alpha for AFEQT was > 0.80 for the whole test and all subsamples, but < 0.70 for most dimensions in dying people. Correlations between each dimension and corresponding two factors was almost overall r > 0.80, p < 0.001. Good convergent validity between dimensions of AFEQT and of Life Attitude Profile-Revised in young and middle-aged participants showed correlations for superordinate indices between -0.23 and 0.72, and an overall p < 0.001. Dying people scored significantly higher for all dimensions, especially "altruistic preoccupation" and "reconciliation with existence" than people in other life stages (p < 0.01- < 0.001). Personality traits of "openness" and "agreeableness" are positively associated with higher scoring of AFEQT dimensions. About 77% of dying participants reported a personal benefit through the interview questions.
With proximity to death, the anthropological dimensions proposed scored significant higher than in other stages of life, reflecting a stronger awareness, confrontation and reconciliation with the end of their own life. These dimensions, especially preoccupation for related persons and coexistence of acceptance and struggle with death have to be taken into account in a sensitive way by supporting dialogues with dying people and their relatives.
Observational cross-sectional study.
基于“Daseinsverabschiedung”的概念，一种关于“预期的存在告别”（Anticipated Farewell to Existence，AFE）的人类学理论被提出，该理论基于六个基础维度：自我、人际关系、时间、身体、世俗和超越，这些维度在面对死亡时以真实的方式被激活。本研究的目的是通过“预期的存在告别问卷”（Anticipated Farewell to Existence Questionnaire，AFEQT），基于这些维度，定量比较临终关怀患者和其他生命阶段的人对死亡的应对程度。
样本（N=485）包括姑息病房和临终关怀机构的临终患者（n=121）；居住在非致命疾病疗养院的老年人（n=62）；年轻成年人（n=152）和中年成年人（n=150）。设计为横断面分析。使用 AFEQT 测量预期告别存在的相关性。使用 Life Attitude Profile-Revised（LAP-R）的维度评估 AFEQT 的内部一致性和收敛效度。使用多元回归模型，包括倾向评分，估计组间差异和与控制变量的关联。
整个测试和所有子样本的 AFEQT 的 Cronbach's alpha 值均大于 0.80，但临终患者的大多数维度均小于 0.70。每个维度与相应的两个因素之间的相关性几乎总体上 r>0.80，p<0.001。年轻和中年参与者的 AFEQT 维度与 Life Attitude Profile-Revised 的维度之间具有良好的收敛效度，上位指标之间的相关性为-0.23 至 0.72，总体 p<0.001。与其他生命阶段相比，临终患者在所有维度上的得分都显著更高，特别是在“利他关注”和“与存在和解”方面（p<0.01-<0.001）。“开放性”和“宜人性”等人格特质与 AFEQT 维度的高分呈正相关。大约 77%的临终患者通过访谈问题报告了个人受益。
随着接近死亡，所提出的人类学维度的得分明显高于其他生命阶段，反映出对自己生命结束的更强意识、应对和和解。在支持与临终患者及其亲属的对话时，需要以敏感的方式考虑这些维度，特别是对相关人员的关注以及接受和与死亡斗争的共存。
观察性横断面研究。
