Kukla Helena, Herrler Angélique, Strupp Julia, Voltz Raymond
Faculty of Human Sciences and Faculty of Medicine, Graduate School GROW - Gerontological Research on Well-being, University of Cologne, Cologne, Germany.
Faculty of Medicine and University Hospital, Department of Palliative Medicine, University of Cologne, Cologne, Germany.
Palliat Med. 2021 Dec;35(10):1793-1814. doi: 10.1177/02692163211042528. Epub 2021 Sep 6.
Awareness of the impending end of one's life can pose profound existential challenges, thereby impairing well-being. Confronting one's own end of life may be an approach to meet the psychological needs and consequently enhance overall well-being. Different approaches of confrontation have been evaluated positively using measures of psychosocial comfort. To date, there exists no systematic overview on the different ways of confrontation (e.g. psychosocial or individual coping approaches).
To synthesize the existing knowledge on the effects of different approaches of confronting one's own end of life on older individuals and those with a life-threatening disease.
A systematic review of quantitative, qualitative, and mixed-methods full research reports was conducted. The retrieved studies were screened and appraised for methodological quality by two independent reviewers based on MMAT and CASP. The findings were synthesized narratively using the meta-summary technique by Sandelowski and Barroso.
Medline, PsycINFO, and Web of Science were searched from inception to 12/2020.
= 49 studies reported on different approaches of confronting one's own end of life, including psychosocial interventions, meaning-enhancing approaches, educational programs, and learning from lived experiences. The results suggest a clear trend toward beneficial effects on psychosocial comfort (e.g. anxiety, sense of meaning, well-being).
Low-threshold opportunities of confrontation have the potential to improve well-being and should be emphasized in practical implementation. The results can serve as a comprehensive basis for future research aiming to investigate the determinants of psychosocial comfort for people nearing the end of life.
意识到自己生命即将结束可能会带来深刻的生存挑战，从而损害幸福感。直面自己的生命终点可能是满足心理需求并进而提高整体幸福感的一种方式。使用心理社会舒适度测量方法对不同的直面方式进行评估，结果显示均具有积极效果。迄今为止，对于不同的直面方式（如心理社会或个体应对方式）尚无系统综述。
综合现有关于不同方式直面自己生命终点对老年人和患有危及生命疾病者影响的知识。
对定量、定性和混合方法的完整研究报告进行系统综述。由两名独立评审员根据MMAT和CASP对检索到的研究进行筛选和方法学质量评估。使用Sandelowski和Barroso的元总结技术对研究结果进行叙述性综合。
检索了Medline、PsycINFO和Web of Science自创建至2020年12月的数据。
49项研究报告了不同的直面自己生命终点的方式，包括心理社会干预、意义增强方法、教育项目以及从生活经历中学习。结果表明对心理社会舒适度（如焦虑、意义感、幸福感）有明显的有益影响趋势。
低门槛的直面机会有可能改善幸福感，在实际实施中应予以强调。这些结果可为未来旨在研究临终者心理社会舒适度决定因素的研究提供全面依据。
