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安宁疗护中的存在之苦:一种存在主义积极心理学视角。

Existential Suffering in Palliative Care: An Existential Positive Psychology Perspective.

机构信息

Department of Psychology, Trent University, Peterborough, ON K9L 0G2, Canada.

Department of Psychology, University of Toronto, Toronto, ON M1C 1A4, Canada.

出版信息

Medicina (Kaunas). 2021 Sep 1;57(9):924. doi: 10.3390/medicina57090924.

Abstract

The COVID-19 pandemic has exposed the inadequacies of the current healthcare system and needs a paradigm change to one that is holistic and community based, illustrated by the healing wheel. The present paper proposes that existential positive psychology (PP 2.0) represents a promising approach to meet the rising needs in palliative care. This framework has a twofold emphasis on (a) how to transcend and transform suffering as the foundation for wellbeing and (b) how to cultivate our spiritual and existential capabilities to achieve personal growth and flourishing. We propose that these objectives can be achieved simultaneously through dialectical palliative counselling, as illustrated by Wong's integrative meaning therapy and the Conceptual Model of CALM Therapy in palliative care. We then outline the treatment objectives and the intervention strategies of IMT in providing palliative counselling for palliative care and hospice patients. Based on our review of recent literature, as well as our own research and practice, we discover that existential suffering in general and at the last stage of life in particular is indeed the foundation for healing and wellbeing as hypothesized by PP 2.0. We can also conclude that best palliative care is holistic-in addition to cultivating the inner spiritual resources of patients, it needs to be supported by the family, staff, and community, as symbolized by the healing wheel.

摘要

新冠疫情暴露出当前医疗体系的不足,需要向整体化和社区化的模式转变,治愈之轮对此进行了说明。本文提出,存在积极心理学(PP 2.0)代表了一种有前途的方法,可以满足姑息治疗中不断增长的需求。该框架有两个重点:(a) 如何超越和转化痛苦,作为幸福的基础;(b) 如何培养我们的精神和存在能力,以实现个人成长和繁荣。我们提出,这些目标可以通过辩证的姑息治疗咨询来同时实现,正如 Wong 的综合意义疗法和姑息治疗中的 CALM 疗法概念模型所说明的那样。然后,我们概述了综合意义疗法在为姑息治疗和临终关怀患者提供姑息治疗咨询方面的治疗目标和干预策略。基于我们对最近文献的回顾,以及我们自己的研究和实践,我们发现,一般来说,存在性痛苦,特别是生命最后阶段的存在性痛苦,确实如 PP 2.0 假设的那样,是治愈和幸福的基础。我们还可以得出结论,最好的姑息治疗是整体性的——除了培养患者的内在精神资源外,还需要得到家庭、工作人员和社区的支持,正如治愈之轮所象征的那样。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c8c/8471755/1959b36176c2/medicina-57-00924-g001.jpg

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