Faculty of Human Sciences and Faculty of Medicine, Graduate School GROW - Gerontological Research on Well-being, University of Cologne, Albertus-Magnus-Platz, 50931, Cologne, Germany.
Faculty of Medicine and University Hospital, Department of Palliative Medicine, University of Cologne, Cologne, Germany.
BMC Palliat Care. 2022 Apr 29;21(1):58. doi: 10.1186/s12904-022-00950-3.
The perception of being closer to death can be experienced due to old age or life-limiting diseases, and can pose profound existential challenges. Actively confronting death-related issues and existential questions may increase psychosocial comfort and stimulate personal growth, whereas dysfunctional coping may lead to existential distress. To date, research on individual and (semi-)professional approaches to confronting the own end of life and the effects on one's well-being remain scarce. Therefore, the aim of this study was to explore individual strategies and wishes in order to derive ideas for appropriate support concepts.
Twenty semi-structured interviews were conducted with people over the age of 80 (n = 11) and with a life-limiting disease (n = 10). The interviews were transcribed verbatim and independently coded by two researchers according to Braun and Clarke's thematic analysis approach.
While the use of (semi-)professional approaches (e.g., therapeutic support) to confronting existential questions in the shape of one's impending death was rare, individual coping strategies did have a positive impact on psychosocial comfort. There were hardly any significant differences between the participants aged 80 and over and those with a life-limiting disease in terms of individual coping strategies or how they approached the ends of their lives. Both groups reported that theoretical education, preparing for the ends of their lives (e.g., funerals), talking about death-related topics, reflecting on death-related topics, and contemplating death in a spiritual sense had positive effects on their assurance, self-determination and relief. The necessity of confrontation and a desire for low-threshold, accessible and flexible services to meet their existential and spiritual needs were highlighted.
There is both a desire and a need for the addressing of existential questions. Outside of private contexts, however, the participants possessed little awareness of support services that focused on confronting end-of-life issues, and rarely used such services. Efforts to raise awareness for psychosocial and spiritual needs should be implemented within the care system, together with low-threshold support concepts, in order to increase psychosocial well-being. More research evaluating individual approaches to confronting the own end of life are needed to better understand this determinant of well-being and its mechanisms of action.
www.germanctr.de , DRKS-ID: DRKS00020577 .
由于年老或患有绝症，人们可能会感觉到自己离死亡更近了，这会带来深刻的存在主义挑战。积极面对与死亡相关的问题和存在主义问题可能会增加心理社会舒适度并激发个人成长，而功能失调的应对方式则可能导致存在主义困扰。迄今为止，关于个体和（半）专业方法来面对自己生命的尽头以及对幸福感的影响的研究仍然很少。因此，本研究的目的是探索个体策略和愿望，以得出适当支持概念的想法。
对 80 岁以上的人（n=11）和患有绝症的人（n=10）进行了 20 次半结构化访谈。访谈记录逐字转录，并由两位研究人员根据 Braun 和 Clarke 的主题分析方法进行独立编码。
虽然很少有人使用（半）专业方法（例如，治疗支持）来面对即将到来的死亡所带来的存在主义问题，但个体应对策略确实对心理社会舒适度产生了积极影响。在个体应对策略或他们如何接近生命的尽头方面，80 岁以上的参与者和患有绝症的参与者之间几乎没有明显差异。两组参与者都报告说，理论教育、为生命的尽头做准备（例如葬礼）、谈论与死亡相关的话题、反思与死亡相关的话题以及从精神层面思考死亡对他们的安全感、自我决定和缓解都有积极的影响。他们强调需要面对，并渴望获得低门槛、可及且灵活的服务，以满足他们的存在主义和精神需求。
人们既渴望又需要解决存在主义问题。然而，在私人环境之外，参与者对专注于处理临终问题的支持服务几乎没有什么认识，也很少使用此类服务。应该在护理系统中共同实施提高对心理社会和精神需求的认识，并结合低门槛的支持概念，以提高心理社会幸福感。需要进行更多研究来评估个体面对自己生命尽头的方法，以更好地理解这一幸福感决定因素及其作用机制。
www.germanctr.de ，DRKS-ID：DRKS00020577。
