Department of Social Work, The Chinese University of Hong Kong, Hong Kong SAR, China.
Bradbury Hospice, Hospital Authority, Hong Kong.
Palliat Support Care. 2024 Aug;22(4):709-717. doi: 10.1017/S1478951522001171.
Although demoralization is common among palliative care patients, it has not yet been examined empirically in the Hong Kong Chinese context. This study aims to examine (1) the prevalence of demoralization among community-dwelling palliative care patients in Hong Kong; (2) the percentage of palliative care patients who are demoralized but not depressed and vice versa; and (3) the association of socio-demographic factors, particularly family support, with demoralization.
A cross-sectional study targeting community-living palliative care patients in Hong Kong was conducted. A total of 54 patients were recruited by a local hospice and interviewed for completing a questionnaire which included measures of demoralization, depression, perceived family support, and demographic information.
The prevalence of demoralization was 64.8%. Although there was overlap between demoralization and depression (52.8% meeting the criteria of both), 7.5% of depressed patients were not demoralized, and 13.2% of demoralized patients were not depressed. Participants who were not single and had more depressive symptoms and less family support had a significantly higher demoralization level.
This is the first study which reports the prevalence of demoralization in Hong Kong. Demoralization was found common in community-living palliative care patients receiving medical social work services in Hong Kong. This study provides evidence of the importance of differentiating the constructs between demoralization and depression. It also provides an implication that those who are married, more depressed, and have the least family support could be the most vulnerable group at risk of demoralization. We recommend that early assessment of demoralization among palliative care patients be considered.
虽然意志消沉在姑息治疗患者中很常见，但在香港中文语境中尚未进行实证研究。本研究旨在：（1）考察香港社区姑息治疗患者中意志消沉的发生率；（2）出现意志消沉但未出现抑郁的患者比例和出现抑郁但未出现意志消沉的患者比例；以及（3）社会人口学因素（特别是家庭支持）与意志消沉的相关性。
本研究采用横断面研究，以香港的社区姑息治疗患者为研究对象。通过当地一家临终关怀机构共招募了 54 名患者，并对其进行了访谈，让他们填写一份问卷，该问卷包括意志消沉、抑郁、感知家庭支持以及人口统计学信息的测量。
意志消沉的发生率为 64.8%。尽管意志消沉和抑郁存在重叠（52.8%的患者同时符合这两种疾病的标准），但仍有 7.5%的抑郁患者没有出现意志消沉，而 13.2%的意志消沉患者没有出现抑郁。非单身、抑郁症状较多、家庭支持较少的患者，其意志消沉程度显著较高。
这是第一项报告香港意志消沉发生率的研究。研究发现，在接受医务社工服务的香港社区姑息治疗患者中，意志消沉较为常见。该研究为区分意志消沉和抑郁这两个概念的重要性提供了证据。同时也表明，已婚、抑郁程度较高、家庭支持最少的患者可能是最容易出现意志消沉的高危脆弱群体。我们建议，应考虑对姑息治疗患者进行早期的意志消沉评估。
