Borelli Eleonora, Bigi Sarah, Potenza Leonardo, Gilioli Fabio, Artioli Fabrizio, Porzio Giampiero, Porro Carlo Adolfo, Efficace Fabio, Bruera Eduardo, Luppi Mario, Bandieri Elena
Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Department of Linguistic Sciences and Foreign Literatures, Catholic University of the Sacred Heart, Milan, Italy.
Front Oncol. 2022 Oct 24;12:991250. doi: 10.3389/fonc.2022.991250. eCollection 2022.
A cancer diagnosis represents a unique trauma, given its life-threatening, multidimensional, and uncertain nature. Gratitude is a construct representing the emotional state that arises when individuals recognize that a benefit has been received as a result of someone else's action or a spiritual entity's intervention. Based on the positive psychological wellbeing, gratitude has been associated with improved health outcomes even in the disease setting. Thus, the models of care that foster gratitude should be adopted in the clinical context. This study aims to explore whether and how gratitude may originate in patients with advanced cancer and their caregivers undergoing early palliative care (EPC).
We analyzed 251 reports from 133 patients and 118 caregivers describing their clinical experience in two EPC units. The sources of gratitude were identified and ranked based on their frequencies. Words expressing gratitude and words referring to communication and spirituality were collected by means of the Linguistic Inquiry and Word Count software and correlated.
In total, 123 (92.5%) of 133 patients' and 97 (82.2%) of 118 caregivers' reports, respectively, included explicit or implicit expressions of gratitude. Gratitude was associated specifically with successful physical symptom management, emotional support, improved attitude toward death, better information, humanity, and the familiar environment. The use of words of gratitude in patients' reports was positively correlated with the use of words referring to communication (r = .215, p = .026) and spirituality (r = .612, p <.001).
Our results suggest that interventions within the EPC model based on doctor-patient-caregiver communication may allow patients and caregivers to experience a feeling of gratitude, and this may represent a resource to be exploited to improve their physical and psychosocial wellbeing.
癌症诊断因其危及生命、多维度且具有不确定性，是一种独特的创伤。感恩是一种心理结构，代表个体认识到因他人的行为或精神实体的干预而获得益处时产生的情绪状态。基于积极的心理健康，感恩即使在疾病背景下也与改善健康结果相关。因此，临床环境中应采用培养感恩的护理模式。本研究旨在探讨晚期癌症患者及其接受早期姑息治疗（EPC）的照护者中感恩是否以及如何产生。
我们分析了来自133名患者和118名照护者的251份报告，描述了他们在两个EPC病房的临床经历。根据感恩出现的频率确定并排列感恩的来源。通过语言查询与字数统计软件收集表达感恩的词汇以及涉及沟通和精神性的词汇，并进行相关性分析。
分别有133名患者中的123名（92.5%）和118名照护者中的97名（82.2%）的报告包含明确或隐含的感恩表达。感恩特别与成功的身体症状管理、情感支持、对死亡态度的改善、更好的信息、人性以及熟悉的环境相关。患者报告中感恩词汇的使用与涉及沟通的词汇使用呈正相关（r = 0.215，p = 0.026），与涉及精神性的词汇使用呈正相关（r = 0.612，p < 0.001）。
我们的结果表明，基于医患 - 照护者沟通的EPC模式干预可能使患者和照护者体验到感恩之情，这可能是一种可利用的资源，以改善他们的身体和心理社会健康。
