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改善波兰疼痛门诊患者的精神健康:一项可行性混合方法研究。

Improving Spiritual Well-Being of Polish Pain Outpatients: A Feasibility Mixed Methods Study.

作者信息

Klimasiński Maciej Wiktor, Baum Ewa, Wieczorowska-Tobis Katarzyna, Stelcer Bogusław

机构信息

Katedra Medycyny Paliatywnej, Uniwersytet Medyczny w Poznaniu, 61-701 Poznań, Poland.

Katedra Nauk Społecznychi Humanistycznych, Uniwersytet Medyczny w Poznaniu, 61-701 Poznań, Poland.

出版信息

J Clin Med. 2024 Jun 20;13(12):3615. doi: 10.3390/jcm13123615.

Abstract

: A physician in a chronic pain treatment clinic must recognize that the relationship between pain and spirituality is bidirectional. Chronic pain can decrease the level of spiritual well-being, and low spiritual well-being can also significantly intensify the perception of pain and worsen coping with it. Currently, for many scientific and medical communities, it is evident that spiritual care is an indispensable element of holistic medicine. : The authors developed a non-religious spiritual care model provided by a physician at a chronic pain treatment clinic from May 2022 to February 2024. : The study utilized a mixed-method approach to conduct the research. The analysis consisted of twelve patients. A FACIT-Sp-12 questionnaire evaluated the individual's spiritual well-being before the intervention. The intervention involved asking patients open-ended questions about their life history, experiences, and spiritual beliefs and the physician's use of active listening and empathetic responses to what patients shared (relationship-building activities). The intervention aimed to assist patients in accepting the limitations of an incurable chronic disease, affirming the value of their lives, enhancing inner harmony, and increasing their sense of belonging to something greater. After the intervention, a re-assessment of the patient's spiritual well-being was conducted using the FACIT-Sp-12 questionnaire. Researchers collected qualitative data through a confidential survey that included the following instructions: "Please express an anonymous opinion on how you perceive the spiritual care provided by the physician". : There was an increase in spiritual well-being, assessed using the FACIT-Sp-12 scale, in 9 out of 12 patients. The median, as well as the average, level of spiritual well-being increased in a statistically significant way after the intervention ( < 0.05). This was primarily due to the higher value of the peace subscale of the questionnaire. Qualitative analysis revealed benefits reported by patients (personal development, gratitude, satisfaction, support, hope) resulting from physician's actions. : Both qualitative and quantitative data showed that establishing a relationship with the doctor improves the spiritual well-being of patients. Therefore, this model can be recommended for physicians in chronic pain treatment clinics.

摘要

慢性疼痛治疗诊所的医生必须认识到疼痛与精神性之间的关系是双向的。慢性疼痛会降低精神健康水平,而低水平的精神健康也会显著加剧对疼痛的感知并恶化应对疼痛的能力。目前,对于许多科学和医学团体来说,精神关怀显然是整体医学不可或缺的要素。作者在2022年5月至2024年2月期间开发了一种由慢性疼痛治疗诊所的医生提供的非宗教性精神关怀模式。该研究采用混合方法进行研究。分析涉及12名患者。一份FACIT-Sp-12问卷在干预前评估了个体的精神健康状况。干预措施包括向患者询问关于他们的生活史、经历和精神信仰的开放式问题,以及医生对患者所分享内容使用积极倾听和共情回应(建立关系活动)。干预旨在帮助患者接受不治之症慢性病的局限性,肯定他们生命的价值,增强内心和谐,并增加他们对更伟大事物的归属感。干预后,使用FACIT-Sp-12问卷对患者的精神健康进行重新评估。研究人员通过一项保密调查收集定性数据,该调查包含以下说明:“请就你如何看待医生提供的精神关怀发表匿名意见”。使用FACIT-Sp-12量表评估,12名患者中有9名的精神健康状况有所改善。干预后,精神健康的中位数以及平均水平在统计学上显著提高(<0.05)。这主要归因于问卷中平和子量表的较高分值。定性分析揭示了患者报告的因医生行为而产生的益处(个人成长、感恩、满足、支持、希望)。定性和定量数据均表明与医生建立关系可改善患者的精神健康。因此,该模式可推荐给慢性疼痛治疗诊所的医生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e66/11204423/fea9f7ba066a/jcm-13-03615-g001.jpg

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