Brinkers Michael, Pfau Giselher, Thielmann Beatrice, Böckelmann Irina
Pain Outpatient Clinic of the Department of Anesthesiology and Intensive Care, Faculty of Medicine, Otto von Guericke University Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany.
Institute of Occupational Medicine, Faculty of Medicine, Otto von Guericke University Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany.
Healthcare (Basel). 2024 Jul 30;12(15):1510. doi: 10.3390/healthcare12151510.
Palliative care is dedicated to terminally ill patients with advanced disease, regardless of diagnosis, under the overarching premise of optimizing quality of life. This narrative review examines the extent to which principles of cybernetics and psychophysiology underlie this approach. Psychophysiology researches the physiological equivalents of psychological states and traits such as activation and individual reactivity, the interoception and the personal characteristics. Cybernetics specifies these principles, which are possible by understanding terms such as "psychophysiology" or "cybernetics" or "self-organization/autopoiesis". The meaning of these terms for palliative care can also be elucidated in relation to the terms "biofeedback", "consciousness", "pain", and "anxiety". The common themes of cybernetics and psychophysiology are environment, subjectivity, personality characteristics, the difference between time scale separation in cybernetic systems, and real-time procedures in environment and rhythm. These lead to special therapies based on psychophysiology, such as consciousness training. The concepts of quality of life, causality, the biopsychosocial model, therapy, and autonomy are examined as palliative care concepts. The equivalents can be described from the perspective of cybernetics. For some palliative care-related terms, cybernetic thinking is already present (quality of life, autonomy, symptom control), while for others, it is not (biopsychosocial). Cybernetic terms (complexity, stability, identity, rhythm) are still used to a lesser extent in palliative care. Terms like genetic basis are common in cybernetics and psychophysiology to explain the identity of the subject in transition. Identity, on the other hand, is the basis of the concept of dignity in palliative care. Psychophysiology investigates disturbances like pain and psychological illnesses, which are also present in palliative care. Psychophysiology, cybernetics, and palliative care have subjectivity and resources in common. Therapies based on cybernetic principles of psychophysiology can also be used for symptom control in palliative care in the oncology setting.
姑息治疗致力于为患有晚期疾病的绝症患者提供服务，无论其诊断结果如何，其首要前提是优化生活质量。本叙述性综述探讨了控制论和心理生理学原理在这种方法中的基础程度。心理生理学研究心理状态和特质的生理等效物，如激活和个体反应性、内感受和个人特征。控制论明确了这些原理，这可以通过理解“心理生理学”“控制论”或“自组织/自创生”等术语来实现。这些术语对姑息治疗的意义也可以通过与“生物反馈”“意识”“疼痛”和“焦虑”等术语的关联来阐明。控制论和心理生理学的共同主题包括环境、主观性、人格特征、控制论系统中时间尺度分离的差异以及环境和节奏中的实时程序。这些导致了基于心理生理学的特殊疗法，如意识训练。生活质量、因果关系、生物心理社会模型、治疗和自主性等概念作为姑息治疗概念进行了审视。等效物可以从控制论的角度进行描述。对于一些与姑息治疗相关的术语，控制论思维已经存在（生活质量、自主性、症状控制），而对于其他一些术语则不然（生物心理社会）。控制论术语（复杂性、稳定性、身份、节奏）在姑息治疗中的使用程度仍然较低。诸如遗传基础等术语在控制论和心理生理学中很常见，用于解释处于转变中的主体的身份。另一方面，身份是姑息治疗中尊严概念的基础。心理生理学研究疼痛和心理疾病等干扰因素，这些在姑息治疗中也存在。心理生理学、控制论和姑息治疗有主观性和资源方面的共性。基于心理生理学控制论原理的疗法也可用于肿瘤学环境中姑息治疗的症状控制。
