Chammas Danielle, Fishel Anne, Cramer Margaret, Brenner Keri O, Rosenberg Leah B
Division of Palliative Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA.
Am J Hosp Palliat Care. 2025 Nov;42(11):1097-1101. doi: 10.1177/10499091241302413. Epub 2024 Nov 20.
Serious illness is rarely experienced by patients in isolation. Many patients present to palliative care (PC) accompanied by their intimate partner. The intimate partnership is a critical axis around which many patients' experiences of serious illness revolve. However, there is a lack of literature and training on how PC clinicians can effectively support couples as a unit. Many existing PC communication strategies can be expanded to the dyadic unit, offering more holistic support for patients, partners, and the entity of their relationship. This paper integrates concepts from couples therapy, psychology, and PC communication to provide insights into the emotional, psychological, interpersonal, and practical challenges couples face during serious illness, as well as opportunities for growth and resilience. Key strategies for PC clinicians include helping couples navigate shifts in relational identity, share the "emotional housework," and transform conflict into connection. Concrete techniques are illustrated throughout this manuscript, employing clinical micro-vignettes to demonstrate their practical application in PC practice. Recognizing the couple as a unified entity empowers clinicians to foster open communication, helping couples maintain connection and evolve intimacy throughout the illness journey. By applying relational concepts and acknowledging the couple's shared experience, PC clinicians can enhance the quality of life for both patients and their partners. Conceptualizing the couple as a distinct entity within PC practice can deepen clinician-patient communication and improve therapeutic effectiveness.
重病患者很少是独自面对疾病的。许多患者在接受姑息治疗（PC）时会有亲密伴侣陪伴。亲密关系是许多患者重病经历围绕的关键轴心。然而，关于PC临床医生如何有效支持伴侣双方作为一个整体的文献和培训却很匮乏。许多现有的PC沟通策略可以扩展到伴侣双方这个单元，为患者、伴侣及其关系整体提供更全面的支持。本文整合了夫妻治疗、心理学和PC沟通等方面的概念，以深入探讨伴侣双方在重病期间面临的情感、心理、人际和实际挑战，以及成长和恢复力的机会。PC临床医生的关键策略包括帮助伴侣双方应对关系身份的转变、分担“情感家务”，以及将冲突转化为联系。本文通过临床小案例展示具体技巧在PC实践中的实际应用。将伴侣视为一个统一的整体，能使临床医生促进开放沟通，帮助伴侣双方在疾病过程中保持联系并深化亲密关系。通过应用关系概念并认可伴侣双方的共同经历，PC临床医生可以提高患者及其伴侣的生活质量。在PC实践中将伴侣视为一个独特的整体，可以深化医患沟通并提高治疗效果。
