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三级肿瘤中心临终关怀机构中照顾者悲伤情绪的管理模式:从预期性哀悼到慰问谈话的初步观察

Management model of caregiver's grief in a tertiary oncological center Hospice, from anticipatory mourning to condolence conversation: preliminary observations.

作者信息

Gallio Ivan, Lorusso Marina, Moscato Matilde, Miranti Chiara, Pasalic Mirsad, Formaglio Fabio, Feltrin Alessandra, Ruggiero Elena

机构信息

Pain Therapy and Palliative Care Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy.

Hospital Psychology Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy.

出版信息

BMC Palliat Care. 2024 Dec 20;23(1):289. doi: 10.1186/s12904-024-01620-2.

Abstract

BACKGROUND

Bereavement is a crucial physiological process in palliative care; grief-processing disorders can be diagnosed at least 6 months after death and can have severe clinical or psychological consequences. This study aims to verify how adequate management of anticipatory mourning and condolence conversations can be protective in the early stages of grief.

METHODS

Patients and caregivers are supported by a multidisciplinary team through semi-structured interviews. In condolence conversations within one month of the death, we identify signs of psychological fragility that require support for adequate processing of the loss.

RESULTS

From the condolence conversations, only 2-4% of caregivers who had received psychological support during the hospital stay and showed a good level of acceptance of their relative's end of life exhibited grief problems within 1 month of death; none showed excessive avoidance of memories, difficulties with trust, or feelings of emotional loneliness.

CONCLUSIONS

Despite the limitations, the preliminary data of our study clearly suggest the protective potential of multidisciplinary support, particularly in reducing the risk of developing grief processing disorders. These considerations encourage us to implement our model of clinical and psychological support systems and develop pathways dedicated to caregivers experiencing greater difficulty.

摘要

背景

丧亲之痛是姑息治疗中的一个关键生理过程;悲伤处理障碍可在死亡后至少6个月被诊断出来,并且可能产生严重的临床或心理后果。本研究旨在验证对预期哀悼和慰问谈话的适当管理在悲伤早期阶段如何具有保护作用。

方法

患者和护理人员由多学科团队通过半结构化访谈提供支持。在死亡后一个月内的慰问谈话中,我们识别出心理脆弱的迹象,这些迹象需要支持以充分处理丧失之痛。

结果

从慰问谈话来看,在住院期间接受过心理支持且对其亲属生命终结表现出较高接受程度的护理人员中,只有2 - 4%在死亡后1个月内出现悲伤问题;没有人表现出过度回避记忆、信任困难或情感孤独感。

结论

尽管存在局限性,但我们研究的初步数据清楚地表明了多学科支持的保护潜力,特别是在降低发生悲伤处理障碍的风险方面。这些考虑促使我们实施临床和心理支持系统模型,并为经历更大困难的护理人员开发专门的途径。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d0d/11662702/53c6049eca5b/12904_2024_1620_Fig1_HTML.jpg

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