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精神关怀干预措施“与你的人生故事对话”:一项关于姑息治疗患者精神健康的纵向研究结果

The spiritual care intervention "In dialogue with your life story": Results of a longitudinal study on palliative clients' spiritual wellbeing.

作者信息

Liefbroer Anke I, Foppen Annemarie, Wierstra Iris R, Nagel Ineke

机构信息

Department of Religion and Practice, Tilburg School of Catholic Theology, Tilburg University, Utrecht / Tilburg, The Netherlands.

Department of Beliefs and Practices, Faculty of Religion and Theology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

出版信息

Palliat Med. 2025 Mar;39(3):413-424. doi: 10.1177/02692163251319143. Epub 2025 Feb 19.

Abstract

BACKGROUND

Spiritual care is important for palliative care, but the evidence base for spiritual care provision is low.

AIM

To investigate the course over time of clients' spiritual wellbeing who participated in the spiritual care intervention "In dialogue with your life story."

DESIGN

The intervention consisted of six individual sessions between client and chaplain of various faiths. A longitudinal study was conducted pre- and post-intervention, and a follow-up approximately 10 weeks after post-intervention. Spiritual wellbeing was measured using the EORTC QLQ-SWB32 and NEIS, and symptoms of anxiety and depression as secondary outcome measure using the HADS. Latent growth modeling was used to investigate changes in outcome measures over time.

SETTING/PARTICIPANTS: Adult clients receiving home-based, palliative care were eligible to participate in this study.

RESULTS

A total of 75 clients and 33 chaplains participated. On the four EORTC QLQ-SWQ32-subscales, a significant increase was found over time on "relationship with self," "relationship with others," and '"existential wellbeing" (linear trends). "Relationship with someone or something greater" significantly increased over time but decreased 10 weeks post-intervention (quadratic trend). On the two NEIS-subscales, ego-integrity significantly increased over time (linear trend), while despair significantly decreased (quadratic trend). On the two HADS-subscales, symptoms of anxiety significantly decreased over time (linear trend). No significant change was found for depressive symptoms.

CONCLUSIONS

We provided first empirical evidence for an increase in clients' spiritual wellbeing after enrollment in the spiritual care intervention "In dialogue with your life story." Future research using control conditions is needed to investigate its causal effect.

摘要

背景

精神关怀对于姑息治疗很重要,但精神关怀提供的证据基础薄弱。

目的

调查参与精神关怀干预“与你的人生故事对话”的客户精神健康随时间的变化过程。

设计

干预包括客户与不同信仰的牧师之间的六次个别会面。在干预前后进行了纵向研究,并在干预后约10周进行了随访。使用欧洲癌症研究与治疗组织QLQ-SWB32和NEIS测量精神健康,并使用医院焦虑抑郁量表(HADS)作为次要结果测量焦虑和抑郁症状。使用潜在增长模型研究结果测量随时间的变化。

设置/参与者:接受居家姑息治疗的成年客户有资格参与本研究。

结果

共有75名客户和33名牧师参与。在欧洲癌症研究与治疗组织QLQ-SWQ32的四个子量表上,“与自我的关系”、“与他人的关系”和“存在幸福感”随时间显著增加(线性趋势)。“与更伟大的人或事物的关系”随时间显著增加,但在干预后10周下降(二次趋势)。在NEIS的两个子量表上,自我完整性随时间显著增加(线性趋势),而绝望感显著下降(二次趋势)。在医院焦虑抑郁量表的两个子量表上,焦虑症状随时间显著下降(线性趋势)。抑郁症状未发现显著变化。

结论

我们提供了首个实证证据,证明参与精神关怀干预“与你的人生故事对话”后客户的精神健康有所增加。未来需要使用对照条件的研究来调查其因果效应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6541/11877982/015958de0fb0/10.1177_02692163251319143-fig1.jpg

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