McCorkle R, Robinson L, Nuamah I, Lev E, Benoliel J Q
School of Nursing, University of Pennsylvania, Philadelphia, USA.
Nurs Res. 1998 Jan-Feb;47(1):2-10. doi: 10.1097/00006199-199801000-00002.
Although some studies have examined the effects of terminal illness care models such as hospice care on survivor outcomes, no studies could be found that examined whether nursing care affected such outcomes.
To determine whether specialized oncology home care services provided to terminally ill patients with lung cancer positively influenced bereavement psychological distress among survivors, compared with other models of care.
A secondary analysis was performed to test the effects of home nursing care for terminally ill patients on spousal psychological distress during bereavement. Forty-six patient-spousal dyads were randomly assigned to either an oncology home care group (OHC), a standard home care group, or an office care control group. Patient-spousal dyads were entered into the study 2 months after the patient's diagnosis of lung cancer and received follow-up until the patient died. Bereaved spouses continued to receive follow-up for 25 months after the patient's death.
Psychological distress was significantly lower initially among spouses of patients that received the OHC intervention compared with the other two groups. Significant mean group differences were found on the subscales of depression and paranoid ideation; marginal group differences were found on the subscales of hostility and psychoticism. There were no significant differences among the groups at 25 months.
These results suggest that the bereaved's psychological distress can be positively influenced depending on how their loved one is cared for during the terminal phase of illness.
尽管一些研究探讨了临终关怀等临终疾病护理模式对幸存者结局的影响，但未发现有研究考察护理是否会影响这些结局。
与其他护理模式相比，确定为晚期肺癌患者提供的专业肿瘤居家护理服务是否会对幸存者的丧亲心理困扰产生积极影响。
进行二次分析，以检验为临终患者提供的居家护理对丧亲期间配偶心理困扰的影响。46对患者-配偶二元组被随机分配到肿瘤居家护理组（OHC）、标准居家护理组或门诊护理对照组。患者-配偶二元组在患者被诊断为肺癌2个月后进入研究，并接受随访直至患者死亡。丧亲配偶在患者死亡后继续接受25个月的随访。
与其他两组相比，接受OHC干预的患者配偶最初的心理困扰显著更低。在抑郁和偏执观念子量表上发现了显著的组间平均差异；在敌意和精神质子量表上发现了边缘组间差异。25个月时，各组之间没有显著差异。
这些结果表明，根据亲人在疾病终末期的护理方式，丧亲者的心理困扰可能会受到积极影响。
