癌症患者生命意义内涵及干预需求的研究进展

文章对癌症患者生命意义的内涵、生命意义的测量工具及其干预需求的研究现状进行综述,以期为开展国内背景下生命意义干预的研究提供参考。     

Does perceived burdensomeness erode meaning in life among older adults?

Background: Identification of risk factors for the loss of meaning in life among older adults is needed. In this article, we test hypotheses derived from the Interpersonal Theory of Suicide concerning the role of perceptions that one is a burden on others as a risk factor for lower meaning in life.

Methods: A prospective design was used to examine the temporal associations between perceptions of burdensomeness on others and perceived meaning in life among older adults (n?=?65) seeking mental health treatment (primarily for depression and/or anxiety) at an outpatient geriatric mental health clinic. Participants completed self-report questionnaires within a month following intake. Follow-up questionnaires were completed over the phone two months later.

Results: Perceived burdensomeness predicted lack of meaning in life two months later, while accounting for depression severity. In contrast, baseline levels of meaning in life did not significantly predict the levels of burdensomeness at two months.

Conclusion: The findings suggest that burdensomeness may contribute to suicide morbidity and mortality in late-life by eroding meaning in life. Empirically supported treatments for late-life depression could be adapted to focus on perceptions of burdensomeness and its connections with meaning in life.     

儒家式应对思想与生命意义追寻肯定的关系

目的 探讨儒家式应对思想与生命意义的追寻肯定之间的关系.方法 采用生命态度剖面图(LAP)中的"生命意义的追寻与肯定"分量表和儒家应对问卷,整群随机抽取378名大学生进行调查.结果 挫折评价作用、挫折内在乐观性和人的责任性均与生命意义的追寻与肯定及其各因子呈显著正相关(分别为r=0.412,r=0.630,r=0.374,P＜0.01),"命"认识因子仅与生命目的和生命控制呈显著负相关(r=-0.113,r=-0.141,P＜0.05);逐步回归分析表明挫折评价作用、挫折内在乐观性和人的责任性是生命意义的追寻与肯定的主要预测因素.结论 儒家式应对思想能在一定程度上预测个体的生命意义的追寻与肯定水平.

Abstract：

Objective To explore the relationship between Confucian coping and life meaning searching and assertion. Methods 378 undergraduates were assessed by the subscale " Meaning Searching and Assertion" in the life attitude profile scale (LAP) and the Confucian coping questionnaire. Results The role of adversity to individual growing,optimism in the adversity and the responsibility as human being were significantly related to life meaning searching and assertion,as well as each factor( r = 0. 412, r = 0. 630, r = 0. 374, P＜0. 01). The viewpoints to "fate" was significantly related to life purpose and life control( r= -0. 113, r= -0. 141, P＜0. 05). Regression analysis showed the role of adversity to individual growing,optimism in the adversity and the responsibility as human being are main predictor of life meaning searching and assertion. Conclusion Confucian coping can predict the individual level of life meaning searching and assertion.     

The meaning of spirituality: a literature review

This paper presents a literature review in relation to the meaning of spirituality. It is proposed that meeting the spiritual needs of patients is a fundamental part of providing holistic nursing care, but that the assessment and meeting of those needs is impeded by inadequate definitions and conceptual frameworks. It should not be assumed that spirituality is either synonymous, or coterminous, with religion, and it is suggested that to adopt this restrictive view is unhelpful in the provision of individualized care. Reflection on the literature reveals that the self, others and 'God' provide the key elements within a definition of spirituality, and that other emerging themes namely meaning, hope, relatedness/connectedness, beliefs/belief systems and expressions of spirituality, can be articulated in the context of those three key elements. In particular, it is proposed that the nature of 'God' may take many forms and, essentially, is whatever an individual takes to be of highest value in his/her life. It is suggested that the themes emerging from the literature can be utilized as a framework to give practitioners and researchers a direction for future exploration of the concept of spirituality.     

大学生生命意义与社会支持、心理控制源及主观幸福感

目的:考察大学生生命意义与社会支持、心理控制源和主观幸福感的关系。方法:采用随机抽样方法对湖南和广东的601名大学生进行问卷调查。结果:男生生命意义感显著高于女生(t=2.53,P0.05),不同专业大学生生命意义差别无统计学意义;生命意义与社会支持、心理控制源、主观幸福感呈显著相关(r=0.60~-0.55,P0.01);大学生感知的主观支持、心理控制源和生活满意度显著预测其生命意义的目标维度,主观支持和总体情感指数显著预测生命意义的实现维度。结论:大学生生命意义水平总体情况良好。社会支持、内在控制感及主观幸福感的提高,有助于改善学生的生命意义感。     

Return to work in the context of everyday life 7–11 years after spinal cord injury – a follow-up study

Abstract

Purpose: The aim of this follow-up study was to explore experiences of return to work in the context of everyday life among adults 7–11 years after spinal cord injury (SCI).

Methods: This study used in-depth interviews and observations in a qualitative design with eight persons who had previously been interviewed in 2008. A narrative approach was used during data gathering and analysis.

Results: Return to work was experienced as something constantly needing to be negotiated in the context of everyday life. Several years after SCI expectations for work and perceptions of possibilities for meaningful work had changed. Five main themes were identified through the analysis, (1) negotiating the possibilities of working, (2) hope for future work tempered with concern, (3) education as a possible path to employment, (4) paths toward return to work in light of unmet support, and (5) unpaid occupations grounded in interest and competence.

Conclusions: Persons who have no higher education or lack viable employment to return to after SCI seem to be vulnerable in return to work. Early and timely interventions tailored to the person’s interests and competencies, in which the rehabilitation team has a distinct coordinating role, are thus critical in return to work.

• Implications for Rehabilitation

• Tensions between hope and expectations for work and unmet needs of support can lead to barriers in return to work, particularly for those who have no higher education or lack employment to return to after spinal cord injury.

• Rehabilitation after spinal cord injury can benefit from focus on how the balance of work fits into routines in the context of everyday life.

• Early and timely interventions integrating the person’s interests and competencies in return to work after spinal cord injury in combination with having a health care provider who has a distinct coordinating role are critical.

     

Spiritual coping strategies: a review of the nursing research literature

AIMS OF THE PAPER: This paper reviews some of the limited nursing research-based literature, orientated towards the use of spiritual coping strategies in illness. This review aims at identifying those spiritual coping strategies used by the believers and nonbelievers followed by implications for holistic nursing care. LITERATURE SEARCH: The CINAHL and MEDLINE CD Rom databases were searched, identifying literature published from 1975 onwards which amounted to 187 articles. The majority of the literature traced were found anecdotal with only few studies investigating directly spiritual coping strategies. Following scrutiny of the available articles, only five research studies explored directly the spiritual coping strategies used in various illness, four of which were conducted in USA and one in UK. Because of the small scale research studies, generalization of the findings of this review is limited to the samples used. THEORETICAL BACKGROUND: Research suggests that spiritual coping strategies, involving relationship with self, others, Ultimate other/God or nature were found to help individuals to cope with their ailments. This may be because of finding meaning, purpose and hope, which may nurture individuals in their suffering. Spirituality is oftenly referred by literature as being synonymous with religiosity. Thus the use of spiritual coping strategies is restricted to individuals who hold religious beliefs. However, the definition of spirituality indicates that this concept is broader than religiosity. The theories on stress-coping (Folkman & Lazarus 1984) and the numinous experience (Otto 1950) outline the rationale for the use of these strategies which are applicable to both the believers and nonbelievers. IMPLICATIONS: This review suggests that the onset of illness may render the individual, being a believer or nonbeliever to realize the lack of control over his/her life. However the use of spiritual coping strategies may enhance self-empowerment, leading to finding meaning and purpose in illness. This implies that holistic care incorporates facilitation of various spiritual coping strategies to safeguard the wholeness and integrity of the patients.     

癌症化疗病人生命意义感现状及其与自我管理效能和生命质量的相关性研究

目的:探讨癌症化疗病人生命意义感现状及其与自我管理效能和生命质量的相关性。方法:选择2018年8月—2019年7月住院治疗的145例癌症化疗病人为研究对象,采用一般资料调查表、中文版生命意义感量表、中文版癌症自我管理效能感量表和癌症治疗功能评价系统中的共性模块表对病人进行调查。结果:病人的生命意义感量表总平均分为(46.35±8.78)分,自我效能量表总平均分为(82.08±24.02)分,生命质量总平均分为(66.76±17.80)分。病人的生命意义感得分与自我效能和生命质量均呈正相关(P<0.05)。结论:癌症化疗病人的生命意义感呈中等水平,并影响其自我管理效能和生命质量。在临床工作中医护人员应重视提高癌症化疗病人的生命意义感,帮助其更好地应对癌症。     

Psychiatric nurses' perspectives of spirituality and spiritual needs during an amalgamation

The purpose of this study was to explore the meaning of spirituality and how the spiritual needs of psychiatric nurses could be supported at work during a hospital amalgamation. Forty-six nurses completed the General Information Questionnaire and described the meaning of spirituality and how their spiritual needs could be supported. Data were analysed by the double-coding qualitative method. The themes identified for the meaning of spirituality included: being hopeful, having belief/belief systems, maintaining relatedness/connectedness and the expression of spirituality. The major themes identified to support nursing staffs' spiritual needs at work included communication, offering hope, being valued and support from spiritual sources. Nurses expressed the importance of spirituality in their lives and the need for spiritual support at work. Data for addressing staff spiritual needs are reported; however, further studies are needed to understand the spiritual needs of nursing staff at work during hospital amalgamations.