Spiritual distress

精神上的痛苦
  • 文章类型: Journal Article
    目的:原发性恶性脑肿瘤患者由于预后有限和症状负担较高而经历严重的健康相关痛苦。因此,神经肿瘤医护人员可能会受到负面情绪影响。这项研究的目的是分析护士和医生在面对这些患者的精神困扰时的态度和行为。
    方法:Neurospirit-DE是一种基于定性的小插图,多中心,在巴伐利亚进行的横断面在线调查,德国。数据分析采用自反性主题分析。
    结果:共有143名护士和医生在46家医院的神经和神经外科病房工作参与了调查。参与者质疑提供精神护理的能力是否可以学习或是一种自然技能。强调了精神关怀作为整个团队的责任,工作人员反映了让精神护理专家参与的适当方式。精神关怀的主要限制是缺乏时间,并且没有将精神参与视为专业角色的一部分。有些人能够从与患者的精神对话中受益,但是许多参与者批评了感知到的情感负担,同时表达了对特定培训和团队反思的迫切需求。
    结论:大多数神经肿瘤科护士和医生将精神关怀视为其职责的一部分,并知道如何减轻患者的精神困扰。尽管如此,神经肿瘤学精神评估工具的验证和患者痛苦的标准化文件,共享的跨专业培训,在面对神经肿瘤学的精神护理时,对专业和个人挑战的反思需要进一步改进和培训。
    OBJECTIVE: People with primary malignant brain tumors experience serious health-related suffering caused by limited prognosis and high symptom burden. Consequently, neuro-oncological healthcare workers can be affected emotionally in a negative way. The aim of this study was to analyze the attitudes and behavior of nurses and physicians when confronted with spiritual distress in these patients.
    METHODS: Neurospirit-DE is a qualitative vignette-based, multicenter, cross-sectional online survey that was conducted in Bavaria, Germany. Reflexive thematic analysis was used for data analysis.
    RESULTS: A total of 143 nurses and physicians working in neurological and neurosurgical wards in 46 hospitals participated in the survey. The participants questioned if the ability to provide spiritual care can be learned or is a natural skill. Spiritual care as a responsibility of the whole team was highlighted, and the staff reflected on the appropriate way of involving spiritual care experts. The main limitations to spiritual care were a lack of time and not viewing spiritual engagement as part of the professional role. Some were able to personally benefit from spiritual conversations with patients, but many participants criticized the perceived emotional burden while expressing the imminent need for specific training and team reflection.
    CONCLUSIONS: Most neuro-oncological nurses and physicians perceive spiritual care as part of their duty and know how to alleviate the patient\'s spiritual distress. Nonetheless, validation of spiritual assessment tools for neuro-oncology and standardized documentation of patients\' distress, shared interprofessional training, and reflection on the professional and personal challenges faced when confronted with spiritual care in neuro-oncology require further improvement and training.
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  • 文章类型: Journal Article
    精神上的痛苦,绝望,抑郁症是姑息治疗中经常使用的概念。需要对这些概念进行同时概念分析(SCA),以澄清姑息治疗中使用的术语。因此,这项研究的目的是进行精神痛苦的SCA,绝望,姑息治疗中的抑郁症。使用Haase模型的方法进行SCA。文献检索于2020年3月进行,并于2022年4月和2024年4月进行了更新。在以下在线数据库上进行了搜索:CINAHL全文,MEDLINE与全文,MedicLatina,LILACS,SciELO,和PubMed。搜索是在发布日期没有限制的情况下完成的。本研究共纳入84篇文章。结果突出表明,这三个概念是不同的,但也有一些重叠之处。精神上的痛苦根植于他们的精神/宗教信仰系统的破裂,生活中缺乏意义,和存在的问题。绝望是一种放弃的感觉,无法控制和解决病人的情况。最后,抑郁症是一种悲伤的状态,有多重受损的情况。总之,完善姑息治疗中的三个概念至关重要,因为它可以促进澄清并促进干预知识的发展。
    Spiritual distress, hopelessness, and depression are concepts that are often used in palliative care. A simultaneous concept analysis (SCA) of these concepts is needed to clarify the terminology used in palliative care. Therefore, the aim of this study is to conduct a SCA of spiritual distress, hopelessness, and depression in palliative care. A SCA was performed using the methodology of Haase\'s model. A literature search was conducted in March 2020 and updated in April 2022 and April 2024. The search was performed on the following online databases: CINAHL with Full-Text, MEDLINE with Full-Text, MedicLatina, LILACS, SciELO, and PubMed. The search was achieved without restrictions on the date of publication. A total of 84 articles were included in this study. The results highlight that the three concepts are different but also share some overlapping points. Spiritual distress is embedded in the rupture of their spiritual/religious belief systems, a lack of meaning in life, and existential issues. Hopelessness is a sense of giving up and an inability to control and fix the patient\'s situation. Finally, depression is a state of sadness with a multi-impaired situation. In conclusion, refining the three concepts in palliative care is essential since it promotes clarification and enhances knowledge development towards intervention.
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  • 文章类型: Journal Article
    评估焦虑症状的变化,抑郁症,以及氯胺酮辅助心理治疗(KAP)前后的心理社会或精神困扰。
    对来自两项为期五年的前瞻性结局研究的参与者数据进行回顾性图表回顾:AIMS医学结果研究(AMOS)和AIMS癌症结果研究(ACOS)。KAP对焦虑的疗效,抑郁症,并评估了当前患者的心理社会或精神健康状况,过去,或物质使用障碍的高风险。使用的验证的心理计量学是广义焦虑症-7(GAD-7),患者健康问卷-9(PHQ-9),和国家健康研究所-所有生活压力源的治疗经验(NIH-HEALS)问卷。
    在2020年11月1日至2022年10月31日之间,共有18名被确定为有问题物质使用的患者完成了至少一次KAP会议以及至少一份基线和KAP后指标问卷。PSU亚群平均得分变化如下:GAD-7(-6.71±9.15,n=14);PHQ-9(-7.44±5.42,n=16);和NIH-HEALS(5.13±13.64,n=15)。入选受试者的KAP人群的平均得分变化如下:GAD-7(-2.45±6.01,n=104);PHQ-9(-3.02±6.01,n=111);和NIH-HEALS(2.93±11.91,n=86)。PSU亚群和KAP群体之间平均得分变化的比较(p<0.05)如下:GAD-7(0.0219,95%C.I.1.37-8.11);PHQ-9(0.0062,95%C.I.1.28-7.56);和NIH-HEALS(0.5197,95%C.I.8.96-4.56)。对于PSU患者,结果显示,在至少一次KAP治疗后,焦虑和抑郁症状显著改善.平均NIH-HEALS评分增加,虽然不是统计上显著的数量。与这一时期登记的KAP患者的一般人群相比,PSU患者的GAD-7和PHQ-9评分平均降低幅度显著.
    接受1至6次氯胺酮辅助心理治疗(KAP)会改善有问题物质使用的患者的焦虑和抑郁评分。三分之二的参与者还经历了心理社会和精神福祉的改善。KAP的使用可能是重要的考虑作为一种疗法,以减少有问题的药物使用患者的焦虑和抑郁症状。
    UNASSIGNED: Assess changes in symptoms of anxiety, depression, and psychosocial or spiritual distress before and after ketamine-assisted psychotherapy (KAP) in individuals with problematic substance use (PSU).
    UNASSIGNED: A retrospective chart review was performed on participant data from two five-year prospective outcomes studies: the AIMS Medical Outcomes Study (AMOS) and the AIMS Cancer Outcomes Study (ACOS). The efficacy of KAP for anxiety, depression, and psychosocial or spiritual well being was assessed in patients with current, past, or high risk of substance use disorder. Validated psychometrics utilized were Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and the National Institute of Health - Healing Experiences of All Life Stressors (NIH-HEALS) questionnaires.
    UNASSIGNED: Between November 1, 2020 and October 31, 2022, a total of 18 patients identified with problematic substance use completed at least one KAP session and at least one baseline and post-KAP metric questionnaire. The PSU subpopulation average score changes were as follows: GAD-7 (-6.71 ± 9.15, n = 14); PHQ-9 (-7.44 ± 5.42, n = 16); and NIH-HEALS (5.13 ± 13.64, n = 15). The average score changes for the KAP population of enrolled subjects were as follows: GAD-7 (-2.45 ± 6.01, n = 104); PHQ-9 (-3.02 ± 6.01, n = 111); and NIH-HEALS (2.93 ± 11.91, n = 86). A comparison of average score changes (p < 0.05) between the PSU subpopulation and KAP population were as follows: GAD-7 (0.0219, 95% C.I. 1.37-8.11); PHQ-9 (0.0062, 95% C.I. 1.28-7.56); and NIH-HEALS (0.5197, 95% C.I. 8.96-4.56). For patients with PSU, results demonstrate statistically significant improvements in anxiety and depression symptoms after at least one KAP session. Average NIH-HEALS scores increased, though not by a statistically significant amount. Compared to the general population of enrolled KAP patients during this period, patients with PSU reported significantly greater average reductions in GAD-7 and PHQ-9 scores.
    UNASSIGNED: Undergoing one to six ketamine-assisted psychotherapy (KAP) sessions was associated with improved anxiety and depression ratings in patients with problematic substance use. Two-thirds of participants also experienced improved psychosocial and spiritual well-being. The use of KAP may be important to consider as a therapy for reducing anxiety and depression symptoms in patients with problematic substance use.
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  • 文章类型: Review
    尽管人们认识到精神上的担忧会增加照顾者的负担,对灵性知之甚少,精神上的幸福,和精神上的痛苦在帕金森病的照顾者。在这份截至2022年10月的文献范围审查中,我们搜索了PubMed,心理信息,Embase,和CINAHL。从最初的328项研究中,14人被包括在内。照顾者因素(例如,抑郁症,年龄)和患者因素(例如,信仰,运动功能)影响护理人员的灵性和精神幸福感。照顾者经历了意义的丧失,存在的内疚,和孤独,并通过默许来应对,文化信仰,祈祷,和感激。未来的研究应该集中在帕金森病照顾者的具体精神需求和干预措施,以解决这些问题。
    Despite recognition that spiritual concerns contribute to caregiver burden, little is known about spirituality, spiritual well-being, and spiritual distress in Parkinson\'s disease caregivers. In this scoping review of the literature through October 2022, we searched PubMed, PsychINFO, Embase, and CINAHL. From an initial pool of 328 studies, 14 were included. Caregiver factors (e.g., depression, age) and patient factors (e.g., faith, motor function) affected caregiver spirituality and spiritual well-being. Caregivers experienced loss of meaning, existential guilt, and loneliness, and coped through acquiescence, cultural beliefs, prayer, and gratitude. Future research should focus on the specific spiritual needs of Parkinson\'s disease caregivers and interventions to address them.
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  • 文章类型: Case Reports
    社会心理和文化因素起着重要的作用,但经常被忽视,在年轻人抑郁症中的作用。在这篇文章中,我们提出了两个年轻的案例,受过教育的男性患有严重的抑郁症和突出的内疚和精神痛苦的主题。我们探索道德不一致之间的关系,精神上的痛苦,通过在成绩优异的年轻学生中出现两例抑郁症,以及对严重抑郁发作的负罪感。两种情况都表现为情绪低落,精神运动减慢,有选择性的mutism根据详细的历史,由于互联网色情使用(IPU)以及由此产生的自我感知成瘾和道德不一致而导致的精神困扰和内gui感与重度抑郁发作的开始和进展有关。使用汉密尔顿抑郁量表(HAM-D)测量抑郁发作的严重程度。使用内疚和羞耻状态量表(SSGS)测量内疚和羞耻的主题。家庭的高期望也是压力的来源。因此,在管理年轻人的心理健康问题时,记住这些因素是很重要的。青春期后期和成年早期是压力很大的时期,容易患上精神疾病。在这个年龄段,抑郁症的社会心理决定因素通常未被探索和解决,导致治疗欠佳。特别是在发展中国家。需要进一步的研究来评估这些因素的重要性,并确定减轻这些因素的方法。
    Psychosocial and cultural factors play an important, but often neglected, role in depression in young individuals. In this article, we present two cases of young, educated males with major depressive disorder and prominent themes of guilt and spiritual distress. We explore the relationship between moral incongruence, spiritual distress, and feelings of guilt with major depressive episodes by presenting two cases of depression in young individuals who were high-achieving students. Both cases presented with low mood, psychomotor slowing, and selective mutism. Upon detailed history, spiritual distress and feelings of guilt due to internet pornographic use (IPU) and the resulting self-perceived addiction and moral incongruence were linked to the initiation and progression of major depressive episodes. The severity of the depressive episode was measured using the Hamilton Depression Scale (HAM-D). Themes of guilt and shame were measured using the State of Guilt and Shame Scale (SSGS). High expectations from the family were also a source of stress. Hence, it is important to keep these factors in mind while managing mental health problems in young individuals. Late adolescence and early adulthood are periods of high stress and vulnerabe to mental illness. Psychosocial determinants of depression in this age group generally go unexplored and unaddressed leading to suboptimal treatment, particularly in developing countries. Further research is needed to assess the importance of these factors and to determine ways to mitigate them.
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  • 文章类型: Journal Article
    目的:这项研究的目的是确定精神痛苦的定义特征(00066)。
    方法:本研究采用Broom法进行综合综述。
    方法:PubMed,ProQuest,WebofScience,Embase,Scopus,和Cochran图书馆,从2010年1月到2020年12月,搜索了波斯科学数据库。
    结果:确定了21篇文章和74个定义特征。在NANDA中提到了其中33个定义特征。文章中频率和重复次数最高的标准是缺乏和平,缺乏希望,愤怒行为的改变,生活中缺乏意义,恐惧和哭泣行为的改变,关注信仰和价值体系和/或上帝。
    结论:一些精神困扰定义特征与其他护理诊断重叠,包括焦虑和绝望.需要进行临床和内容验证研究,并且需要确定诊断不同文化和宗教中精神困扰的主要标准。
    The aim of this study was to identify the defining characteristics of spiritual distress (00066).
    This study was conducted by integrated review method using Broom method.
    PubMed, ProQuest, Web of Science, Embase, Scopus, and Cochran Library, and Persian scientific databases were searched from January 2010 to December 2020.
    Twenty-one article and 74 defining characteristics were identified. 33 of these defining characteristics was mentioned in NANDA. The criteria with the highest frequency and repetition in articles were lack of peace, lack of hope, change in anger behaviour, lack of meaning in life, change in fear and crying behaviour, Concern about belief and values system and/or God.
    Some of the spiritual distress defining characteristics overlap with other nursing diagnoses, including anxiety and hopelessness. Clinical and content validation studies need to be conducted and the main criteria for diagnosing spiritual distress in different cultures and religions need to be identified.
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  • 从最初诊断到整个疾病轨迹,神经系统疾病对患者及其家人提出了多重挑战。包括与接受诊断相关的挑战及其各种影响,以及对未来患病生活的焦虑。患者及其家人通常依靠他们的灵性来应对并维持疾病中的意义和尊严。因此,精神护理是神经系统疾病患者整体医疗的重要组成部分。精神护理提供遵循通才-专家模式,这要求所有参与护理面临严重疾病的患者的医疗保健专业人员在识别和解决精神需求方面发挥作用。这种模式的特点是通才精神护理提供者(例如,护士,医师,社会工作者)通过历史拍摄进行精神筛选。牧师充当专业的精神护理提供者,可以更深入地解决精神护理问题。此外,几种发达的心理治疗方法可能对神经系统疾病患者有用,牧师经过特别培训,可以为患有神经系统疾病的患者及其家人提供支持性的精神护理,并与医生和医疗团队的其他成员一起工作,作为整体护理方法的一部分。
    Neurologic illnesses present multiple challenges to patients and their families from the time of initial diagnosis and throughout their illness trajectory, including challenges related to accepting the diagnosis and its various impacts and anxiety about future living with their illness. Often patients and their families rely on their spirituality to cope with and to maintain meaning and dignity in the midst of disease. As a result, spiritual care provision is a critical component of holistic medical care to patients with neurologic illness. Spiritual care provision follows a generalist-specialist model, which requires all healthcare professionals involved in the care of patients facing serious illness to play a role in recognizing and addressing spiritual needs. This model is characterized by generalist spiritual care providers (e.g., nurses, physicians, social workers) who perform spiritual screenings through history taking. Chaplains function as specialist spiritual care providers and can address spiritual care more deeply. In addition, several developed psychotherapeutic approaches may be useful for patients with neurologic disease, and chaplains are especially trained to offer supportive spiritual care to patients with neurologic illnesses and their families and to work together with physicians and other members of the healthcare team as part of a holistic approach to care.
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  • 文章类型: Journal Article
    背景:癌症患者会接受几种类型的治疗,包括化疗.在这种情况下,患者经历了几次护理诊断,包括精神上的痛苦.精神痛苦诊断的定义是基于生活中缺乏意义和目的,一种痛苦的感觉,和一种脱节的感觉。
    目的:本研究的目的是确定患病率,灵敏度,特异性,和预测癌症化疗患者精神痛苦的护理诊断。
    方法:本研究采用纵向问卷设计,每季度收集12个月的数据。通过随机抽样招募参与者,在葡萄牙一个肿瘤学日病房的门诊患者中。
    结果:患者开始化疗后3个月,精神困扰的发生率最高。特异性的最高价值是生活中缺乏意义和表达痛苦,敏感度的最高价值与精神痛苦诊断有关。精神痛苦的预测因素是表达痛苦,异化,质疑生活中的意义,缺乏宁静,质疑痛苦的意义,绝望,生活中缺乏意义。
    结论:精神困扰是一种人类反应,目前正在接受化疗的患者中,并且最高的患病率似乎发生在开始化疗后3个月。在本研究中,表达痛苦和生活意义的缺乏不仅对定义特征(DC)起作用,也是精神痛苦诊断的预测因素。
    结论:对患病率的识别,预测因子,灵敏度,化疗癌症患者精神困扰护理诊断的DC和特异性可以促进护士的临床推理,并改善临床实践中的护理计划,以提高癌症患者的精神幸福感。
    Cancer patients are exposed to several types of treatments, including chemotherapy. In this context, patients experience several nursing diagnoses, including spiritual distress. The definition of the diagnosis of spiritual distress is grounded in lack of meaning and purpose in life, a sense of suffering, and a feeling of disconnected.
    The aim of this study was to determine the prevalence, sensitivity, specificity, and predictors of the nursing diagnosis of spiritual distress of cancer patients undergoing chemotherapy.
    The study used a longitudinal questionnaire design with quarterly data collection points over a 12-month period. Participants were recruited through random sampling, in an outpatients\' setting in one oncology day unit in Portugal.
    The highest prevalence of spiritual distress was found at 3 months after patients started chemotherapy. The highest value of specificity was lack of meaning in life and express suffering, and the highest values of sensitivity concerned spiritual distress diagnosis. The predictors of spiritual distress were express suffering, alienation, questioning meaning in life, lack of serenity, questioning the meaning of suffering, hopelessness, and lack of meaning in life.
    Spiritual distress is a human response that is current in patients undergoing chemotherapy, and the highest prevalence seems to occur at 3 months after commencing chemotherapy. Express suffering and lack of meaning in life play the role not only of defining characteristics (DC) in this study, but also of predictors in the diagnosis of spiritual distress.
    The identification of the prevalence, predictors, sensitivity, and specificity of the DC of the nursing diagnosis of spiritual distress in cancer patients undergoing chemotherapy may facilitate nurses\' clinical reasoning and improve the planning of nursing care in clinical practice in order to improve spiritual well-being in cancer patients.
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  • 文章类型: Journal Article
    面临严重和危及生命的疾病的患者和家庭面临精神痛苦的风险。筛选精神困扰是识别问题的有效方法。灵性状态量表采用uniq。
    Patients and families facing serious and life- threatening illnesses are at risk for spiritual distress. Screening for spiritual distress is an efficient way of identifying issues. The State of Spirituality scale takes a uniq.
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  • 文章类型: Journal Article
    我们进行了文献检索,以确定和比较精神痛苦的经验维度的定义。搜索了关键数据库,截至2021年,包括在内,在临床环境中定义为“精神”或“存在性”疼痛/痛苦的论文。在144次点击中,七篇论文提供了理论定义/描述;没有纳入临床观察或潜在的病理生理结构。基于这些发现,我们为“精神痛苦”提出了一个新的定义,即“自我认同的个人不适体验”,或实际或潜在的伤害,对一个人与上帝或更高权力的关系的威胁。“我们更新的定义可以为未来的疼痛评估和管理研究提供信息。
    We conducted a literature search to identify and compare definitions of the experiential dimension of spiritual pain. Key databases were searched, up to the year 2021 inclusive, for papers with a definition of \"spiritual\" or \"existential\" pain/distress in a clinical setting. Of 144 hits, seven papers provided theoretical definitions/descriptions; none incorporated clinical observations or underlying pathophysiological constructs. Based on these findings, we propose a new definition for \"spiritual pain\" as a \"self-identified experience of personal discomfort, or actual or potential harm, triggered by a threat to a person\'s relationship with God or a higher power.\" Our updated definition can inform future studies in pain assessment and management.
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