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2017-04-09 发布于江苏
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Burden to others and the__ terminally ill[PMIDJ17616329].pdf

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Burden to others and the__ terminally ill[PMIDJ17616329]

Vol. 34 No. 5 November 2007 Journal of Pain and Symptom Management 463Original Article Burden to Others and the Terminally Ill Harvey Max Chochinov, MD, PhD, Linda J. Kristjanson, PhD, Thomas F. Hack, PhD, CPsych, Thomas Hassard, PhD, Susan McClement, PhD, and Mike Harlos, MD Departments of Psychiatry (H.M.C.), Family Medicine (H.M.C.), Community Health Sciences (H.M.C., T.H.), and Faculty of Nursing (T.F.H., S.M.), University of Manitoba, Winnipeg; Manitoba Palliative Care Research Unit (H.M.C., T.F.H, S.M.), and Patient and Family Support Services (H.M.C., T.F.H.), CancerCare Manitoba, Winnipeg; and St. Boniface General Hospital (M.H.), Winnipeg, Manitoba, Canada; and WA Centre for Cancer Palliative Care (H.M.C., L.J.K.), Curtin University, Perth, Australia Abstract Studies of patients who are terminally ill consistently identify strong associations between ‘‘sense of burden to others’’ and marked end-of-life distress. However, little research has addressed the issue of burden to others among patients nearing death. The aim of this study was to carefully examine ‘‘burden to others’’ and clarify its relationship with various psychosocial, physical, and existential issues arising in patients who are terminally ill. A cohort of 211 patients with end-stage cancer was assessed, using an assortment of validated psychometrics to document psychosocial, physical, and existential aspects of their end-of-life experience. This included an assessment of their sense of ‘‘burden to others.’’ Forty percent of participants indicated a negligible sense of burden to others, scoring within the lowest quarter on an ordinal measure of ‘‘burden to others;’’ 25% scored within the second lowest quarter; 12% within the third quarter; and 23% within the highest or most severe range. The most highly correlated variables with ‘‘sense of burden to others’’ included depression (r ? 0.460; df ? 201, P 0.0001), hopelessness (r ? 0.420; df ? 199, P 0.0001), and outlook (r ? 0.362; df ? 200, P