Cautioning Health-Care Professionals
Cautioning Health-Care Professionals
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警告医疗保健专业人员
DOI：
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发表时间：
2017
期刊：
影响因子：
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通讯作者：
Kathrin Boerner
中科院分区：
文献类型：
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作者：
M. Stroebe;H. Schut;Kathrin Boerner
科学和实践似乎深深地陷入了所谓的悲伤阶段理论。保健专业人员继续“规定”分期。基本上，这种观点支持这样一种观点，即失去亲人的人在亲人去世后，随着时间的推移会经历一系列特定的反应。它经常被解释为规定性的，作为一个进程，失去亲人的人必须遵循，以适应损失。评估阶段理论是至关重要的，尤其是考虑到适应不良的“持续性复杂丧亲相关障碍”作为DSM-5中进一步研究的一个类别的现状。因此，我们回顾了这种方法的地位和价值。近几十年来，它在研究人员和实践者中仍然具有巨大的影响力，但也有强烈的反对意见。主要关切包括缺乏可靠的经验证据、概念清晰度或解释潜力。它对治疗服务的设计或分配缺乏实际效用，也无助于确定那些在悲伤过程中有风险或有并发症的人。最令人不安的是，期望失去亲人的人会，甚至应该，经历悲伤的阶段可能对那些不这样做的人有害。按照这样的推理路线，我们认为，阶段理论应该被所有相关的人（包括丧亲者自己）抛弃;充其量，它应该被降级到历史领域。有其他的模型可以更好地代表悲伤的过程。我们制定的指导方针，以加强这种超越阶段的方法在理论和实践。
Science and practice seem deeply stuck in the so-called stage theory of grief. Health-care professionals continue to “prescribe” stages. Basically, this perspective endorses the idea that bereaved people go through a set pattern of specific reactions over time following the death of a loved one. It has frequently been interpreted prescriptively, as a progression that bereaved persons must follow in order to adapt to loss. It is of paramount importance to assess stage theory, not least in view of the current status of the maladaptive “persistent complex bereavement-related disorder” as a category for further research in DSM-5. We therefore review the status and value of this approach. It has remained hugely influential among researchers as well as practitioners across recent decades, but there has also been forceful opposition. Major concerns include the absence of sound empirical evidence, conceptual clarity, or explanatory potential. It lacks practical utility for the design or allocation of treatment services, and it does not help identification of those at risk or with complications in the grieving process. Most disturbingly, the expectation that bereaved persons will, even should, go through stages of grieving can be harmful to those who do not. Following such lines of reasoning, we argue that stage theory should be discarded by all concerned (including bereaved persons themselves); at best, it should be relegated to the realms of history. There are alternative models that better represent grieving processes. We develop guidelines to enhance such a move beyond the stage approach in both theory and practice.
影响因子：
158.5
作者：
Schulz, R;Mendelsohn, AB;Belle, SH
通讯作者：
Belle, SH
影响因子：
120.7
作者：
Maciejewski, Paul K.;Zhang, Baohui;Prigerson, Holly G.
通讯作者：
Prigerson, Holly G.
影响因子：
3.7
作者：
Bonanno, GA;Wortman, CB;Nesse, RM
通讯作者：
Nesse, RM