Resilience and Coherence in Palliative Medicine

姑息医学的弹性和连贯性

• 批准号: 410364873
• 负责人: Professor Dr. Lukas Radbruch
• 金额: --
• 依托单位: Klinik und Poliklinik für Palliativmedizin
• 依托单位国家: 德国
• 项目类别: Research Units
• 财政年份: 2019
• 资助国家: 德国
• 起止时间: 2018-12-31 至 2022-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/410364873?language=en
• 关键词: Resilience; Coherence; Palliative; Medicine

The objective of this project (TP 6) is an analysis of the concept of resilience and the comparison with other much used concepts in the field of palliative medicine such as sense of coherence, dignity-centered therapy, biography work, quality of life, meaning in life or mindfulness.The analysis will use three stages. In the first stage a systematic literature research in medical and social data bases such as Pubmed, Embase, Psychinfo and Google Scholar will identify available literature on interventions (dignity-centered therapy, logotherapy, biography, mindfulness stress reduction) and concepts (resilience, sense of coherence, meaning in life), if related to the medical care of severely ill or dying patients. Evaluation will be performed as an analysis of discourse in the literature. This will be supplemented with expert interviews. Relevant stakeholders in hospice and palliaive care will be interviewed in six focus groups with at least five participants. International experts will be interviewed via telephone or skype. Another six focus groups will be held with staff members of palliative care services, providing the perspective of daily routine practice. In the second stage of the project interviews with palliative care patients and their caregivers will be used to validate the hypotheses that have been developed in the first stage. Narrative semistructured interviews will be performed with 30 patients and 30 caregivers in different palliative care settings. In the third phase the hypotheses will be used for the construction of a grounded theory on the relationship and correlations between the concepts and interventions under investigation. The hypotheses and the grounded theory are the results of the project (TP 6). In addition, a matrix with the mutual influences of the evaluated interventions, concepts and values will be described. This contributes to the systematic development of the potential for medical and spiritual assessment instruments. However, as a specific perspective of this project it will also discuss critically the bounderies of assessment, and which aspects of resilience may not be accessible to assessment instruments, no matter how optimal they are constructed. The project thus also contributes to the third objective of the research group by expanding and correcting the discussion on resilience with potential unmeasurable elements.

本项目（TP 6）的目的是分析复原力的概念，并与姑息医学领域中其他常用的概念进行比较，如连贯感，尊严中心疗法，传记作品，生活质量，生活意义或正念。分析将分为三个阶段。在第一阶段，在医学和社会数据库（如Pubmed，Embase，Psychinfo和Google Scholar）中进行系统的文献研究，将识别有关干预措施（尊严中心疗法，意义疗法，传记，正念减压）和概念（弹性，连贯性，生命意义）的可用文献，如果与重病或垂死患者的医疗护理有关。评估将作为文献中的话语分析进行。这将辅之以专家访谈。临终关怀和安宁疗护的相关利益攸关方将在六个焦点小组中接受采访，至少有五名参与者。国际专家将通过电话或skype接受采访。另外六个焦点小组将与姑息治疗服务的工作人员举行，提供日常实践的观点。在项目的第二阶段，将通过与姑息治疗患者及其护理人员的访谈来验证第一阶段提出的假设。叙述性半结构式访谈将在不同的姑息治疗环境中与30名患者和30名护理人员进行。在第三阶段，假设将被用于构建一个基础理论的关系和相互关系的概念和干预措施的调查。假设和基础理论是项目（TP 6）的结果。此外，还将描述一个矩阵，其中包括所评价的干预措施、概念和价值观的相互影响。这有助于系统地开发医疗和精神评估工具的潜力。然而，作为本项目的一个具体视角，它还将批判性地讨论评估的界限，以及评估工具可能无法访问复原力的哪些方面，无论这些工具的构建如何优化。因此，该项目也有助于研究小组的第三个目标，扩大和纠正关于具有潜在不可计量因素的复原力的讨论。