Zusammenfassung
HINTERGRUND: Unterstützende Aspekte ambulanter Palliativdienste umfassen medizinische, psychologische und spirituelle Bedürfnisse von Patienten und ihren betreuenden Angehörigen. Die Zielsetzung der vorliegenden Arbeit ist die Untersuchung der postmortalen Trauerverarbeitung betreuender Angehöriger. METHODIK: In der Studie wurde der Einfluss eines ambulanten Palliativdienstes auf die postmortale Trauerverarbeitung von 50 betreuenden Angehörigen verstorbener Patienten untersucht. Die Interviews wurden mithilfe eines für die Untersuchung erstellten Fragebogens in Bezug auf die validierten Kriterien von Prigerson, Horowitz sowie der Definition nach ICD-10 zur Trauerverarbeitung erstellt. Eingeschlossen wurden alle Personen im Alter von über 18 Jahren, die den Patienten während seiner Krankheit überwiegend betreuten. ERGEBNISSE: Es konnten insgesamt 46 betreuende Angehörige entsprechend der definierten Kriterien in die Untersuchung eingeschlossen werden. Gemäß den Kriterien von Prigerson, Horowitz sowie nach ICD-10 wurde bei bis zu 30% der Untersuchten eine komplizierte Trauerverarbeitung festgestellt. Bezüglich der drei Kriterien konnte kein statistisch signifikanter Unterschied festgestellt werden (P > 0,05). Ebenfalls konnte unter Berücksichtigung des Alters, des Geschlechts der Angehörigen, der Art der Tumorerkrankung, der Dauer der Erkrankung oder der Qualitätsempfindung der Betreuung durch den ambulanten Palliativdienst kein statistisch signifikanter Unterschied der Trauerverarbeitung bzw. des Risikos für eine pathologische Trauerreaktion ermittelt werden (P > 0,05). Insgesamt waren 97% der Angehörigen mit der Betreuung durch den Palliativdienst zufrieden. SCHLUSSFOLGERUNG: Die Ergebnisse unserer Untersuchung lassen vermuten, dass die Unterstützung betreuender Angehöriger das Risiko einer pathologischen Trauerreaktion vermindern kann. Eine sorgsame Exploration möglicher Faktoren, die auf eine pathologische Trauerreaktion deuten, ist in der Betreuung von besonderer Bedeutung. Unterstützende spezialisierte ambulante palliativmedizinische Hilfsangebote sind zu empfehlen, um zahlreiche Probleme zu reduzieren und die Trauerreaktion positiv zu beeinflussen. Deshalb scheint es notwendig, Hilfe sowohl vor als auch nach dem Tod eines Patienten anzubieten, um die Trauerverarbeitung positiv beeinflussen zu können.
Summary
BACKGROUND: Care aspects of outpatient palliative-care teams involve the medical, psychological, and spiritual needs of patients and their caregivers. The objective of our study was to examine the post-mortal bereavement of family caregivers. METHODS: The investigation was based on interviews with 50 family caregivers of 50 palliative-care patients assessed by a palliative-care team. Each caregiver was interviewed using interview sheets (mixed method designs) in accordance with three groups of validated criteria for complicated grief: Prigerson, Horowitz, and ICD-10. RESULTS: Forty-six family caregivers of terminally ill patients participated in the study. Complicated grief existed in up to 30% of the caregivers, based on the three sets of criteria. There was no significant difference (P > 0.05) among the three groups and no significant differences were found (P > 0.05) in relation to age, sex, psychosocial distress, primary cancer disease, and duration of illness or quality of care. Overall, 97% of the care-giving relatives were satisfied with the help given by the palliative-care team. CONCLUSION: The results of the study suggest that care from a specialized palliative-care team providing psychological and social support may reduce the risk of complicated grief. Careful exploration of possible risk factors for complicated grief is important for optimal care. Our study shows that healthcare providers play an important role in helping family caregivers to manage the multiple burdens and the grieving reaction. Family-focused grief therapy may prevent complicated grieving reactions.
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Wiese, C., Morgenthal, H., Bartels, U. et al. Post-mortal bereavement of family caregivers in Germany: a prospective interview-based investigation. Wien Klin Wochenschr 122, 384–389 (2010). https://doi.org/10.1007/s00508-010-1396-z
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DOI: https://doi.org/10.1007/s00508-010-1396-z