[논문]Existential Issues and Psychosocial Interventions in Palliative Care

Lee, Jae-Hon

doi:10.14475/kjhpc.2020.23.4.167

Existential Issues and Psychosocial Interventions in Palliative Care 원문보기

한국호스피스·완화의료학회지 = Korean journal of hospice and palliative care, v.23 no.4, 2020년, pp.167 - 171

Lee, Jae-Hon (Department of Psychiatry, School of Medicine, Gyeongsang National University Hospital)

Abstract ▼ AI-Helper

The finite nature of human existence leads many to search for meaning, which comes into sharper relief for those who are imminently facing death. Therefore, universal existential concerns such as the inevitability of death, existential isolation, loss of meaning, freedom, and dignity are inherent psychological issues in palliative care. Consequently, one of the critical challenges facing palliative care is how to address these issues effectively. This paper provides an overview of common themes of existential concerns and psychotherapeutic interventions to address existential distress among patients in palliative care.

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문제 정의

In this paper, we review the major existential issues that face patients receiving palliative care, and discuss specialized psy- chotherapeutic methods to help patients cope with these issues.

제안 방법

Privacy boundaries, social support, care tenor, burden to others, and aftermath concerns are the components of the social dignity inventory. Sessions are tape-recorded, transcribed, and edited, with the therapist helping the patient to organize the dignity psychotherapy question protocol. The transcript is returned to the patient within one to two days and it is usually left for the family as part of the patient’s personal legacy.
The second session introduces sources of meaning, and the patient conducts an experiential exercise on the origin of each type of meaning. The patient then finishes the procedure during the third session by discussing his or her legacy through an experiential exercise looking for calmness. This process ultimately aims to effectively cope with existential issues through the pursuit of an enhanced sense of meaning and purpose.
This therapy technique involves 1) the concept of meaning and sources of meaning; 2) cancer and meaning, and meaning in the historical context of life; 3) storytelling and the life project; 4) the limitations and finiteness of life; 5) responsibility, creativity, and deeds; 6) experiences of nature, art, and humor; and 7) goodbyes and hopes for the future. The procedure for individual patients is administered in seven once-weekly sessions, each of which last 90 minutes. The structure of each session involves processing the previous session, an introduction to the session topic, an experiential exercise, and a review of the homework assignment for the following session.

참고문헌 (15)

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6 Chochinov HM 2006 Dying, dignity, and new horizons in palliative end-of-life care CA Cancer J Clin 56 84 103 quiz 104 5 10.3322/canjclin.56.2.84 16514136

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7 Breitbart W 2017 Meaning-centered psychotherapy in the cancer setting finding meaning and hope in the face of suffering Oxford University Press New York, NY 10.1093/med/9780199837229.001.0001
8 Kierkegaard S Hong HV Hong EH 1983 Fear and trembling ; Repetition Princeton University Press Princeton, NJ
9 Rodin G Chochinov HM Breitbart W 2009 Individual psychotherapy for the patient with advanced disease Handbook of psychiatry in palliative medicine 2nd ed Oxford University Press New York, NY 443 53
10 Viederman M 1983 The psychodynamic life narrative: a psychotherapeutic intervention useful in crisis situation Psychiatry 46 236 46 10.1080/00332747.1983.11024196 6622599
11 Viederman M Chochinov HM Breitbart W 2000 The supportive relationship, the psychodynamic life narrative, and the dying patient Handbook of psychiatry in palliative medicine 2nd ed Oxford University Press New York, NY 215 23
12 Breitbart W Rosenfeld B Pessin H Applebaum A Kulikowski J Lichtenthal WG 2015 Meaning-centered group psychotherapy: an effective intervention for improving psychological well-being in patients with advanced cancer J Clin Oncol 33 749 54 10.1200/JCO.2014.57.2198 25646186

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13 Rodin G Lo C Rydall A Shnall J Malfitano C Chiu A 2018 Managing Cancer and Living Meaningfully (CALM): A Randomized Controlled Trial of a Psychological Intervention for Patients With Advanced Cancer J Clin Oncol 36 2422 32 10.1200/JCO.2017.77.1097 29958037

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14 Chochinov HM Hack T Hassard T Kristjanson LJ McClement S Harlos M 2005 Dignity therapy: a novel psychotherapeutic intervention for patients near the end of life J Clin Oncol 23 5520 5 10.1200/JCO.2005.08.391 16110012

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15 Chichinov HM 2002 Dignity-conserving care-a new model for palliative are: helping the patient feel valued JAMA 287 2253 60 10.1001/jama.287.17.2253 11980525

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Existential Issues and Psychosocial Interventions in Palliative Care 원문보기

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