Logotherapy as a Psychotherapeutic Technique in Psychogeriatric Palliative Care Wards

Kod svakog bolesnika, a osobito onog s neizlječivom bolesti kao što je demencija, neophodan je holistički pristup. Posljednjih godina se razvojem palijativne medicine nastoji ublažiti tjelesna bol i psihološka patnja, kako bi se bolesniku poboljšala preostala kvaliteta života i omogućilo dostojanstveno umiranje. Patnja kroz koju prolazi bolesnik utječe na članove njegove obitelji, ali i na medicinsko osoblje - članove palijativnog tima. Postavlja se pitanje kako pomoći kada je kurativna medicina svojim dijagnostičkim i terapijskim pristupom iscrpila svoje mogućnosti. Budući da je jedan od principa djelovanja u palijativnoj medicini integralna medicinska skrb na fizičkoj, psihičkoj i duhovnoj razini, najprihvatljivija psihoterapijska metoda kod ovih bolesnika je logoterapija, koja osobu doživljava kroz sve ove dimenzije, a posebno naglašava važnost duhovne. Logoterapija se uspješno koristi i kod članova obitelji bolesnika, a njeni principi pomažu i članovima palijativnog tima da se nose s različitim izazovima svakodnevnog posla. U središtu logoterapije je spoznaja da je čovjek, prema svojoj prirodi, usmjeren prema traženju smisla, u čemu treba osluškivati svoju savjest. Logoterapija ukazuje na prepoznavanje sudbinskog i slobodnog prostora i potiče na aktivno djelovanje u slobodnom prostoru. Čak i kada se sudbina ne može promijeniti (bolest, smrt), čovjek je slobodan prema njoj zauzeti stav. Naša najjača motivacija je tražiti smisao izvan sebe, u nekome ili nečemu, na način da nadiđemo svoje „ja“. Imati smislenu životnu zadaću, znači imati zdravi život.With each patient, especially those with an incurable disease such as dementia, a holistic approach is essential. In recent years, through the development of palliative medicine, medical professionals have been trying to reduce physical pain and psychological suffering in order to improve the patient’s quality of life and to enable a dignified death. The patient’s suffering affects their family members, as well as medical staff - the palliative care professionals. The question is how to help when curative medicine has exhausted all its options with its diagnostic and therapy treatments. Since integral medical care on a physical, psychological, and spiritual level is one of the principles of action in palliative medicine, the best psychotherapeutic method for treating such patients is logotherapy, which considers a person through all these dimensions, with special focus on the spiritual. Logotherapy is successfully used with the patient’s family members, and its principles help palliative care professionals deal with the different challenges of their daily work. Logotherapy is based on the understanding that it is in the human nature to search for meaning while guided by conscience. Logotherapy points at recognizing human fate and freedom and encourages actively exercising that freedom. Even when fate cannot be changed (death, illness), a person is free to choose the attitude they have toward it. Our strongest motivation is to search for meaning outside ourselves, in someone or something, by transcending our “self”. To have a meaningful purpose in life is to have a healthy life

Attitudes of nurses and technicians towards patient dying and death

Uvod: Smrt je jedina sigurna stvar u životu. Ipak, smrti i umiranju se može pristupiti na zdrav način. Razumijevanje i poštivanje različitosti mišljenja ljudi o umiranju i smrti promiče zdrav način umiranja kao i prihvaćanje vlastite smrtnosti. Palijativna skrb je proces koji je usmjeren na holistički pristup pacijentu. Pacijenta se gleda kao jedinku te se poštuju njegove osobne, kulturne, religijske i etičke vrijednosti. Kako se skrb i potpora pruža pacijentu, isto tako je potrebno pružiti potporu obitelji umirućeg pacijenta. Ciljevi istraživanja: Ispitati povezanost stavova medicinskih sestara i tehničara o umiranju i smrti bolesnika prema radnom stažu, radnom mjestu i stupnju obrazovanja. Ispitati postoji li razlika prema stavovima medicinskih sestara i tehničara vezano uz dodatnu edukaciju iz palijativnog pristupa, religijskih vjerovanja i komunikacijskih vještina. Metode: U istraživanje je uključeno 60 medicinskih sestara/tehničara Klinike za psihijatriju Vrapče, srednje stručne spreme, prvostupnici i visoke stručne spreme, u dobi od 18 do 65 godina. Uvjet za ispunjavanje upitnika je bio potpisani informirani pristanak te upoznavanje sa svrhom istraživanja. Korišten je standardizirani upitnik Death Attitude Profile-Revised autora Wong, Reker i Gasser. Upitnik se sastoji od 32 tvrdnje koje se tiču različitih stavova ljudi prema smrti. Rezultati: Istraživanjem dobiveni rezultati pokazuju kako ne postoji značajna razlika između medicinskih sestara/tehničara ovisno u dužini radnog staža i razini obrazovanja. Medicinske sestre/tehničari koji imaju dodatne edukacije iz palijativne skrbi pokazuju da lakše prihvaćaju smrt od osoba koje nemaju edukaciju iz palijativne skrbi. Ispitanici koji se smatraju religioznijima, skloni su lakše prihvatiti smrt te prihvaćaju smrt kao pristup i ulaz u zagrobni život, za razliku od osoba koje nisu religiozne te. Isto tako, religioznije osobe smatraju kako je smrt kraj patnje za bolesnu osobu i početak zagrobnog života. Zaključak: Istraživanje je pokazalo da ne postoje značajne razlike između spola, radnog staža, radnog mjesta, razine obrazovanja u stavovima prema smrti i umiranju. Religioznije osobe imaju pozitivniji stav prema umiranju te medicinske sestre i tehničari koji imaju dodatne edukacije iz palijativne skrbi lakše prihvaćaju smrt kao prirodan tijek života. Ovakvi podaci nam govore da je potrebno još više razvijati palijativnu skrb te provoditi više edukacija.Introduction: Death is the only sure thing in life. Nevertheless, death and dying can be approached in a healthy way. Understanding and respecting the diversity of people's opinions about dying and death promotes a healthy way to die as well as accepting their own mortality. Palliative care is a process that focuses on a holistic approach to the patient. The patient is seen as an individual and his personal, cultural, religious and ethical values are respected. As care and support is provided to the patient, it is also necessary to provide support to the family of the dying patient. Research goals: Examine the link between nurses' and technicians' attitudes towards the death and death of patients towards work experience, the workplace and the level of education. To examine whether there is a difference in attitudes of nurses and technicians related to additional education in a palliative approach, religious beliefs and communication skills. Methods: The study included 60 nurses of the Clinic for Psychiatry Vrapče, secondary education, bachelors and higher education, aged 18 to 65 years. The condition for completing the questionnaire was a signed informed consent and acquaintance with the purpose of the research. A standardized Death Attitude Profile-Revised questionnaire by Wong, Reker, and Gasser was used. The questionnaire consists of 32 statements concerning different attitudes of people towards death. Results: The research results show that there is no significant difference between nurses depending on the length of service and the level of education. Nurses who have additional education in palliative care show that they accept death more easily than people who do not have education in palliative care. Respondents who consider themselves more religious tend to accept death more easily and accept death as an approach and entrance to the afterlife, unlike non-religious people and. Likewise, more religious people consider death to be the end of suffering for a sick person and the beginning of the afterlife. Conclusion: Research has shown there are no significant differences between gender, work experience, workplace, level of education in attitudes towards death and dying. More religious people have more positive attitude towards dying, and nurses who have additional education in palliative care more easily accept death as a natural course of life. This kind of data tells us that it is necessary to develop palliative care even more and conduct more education

Attitudes of nurses and technicians towards patient dying and death

Uvod: Smrt je jedina sigurna stvar u životu. Ipak, smrti i umiranju se može pristupiti na zdrav način. Razumijevanje i poštivanje različitosti mišljenja ljudi o umiranju i smrti promiče zdrav način umiranja kao i prihvaćanje vlastite smrtnosti. Palijativna skrb je proces koji je usmjeren na holistički pristup pacijentu. Pacijenta se gleda kao jedinku te se poštuju njegove osobne, kulturne, religijske i etičke vrijednosti. Kako se skrb i potpora pruža pacijentu, isto tako je potrebno pružiti potporu obitelji umirućeg pacijenta. Ciljevi istraživanja: Ispitati povezanost stavova medicinskih sestara i tehničara o umiranju i smrti bolesnika prema radnom stažu, radnom mjestu i stupnju obrazovanja. Ispitati postoji li razlika prema stavovima medicinskih sestara i tehničara vezano uz dodatnu edukaciju iz palijativnog pristupa, religijskih vjerovanja i komunikacijskih vještina. Metode: U istraživanje je uključeno 60 medicinskih sestara/tehničara Klinike za psihijatriju Vrapče, srednje stručne spreme, prvostupnici i visoke stručne spreme, u dobi od 18 do 65 godina. Uvjet za ispunjavanje upitnika je bio potpisani informirani pristanak te upoznavanje sa svrhom istraživanja. Korišten je standardizirani upitnik Death Attitude Profile-Revised autora Wong, Reker i Gasser. Upitnik se sastoji od 32 tvrdnje koje se tiču različitih stavova ljudi prema smrti. Rezultati: Istraživanjem dobiveni rezultati pokazuju kako ne postoji značajna razlika između medicinskih sestara/tehničara ovisno u dužini radnog staža i razini obrazovanja. Medicinske sestre/tehničari koji imaju dodatne edukacije iz palijativne skrbi pokazuju da lakše prihvaćaju smrt od osoba koje nemaju edukaciju iz palijativne skrbi. Ispitanici koji se smatraju religioznijima, skloni su lakše prihvatiti smrt te prihvaćaju smrt kao pristup i ulaz u zagrobni život, za razliku od osoba koje nisu religiozne te. Isto tako, religioznije osobe smatraju kako je smrt kraj patnje za bolesnu osobu i početak zagrobnog života. Zaključak: Istraživanje je pokazalo da ne postoje značajne razlike između spola, radnog staža, radnog mjesta, razine obrazovanja u stavovima prema smrti i umiranju. Religioznije osobe imaju pozitivniji stav prema umiranju te medicinske sestre i tehničari koji imaju dodatne edukacije iz palijativne skrbi lakše prihvaćaju smrt kao prirodan tijek života. Ovakvi podaci nam govore da je potrebno još više razvijati palijativnu skrb te provoditi više edukacija.Introduction: Death is the only sure thing in life. Nevertheless, death and dying can be approached in a healthy way. Understanding and respecting the diversity of people's opinions about dying and death promotes a healthy way to die as well as accepting their own mortality. Palliative care is a process that focuses on a holistic approach to the patient. The patient is seen as an individual and his personal, cultural, religious and ethical values are respected. As care and support is provided to the patient, it is also necessary to provide support to the family of the dying patient. Research goals: Examine the link between nurses' and technicians' attitudes towards the death and death of patients towards work experience, the workplace and the level of education. To examine whether there is a difference in attitudes of nurses and technicians related to additional education in a palliative approach, religious beliefs and communication skills. Methods: The study included 60 nurses of the Clinic for Psychiatry Vrapče, secondary education, bachelors and higher education, aged 18 to 65 years. The condition for completing the questionnaire was a signed informed consent and acquaintance with the purpose of the research. A standardized Death Attitude Profile-Revised questionnaire by Wong, Reker, and Gasser was used. The questionnaire consists of 32 statements concerning different attitudes of people towards death. Results: The research results show that there is no significant difference between nurses depending on the length of service and the level of education. Nurses who have additional education in palliative care show that they accept death more easily than people who do not have education in palliative care. Respondents who consider themselves more religious tend to accept death more easily and accept death as an approach and entrance to the afterlife, unlike non-religious people and. Likewise, more religious people consider death to be the end of suffering for a sick person and the beginning of the afterlife. Conclusion: Research has shown there are no significant differences between gender, work experience, workplace, level of education in attitudes towards death and dying. More religious people have more positive attitude towards dying, and nurses who have additional education in palliative care more easily accept death as a natural course of life. This kind of data tells us that it is necessary to develop palliative care even more and conduct more education