Psychosocial and spiritual needs of patients with chronic diseases: validation of the Chinese version of the Spiritual Needs Questionnaire.

OBJECTIVE: Even in secular societies, a small portion of patients find their spirituality to help cope with illness. But for the majority of patients, psychosocial and spiritual needs are neither addressed nor even considered a relevant factor by health care professionals. To measure such specific needs, the Spiritual Needs Questionnaire (SpNQ) was developed. The aim of this study was to validate the Chinese version of the SpNQ (SpNQ-Ch) and thus to measure psychosocial and spiritual needs of Chinese patients. METHODS: This was a cross-sectional study among 168 patients with chronic diseases who were recruited in the Changhai Hospital of Traditional Chinese Medicine, Shanghai, China using standardized questionnaires. We performed reliability and factor analyses, as well as analyses of variance, first order correlations and regression analyses. RESULTS: The 17-item SpNQ-Ch had a similar factorial structure as the original version with two main and three minor factors which accounted for 64% of variance, and internal consistency estimates (Cronbach's α) ranging from 0.51 to 0.81. Included were the 4-item scale Inner Peace Needs, the 5-item scale Giving/Generativity Needs, the 5-item scale Religious Needs (with 2 sub-constructs, Praying and Sources), and a 3-item scale Reflection/Release Needs. In Chinese patients with cancer (63%), pain affections (10%), or other chronic conditions (23%), the needs for Giving/Generativity (which refer to categories of Connectedness and Meaning) and Inner Peace Needs scored highest, while Religious Needs and the Reflection/Release Needs scored lower. CONCLUSION: The SpNQ-Ch is congruent with its primary version, and can be used in future studies with the mostly nonreligious patients from China. First findings indicate specific psychosocial and spiritual needs which should be addressed by health care professionals to support patients in their struggle with chronic illness in terms of psycho-emotional stabilization, finding hope and meaning, and thus achieving peaceful states of mind despite chronic illness.

[Syndrome differentiation and treatment of Taiyang disease in Shanghan Lun].

OBJECTIVE: To explore the laws in syndrome differentiation of Taiyang disease and the prescriptions and herbs used in its treatment in Shanghan Lun (Treatise on Febrile Diseases). METHODS: The occurrence rates of main syndromes of Taiyang disease, and the usage frequency of the prescriptions and herbs in its treatment were calculated, and the laws in syndrome differentiation and herbal medication were analyzed by hierarchical clustering analysis. RESULTS: Fever and aversion to cold were found to be the main symptoms of Taiyang disease and usually accompanied with headache, absent sweating, neck stiff, floating and tight pulse, and body ache. The accompanying or aggravated symptoms could be classified into lung system syndrome with the manifestations of sweating and asthma, spleen-deficiency syndrome with the manifestations of gastric fullness and diarrhea, stomach syndrome with vomit and constipation. Guizhi decoction was the main prescription used in the treatment of Taiyang disease. Mahuang (Herba Ephedrae) matching Xingren (Semen Armeniacae), Dahuang (Radix et Rhizoma Rhei) matching Mangxiao (Natrii Sulfas), Baizhu (Rhizoma Atractylodes Macrocephalae) matching Fuling (Poria), Fuzi (Radix Aconiti Lateralis) matching Ganjiang (Rhizoma Zingiberis), Chaihu (Radix Bupleuri) matching Huangqin (Radix Scutellariae), Banxia (Rhizoma Pinelliae), and Renshen (Radix Ginseng) as the main compatibilities were used in treating lung diseases, stomach diseases, spleen-deficiency diseases, kidney-deficiency diseases and Shaoyang diseases respectively. CONCLUSION: Exterior syndrome, as a common syndrome in Taiyang disease, is usually treated with Guizhi decoction. The change in syndromes from upper-energizer to lower-energizer in exterior disease can be found from the change of symptoms and the use of herbs. And the development from defending stage to qi stage in exterior disease can be found in the use of prescriptions in Shanghan Lun.