癌末患者的心理社會問題、因應策略與負向情緒

Psychosocial Problems, Coping Strategies, and Negative Feelings in Terminal Cancer Patients

癌症是一種主要的慢性疾病，一直名列國人的十大死因之首，台灣安寧照護（緩和醫療）正式起源於1990年，安寧照護重視患者與健康有關的生活品質的提升。生活品質是一個複雜的構念，具有多重的向度與範疇，本文強調心理範疇的福祉感，包括兩個主觀的層面，一是情緒層面，包含負向情感與正向情感，其次是認知判斷上的生活滿足感。負向情緒可分為焦慮與憂鬱兩個向度。本研究即以瞭解癌末患者的負向情緒為主題，探討患者在面對疾病與死亡的壓力經驗下，產生不同的心理社會問題以及採取何種因應策略，並瞭解其對患者負向情緒產生的影響。研究程序上為了同時考量臨床服務與研究，因此採取兩位心理學研究所的實習生，經由與患者、家屬以及醫療人員的晤談與觀察，完成「台大醫院緩和醫療病房焦慮及憂鬱評估表」與「台大醫院緩和醫療病房心理社會評估表」的評估，一共收集了39位，其中男性21位，女性18位，平均年齡為61.6 歲，標準差為11.7歲。研究結果顯示癌末患者的負向情緒困擾，並不會直接受心理社會問題的影響。因應策略與負向情緒則均成負相關的趨勢，尤其是認知重新定義的因應策略，顯示癌末患者在控制性低的壓力經驗下，不論採取何種方式均對負向情緒有減低的效果。

Cancer can be a threat to life itself, as well as to the individual's perception of quality of life as especially for terminal patients. Quality of life is a complex construct that is associated with multiple domains. Psychological researchers on the study the domain of psychological well-being. Researchers have identified two facets of subjective well-being: a cognitive judgment of life satisfaction and an emotional aspect consisting of independent positive feeling and negative feeling components. This paper was aimed to study the relationship among psychosocial problems, coping strategies and negative feelings. Thirty-nine terminal cancer patients (21 male, 18 female), average age 61.6 years, completed Negative Feeling Scale (anxiety and depression) and Psychosocial Problem and Coping Strategy Checklist. Results of the study indicated: a. psychosocial problems have not directly influenced to negative feelings; b. cognitive reappraisal coping strategy was negatively related to negative feelings; c. psychosocial problems and coping strategies was specifically related.