癌症病人之創傷後壓力症狀

Cancer-Related Posttraumatic Stress Symptoms in Patients With Cancer

高達50%以上的癌症病人有不同程度的情緒困擾（如創傷後壓力症狀），然而國內學者在癌症病人情緒困擾之研究焦點大多以憂鬱為主軸，較少關注其在創傷後壓力症狀的議題。本文範疇涵蓋定義癌症相關的創傷後壓力症與癌症相關的創傷後壓力症狀、比較個別會談與自填問卷兩種創傷後壓力症與症狀測量工具的異同與應用、分析癌症相關的創傷後壓力症與症狀的盛行率、歸納癌症相關的創傷後壓力症與症狀的基本屬性（年輕、女性、低教育程度、低社會經濟地位）、臨床因子（末期病人、接受化療、剛接受完治療）與心理社會（負向心理特質、缺乏社會支持及因應能力與策略）等危險因子、並彙整認知心理治療介入措施改善癌症相關的創傷後壓力症與症狀之成效。最後並做成臨床實務與研究之建議，期能提供護理人員對照護創傷後壓力症及症狀情緒困擾病人的基本概念與激發護理專家對此議題的研究動機。

At least half of patients with cancer experience emotional distress (e.g., posttraumatic stress symptoms). Most of the studies on the emotional distress of Taiwanese cancer patients have focused on issues of depression rather than on posttraumatic stress disorder. The scope of the present article covers the definitions of cancer-related posttraumatic stress disorder (CR-PTSD) and cancer-related posttraumatic stress symptoms (CR-PTSS), identifies the differences and similarities between professional interview and self-administered measurement tools and their applications; analyzes the prevalence of CR-PTSD and CR-PTSS; identifies the possible contributing sociodemographic (younger age, female, low education, low socio-economic status), clinical (advanced stage, undergoing chemotherapy, just completed the therapy), and psychosocial (negative psychological traits, poor social support, and insufficient coping strategies) of CR-PTSD and CR-PTSS; and aggregates the effects of cognitive and psychosocial interventions on CR-PTSD and CR-PTSS. Furthermore, recommendations for clinical practice and research are discussed. This article is expected to provide practicing nurses with a basic concept of caring for emotional distress and to inspire researchers to conduct further study of issues related to CR-PTSD and CR-PTSS.