運用認知行為治療促進乳癌病人心理健康

Using the Cognitive Behavioral Therapy to Improve the Mental Health of Women With Breast Cancer

過去研究顯示，乳癌病人承受多重的心理壓力，例如憂鬱、焦慮、失眠以及慢性疲憊等，因而護理人員在照顧乳癌病人過程，除了協助減少病人身體上的病痛外，亦應提供身、心理照護。文獻顯示，過去常被用於輔助改善精神症狀的認知行為治療，運用在乳癌病人也有其療效，在治療過程當中，藉由改變病人的認知模式，可有效減緩病人的心理壓力與困擾。本文探討乳癌所衍生的心理健康問題、引入認知行為治療、陳述認知行為治療運用在乳癌病人的成效，以及國外護理人員接受認知行為治療相關教育訓練的模式。透過國外成功的經驗，建議透過跨團隊合作機制，發展有關認知行為治療教育訓練課程等，以加強護理人員心理層面的照護技能，有效的緩解乳癌婦女的心理問題，提升整體照護品質。

Previous studies have shown that patients with breast cancer may suffer from symptoms of psychological distress, such as: depression, anxiety, insomnia, and chronic fatigue. Nurses are expected to offer physical and mental support to these patients. Cognitive behavior therapy (CBT) is commonly used in psychiatry as well as in the treatment of patients with breast cancer. CBT is believed to reduce mental distress in patients by changing their negative cognitive schema. The present article discusses the mental problems of patients with breast cancer and introduces the effects of using CBT on patients with breast cancer. Successful examples of training clinical nurses to apply CBT to the patients are introduced in order to facilitate the design of effective CBT training programs for nurses that improve professional knowledge and skills in dealing with the mental health problems of these patients and further enhance the quality of nursing care.