心理調節措施在癌症患者身體心像改變及情緒困擾之成效－－系統性文獻回顧

The Effects of Psychological Adjustment Intervention on Body Image Change and Emotional Distress in Cancer Patients: A Literature Review

背景：癌症治療會造成外觀改變，進而影響身體心像及產生情緒困擾使生活品質降低，心理調節措施對於身體心像及情緒困擾成效尚不明確。目的：探討心理調節措施介入，對改善癌症患者身體心像改變及情緒困擾之成效。方法：以系統性文回顧法，使用「癌症」、「情緒困擾」、「身體心像」、「心理影響」、「心理調節」、「心理措施」、「心理成效」、「cancer」、「emotional distress」、「body image」、「psychological effects」、「psychological adjustment」、「psychologicalintervention」、「psychological effectiveness」等關鍵字進行搜尋2017年8月前之資料庫文獻，使用PubMed、Cochrane Library、MEDLINE、Embase、ProQuest、華藝線上圖書館等資料庫（CEPS），選取符合條件為改善身體心像及情緒困擾之心理調節為介入措施之隨機分派臨床試驗研究文章，共得五篇。結果：本文獻回顧五篇隨機臨床實驗之研究，共390位癌症患者接受心理調節措施，分別為乳癌、大腸直腸癌及頭頸癌患者。結果發現使用不同之心理調節措施如：外觀修飾、瑜伽、冥想及網站自我學習，其介入方案、持續時間及頻率皆有所不同，可改善身體心像及情緒困擾，但仍需較多樣本數及長時間追蹤評估其成效。結論／實務應用：整合文獻結果，臨床照護可運用外觀修飾、運動、冥想或網站自我學習等心裡調節措施，改善癌症病人的身體心像及情緒困擾。 Background: Anti-cancer treatments impact on appearance image and cause body image change andemotional distress, leading to poor quality of life. The effects of psychological adjustment interventionson body image change and emotional distress in cancer patients remaining unclear.Purpose: This paper reviewed the effects of psychological adjustment intervention on body image changeand emotional distress in cancer patients.Methods: Literature search was conducted in databases, including PubMed, Cochrane Library,MEDLINE, Embase, ProQuest, and Airiti Library using the keywords “cancer”, “emotional distress”,“body image”, “psychological adjustment”, “psychological intervention”, “psychological effectiveness”.The search limited articles published before August 2017. Based on the inclusion and exclusion criteria,five articles of relevant randomized controlled trials were extracted for review.Results: Three hundred and ninety cancer patients (breast cancer, colorectal cancer, and head and neckcancer) in the five randomized trial received psychological adjustment interventions. Different types ofpsychological adjustment intervention, including appearance modification, yoga, meditation and websiteself-learning, with various contents, duration, and frequency can improve body image changes andemotional distress. Further research with large sample size and long-term evaluation is required to verifythe effects of psychological adjustment intervention.Conclusions/Implications for practice: In clinical care, exercise, appearance modification, mindfulnessprogram or website self-learning can be applied in cancer patients for improving body image and reducingpsychological distress.