淺談婦科癌症病人的心理困擾與支持－－不僅僅只是疾病

Talk About Psychological Distress and Support in Women With Gynecological Cancer: NOT Just the Disease

子宮頸癌、子宮體癌與卵巢癌是三種常見的婦科癌症。病人在診斷後常需接受一連串的治療，如：手術、化學治療，或放射線治療。然而，在診斷與治療後經常面臨後遺症的困擾，包括：停經症狀、不孕、性功能障礙、失禁、焦慮、憂鬱，甚至關係上的改變。家人與親密友人的支持可緩解病人在接受診斷與治療時的心理困擾，但是有些侵入性治療與隱私議題，如：陰道放射線治療、陰道擴張器使用、性功能障礙等，仍然是病人很難向家人分享的訊息，導致病人常孤獨地面對疾病和治療的衝擊。健康照護提供者應適時提供病人心理支持，主動詢問病人私密性的議題，並滿足病人對相關訊息的需求，以緩解病人心理壓力。健康照護者也可以提供一對一的諮詢，給予個別化的照護訊息，增加病人對自己健康狀態的了解。在疫情期間，病人可能因為自我隔離或病毒感染導致社交隔離或延遲癌症治療，醫療照護者也可以適時給予電話關懷，並提供相關治療訊息，增加病人的社會支持，緩解病人的心理困擾。

Cervical cancer, uterus cancer, and ovarian cancer are three common gynecological cancers. After diagnosis, the three therapeutic modalities available for treating gynecological cancers include surgery, chemotherapy, and radiotherapy. During the diagnostic and treatment periods, these patients usually suffer from physical and psychologic distresses, including menopausal symptoms, infertility, sexual dysfunction, incontinence, anxiety, depression, and relationship changes, among others. Support from family members and significant others has the potential to buffer the psychological distress perceived by patients with gynecological cancers. However, those patients who undergo invasive treatment modalities or have intimate issues such as brachytherapy, the need to use a vaginal dilator, and sexual dysfunction tend to conceal relevant information from their families or friends, which may increase self-perceived loneliness when facing the impacts of the disease and treatments. Healthcare providers may help alleviate patients’psychological stresses by providing psychological support in a timely manner, initiating discussions of intimate issues, and fulfilling patient needs for related information. In addition, healthcare providers may provide one-on-one counseling and individualized care information to increase patients’understanding of their health status. Furthermore, during the COVID-19 pandemic, patients may self-isolate to avoid becoming infected or to recuperate from a COVID-19 infection, causing social isolation or delays of cancer treatment. Healthcare providers may further place caring phone calls and provide treatment information to increase patients’social support and lessen their psychological distress.