與癌共處──正念於癌因性疲憊之臨床應用

Living With Cancer: Clinical Application of Mindfulness on Cancer-Related Fatigue

癌因性疲憊為癌症病人最常經歷且為時最久的不適症狀，影響病人產生諸多層面上的困擾，如身體、心理、情緒及認知等，大幅降低其生活品質。近年來身心整合醫學（mind-body integrative medicine）開始發展，實證研究陸續顯示，正念（mindfulness）可作為癌因性疲憊之症狀管理策略。因此本文透過文獻回顧，簡介癌因性疲憊的定義、評估及處置，並歸納整理正念的源起與相關概念，介紹正念運用於癌因性疲憊之相關實證處理策略與成效，如正念減壓（mindfulness-based stress reduction）及正念認知療法 （mindfulness-based cognitive therapy）等，藉此提供臨床工作者未來照護癌因性疲憊病人之參考。

Cancer-related fatigue is the most common and longest-lasting symptom of discomfort experienced by cancer patients. Its effects on patients include physical, psychological, emotional, and cognitive stress, which greatly reduce quality of life. The field of mind-body integrated medicine has improved gradually in recent years, with many evidence-based studies supporting the efficacy of mindfulness as a symptom management strategy for cancer-related fatigue. Based on a review of the literature, this paper introduces the definition of cancer-related fatigue and related assessments and treatments, describes the origin of mindfulness and related concepts, and introduces mindfulness-based empirical treatment strategies for cancer-related fatigue, including mindfulness-based stress reduction and mindfulness-based cognitive therapy, and their effects. The findings are intended to provide clinicians with a reference for the future care of patients with cancer-related fatigue.