運用生命一致感貫穿癌症存活者及其家屬之情緒支持及照護策略

Applying Sense of Coherence to Guide the Emotional Support and Care Strategies of Cancer Survivors and Their Families

癌症照護與存活議題已成為全球公共衛生的重大挑戰。隨著治療進步與早期篩檢推廣，癌症存活者人數逐年增加。然而，即使治療結束，病人仍需面對身體副作用、復發恐懼與生活品質下降，其家屬照顧者亦承受長期心理與情緒壓力。因此，如何協助病人及家屬有效適應疾病影響並建立心理支持策略，已是臨床照護的重要課題。Antonovsky學者提出的「生命一致感」（sense of coherence）概念，提供理解病人與家屬在壓力中維持身心平衡的重要視角。生命一致感包含「可理解性」、「可掌控性」與「意義感」三大構面，能幫助個體將困境轉化為可承受且具意義的經驗，並針對三大面向提出具體策略：透過多層次同理提升可理解性，運用接受與承諾療法（acceptance and commitment therapy）技巧強化可掌控性，並以意義療法與價值澄清引導意義感重建。期望此「生命一致感」概念的運用能協助病人與家屬減輕情緒困擾，提升生活品質與心理韌性，並作為臨床護理師提供促進癌症存活者及其家屬獲得理解、力量與希望的實務指引。

Cancer care and survivorship have become critical global public health challenges. With advances in treatment and the promotion of early screening, the number of cancer survivors has been steadily increasing. However, after completing treatment, patients face physical side effects, fear of recurrence, and declines in quality of life, while their family caregivers endure long-term psychological and emotional stress. Therefore, helping patients and families adapt to the impacts of illness and establishing effective psychological support strategies are now key issues in clinical care. Antonovsky’s concept of the Sense of Coherence (SOC) provides an important framework for understanding how patients and families maintain psychological balance under stress. The three core components of SOC, namely comprehensibility, manageability, and meaningfulness, help individuals transform adversity into experiences that are both manageable and meaningful. Drawing on psycho-oncological research and clinical practice, concrete strategies are proposed in this paper for each of the three SOC components, with comprehensibility enhanced using multi-level empathy, manageability strengthened using techniques from Acceptance and Commitment Therapy, and meaningfulness fostered using meaning therapy and value clarification. The goal of this framework is to help patients and families reduce emotional distress, improve their quality of life and psychological resilience, and provide clinical nurses with practical guidance to help cancer survivors and their families gain understanding, strength, and hope.