癌末病人憂鬱症之靈性照顧

Spiritual Care of Terminal Cancer Patients with Depression

釋慧岳(Hwei-Yue Bhikkhuni) ； 釋宗惇(Tsung-Tueng Bhikkhuni) ； 陳慶餘(Ching-Yu Chen)

《安寧療護雜誌》 12卷3期 (2007/08) Pp. 273-286

https://doi.org/10.6537/TJHPC.2007.12(3).2

摘要

癌症病人的憂鬱症是一般人的三倍，而高達六成的癌末病人曾經驗憂鬱症，四分之三的自殺事件中，憂鬱症列爲重要因素之一。幫助癌末病人善終是安寧緩和醫療的主要目標，能否有充份的死亡準備則與病人的善終息息相關。然而病人在死亡準備的過程中，憂鬱症與自殺事件的發生常會阻礙或中斷了病人的死亡準備。本報告就臨床佛教宗教師的角色來照顧癌末病人的憂鬱及其靈性課題，以期改善其生活品質，且能有充份的死亡準備以達到善終的目標。在研究方法上採用臨床個案和分析，提出生存法則之挫敗與自責是次發性憂鬱症病人主要原因。本土化的照顧模式，是從關係的建立開始，漸次加強家庭社會的支持，恢復自我尊嚴、改善自我放棄、舒緩不捨及完成心願等靈性課題，而解脫之道在於應用佛法提升內在力量，超越死亡恐懼。

關鍵字

臨床佛教宗教師 ； 癌末病人 ； 憂鬱症 ； 生存法則

並列摘要

People with cancer are three times more likely than the general public to experience a depressive disorder. In the advanced stages of cancer, the incidence of major depressive syndromes increases to 60%. Suicide events occur in 75% of patients with depression. Good death is the main goal of hospice palliative care. It is correlated with sufficient preparation for death. However, depression and suicide always distract patients from death preparation. The report introduces clinical Buddhist chaplains to take care of terminal cancer patients with depression by resolving their spiritual issues to improve their life quality and prevent them from committing suicide. The final goal is to help terminal cancer patients to make sufficient preparation for a good death. We adopt modified DSM-IV criteria to diagnose major depression in terminal cancer patients. Clinically, depressed patients can be effectively treated with combinations of enhancing social support, pharmacologic, psychotherapeutic, counseling, complementary, and cognitive-behavioral interventions. The study using cases report is intended to illustrate the way of clinical Buddhist chaplains to take care of terminal cancer patients with depression. Starting from building up good relationship with the patient, we gradually strengthen the family and social support, resolving spiritual issues such as low self-esteem, self-abandon, unwillingness, and unfinished wishes. We highlight the Buddhist way to get rid of suffering from depression mainly from defeated principle of survival and self-blame by enhancing the inner power to overcome the fear of death.

並列關鍵字

clinical Buddhist chaplain ； terminal cancer patient ； depression ； survival principle