與癌共處－正念於癌因性疲憊之臨床應用

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。

關鍵字

癌症；疲憊；癌因性疲憊；正念

並列摘要

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.

並列關鍵字

cancer ； fatigue ； cancer-related fatigue ； mindfulness

參考文獻

Banipal, R., Singh, H., & Singh, B. (2017). Assessment of cancer-related fatigue among cancer patients receiving various therapies: A cross-sectional observational study. Indian Journal of Palliative Care, 23(2), 207–211. https://doi.org/10.4103/IJPC.IJPC_135_16

Bower, J. E. (2014). Cancer-related fatigue–Mechanisms, risk factors, and treatments. Nature Reviews. Clinical Oncology, 11(10), 597–609. https://doi.org/10.1038/nrclinonc.2014.127

Chang, Y.-C., Lin, G.-M., Yeh, T.-L., Chang, Y.-M., Yang, C.-H., Lo, C., Yeh, C.-Y., & Hu, W.-Y. (2022). Impact of mindfulness-based stress reduction on female sexual function and mental health in patients with breast cancer. Supportive Care in Cancer, 30(5), 4315–4325. https://doi.org/10.1007/s00520-021-06540-y

Hann, D. M., Jacobsen, P. B., Azzarello, L. M., Martin, S. C., Curran, S. L., Fields, K. K., Greenberg, H., & Lyman, G. (1998). Measurement of fatigue in cancer patients: Development and validation of the Fatigue Symptom Inventory. Quality of Life Research, 7(4), 301–310. https://doi.org/10.1023/a:1024929829627

He, J., Hou, J.-H., Qi, J., Zhang, T., Wang, Y.-L., & Qian, M. (2020). Mindfulness ased stress reduction interventions for cancer related fatigue: A meta-analysis and systematic review. Journal of the National Medical Association, 112(4), 387–394. https://doi.org/10.1016/j.jnma.2020.04.006

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