非癌病人與癌症病人於居家安寧心理照護需求之差異

目的：目前僅有相當少數的非癌末期病人使用安寧緩和照護。然而疾病過程中經歷到的生理症狀與心理、靈性的需求，並不亞於癌症病人，且返家後同樣會面臨疾病適應與壓力因應議題。因此，本研究欲分析非癌病人及家屬在生命末期心理照護議題上的現況及與癌症病人的差異。方法：採用次級資料分析法分析2019年1月至2020年3月底，臺北市某區域醫院於居家安寧階段的受試者共169位，其中非癌病人有78人，癌症病人有91人。所有受試者皆評估其人口學變項、心理服務項目與臨床醫療變項。結果：非癌病人與癌症病人在以病人本身及家屬為主要服務對象時，其心理照護議題皆以情緒困擾為主。其比例分別為非癌病人61.9%，癌症病人59.6%；非癌病人家屬35.7%，癌症病人家屬40.0%。然而，兩群病人在家庭為主的心理照護議題有部分相異。非癌病人以家庭溝通（50.0%）為主，其次是壓力因應（36.4%）；癌症病人則以情緒困擾（22.0%）為主，再來是醫病溝通（22.0%）。結論：癌症病人及非癌病人在自身、家屬與家庭同樣需要心理照護之協助，且議題有所異同。因此，針對非癌病人之特定需求提供全面且深入的心理專業服務，在居家安寧照護中甚為重要。

關鍵字

非癌病人；心理照護；居家安寧療護；癌症病人

並列摘要

Purpose: Only a small number of non-cancer patients use palliative care. However, those patients experience physical symptoms, psychological and spiritual needs during the disease process like cancer patients. When non-cancer patients return home, they will still face life adaptation and stress adjustment situation. This study thus aims to further compare the difference between non-cancer and cancer patients’ psychological issues. Method: This study used the secondary data analysis to examine the psychological records for patients with palliative care. A total of 169 participants who had accepted home-based palliative care with psychological services were enrolled in this study from January 2019 to the end of March 2020, of which 78 were non-cancer patients and 91 were cancer patients. The demographic, psychological issues and clinical variables were recorded by the psychologists. Result: The results show both non-cancer patients and cancer patients and their relatives have issues with emotional distress. The portion of non-cancer patients is 61.9%, cancer patients is 59.6%. The portion of non-cancer patients' relatives is 35.7%, cancer patients' relatives is 40.0%. On the other hand, non-cancer patients' family mostly have issues of family communication (50.0%) and pressure adjustment (36.4%), while cancer patients mostly have issues with emotional distress (22.0%) and communication between doctors and patients (22.0%). Conclusion: Patients and families with non-cancer diseases both need psychological cares. Therefore, provide psychological cares to non-cancer patients is important in home-based palliative care.

並列關鍵字

non-cancer patients ； psychological care ； palliative care ； cancer patients

參考文獻

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陳明玉。癌症末期病人主要照顧者壓力負荷與家庭功能之相關性探討－以安寧居家照護為例。台中：中國醫藥大學醫務管理學系碩士班學位論文，2010。doi:10.6830/CMU.2010.00098

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非癌病人與癌症病人於居家安寧心理照護需求之差異

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