應用自我調節模式於癌症病人害怕復發之處置

Applying the Self-Regulation Model to Manage the Fear of Recurrence in Cancer Patients

陳彥汝(Yen-Ju Chen) ； 陳淑卿(Shu-Ching Chen) ； 賴裕和(Yeur-Hur Lai) ； 李芸湘(Yun-Hsiang Lee)

《台灣醫學》 19卷1期 (2015/01) Pp. 91-98

https://doi.org/10.6320/FJM.2015.19(1).13

摘要

害怕復發為多數完成癌症治療療程的存活者最關心的議題，害怕復發為擔心、害怕癌症會再次發生，具有負面的情緒感受與侵入式思考的特質，造成病人長期的心理困擾，影響日常行為的表現，然而，若能有效的調適及因應害怕復發，則可提升生活品質，逐漸回到健康的生活型態，因此，臨床醫護人員需具備評估存活者關注害怕復發的能力，判斷病人對疾病的詮釋及其因應策略，藉由醫護人員的介入與指導，協助其存活期的調適。本文以Leventhal的自我調節模式，介紹疾病詮釋、因應策略與評價，提出具體的措施，協助病人能正向詮釋疾病、採取有效的因應策略與評價等，並期望能提升醫護人員對於害怕復發的認識與察覺度，促進病人在存活期有良好的因應與適應。

關鍵字

癌症 ； 害怕復發 ； 自我調節

並列摘要

Fear of recurrence is the worry and fear that cancer will come back again after treatment. It is the primary concern of cancer survivors. The characteristics of fear of recurrence consist of negative emotional perceptions and intrusive thoughts, and it adversely impacts psychological distress and daily behavioral performance. However, effective adaptation and coping with fear of recurrence may help patients to enhance their quality of life and return to a healthy life style. Therefore, to help patients better cope with the fear of recurrence, clinical experts need to have the skills to assess fear of recurrence, and appraise patients' interpretation of disease and coping strategies in order to design further intervention. This article applies Leventhal's self-regulation model to describe the interpretation of disease, coping strategies and appraisal. Specific recommendations for caring interventions are provided to help patients develop a positive interpretation of disease, and to adopt effective coping strategies and appraisal. This article includes information to improve clinical experts' ability to recognize the fear of recurrence and to enhance patients' coping and adaptive skills during survivorship.

並列關鍵字

cancer ； fear of recurrence ； self-regulation

參考文獻

1. Baker F, Denniston M, Smith T, et al: Adult cancer survivors: how are they faring? Cancer 2005;104:2565-76.

2. Martini N, Bains MS, Burt ME, et al: Incidence of local recurrence and second primary tumors in resected stage I lung cancer. J Thorac Cardiovasc Surg 1995;109:120-9.

3. Scott WJ, Howington J, Feigenberg S, et al: Treatment of non-small cell lung cancer stage I and stage II: ACCP evidence-based clinical practice guidelines (2nd edition). Chest 2007;132:234S-242S.

4. Silvestri GA, Tanoue LT, Margolis ML, et al: The noninvasive staging of non-small cell lung cancer: the guidelines. Chest 2003;123:147S- 156S.

5. Poon RT: Prevention of recurrence after resection of hepatocellular carcinoma: a daunting challenge. Hepatology 2011;54:757-9.