透過您的圖書館登入
IP:34.228.168.200
  • 期刊

癌症末期併憂鬱症病人之心理治療:存在-認知模式初步建構

Psychotherapy among Terminal Cancer Patients with Major Depressive Disorder: The Preliminary Construction of Existential-Cognitive Model

摘要


在安寧緩和照顧中,處理癌症末期併憂鬱症病人是困難的,有關這類病人的心理治療少有文獻。本研究的目的包括:從存在-認知層面的心理治療來處遇癌症末期併憂鬱症病人,以及嘗試初步建構存在-認知心理治療模式。癌症末期病人,經由精神科醫師診斷爲憂鬱症,並在簽署知情同意書後,被轉介接受以存在-認知層面的心理治療。心理治療時全程數位錄音。文本爲心理治療的逐字稿。透過此在詮釋學,研究者充分地瞭解在心理治療中發生的事。文本以Colaizzi的七個步驟分析。 四位病人共有22個有效的文本。心理治療的介入時所呈現的主題,包括:確定病人的意識狀態、促進病情的自我察覺、察覺自動化負面思考、挑戰自動化負面思考、促進病人存在於當下、與病人共在、討論病人過去的生命意義以及促進病人建構當下的生命意義。心理治療後病人改變的因素,是治療者的同理心、尊嚴的對待、身體痛苦的改善、其他存在者的影響、病人當下的選擇、生命意義的整合、重新建構生命最後階段的存在意義,與愛的力量。由詮釋循環初步建構存在-認知心理治療。 對於癌症末期併憂鬱症病人而言,合併存在主義與認知方式的心理治療,能夠影響病人生命最後階段的認知。存在-認知心理治療的模式可能發展成處理這類病人的新方法。

並列摘要


It is difficult to manage terminal cancer patients with major depressive disorder (MDD) in hospice palliative care. The purposes of the study include finding the main themes of terminal cancer patients with MDD in existential-cognitive viewpoints, treating these patients in psychotherapy, and trying to construct the model of existential-cognitive psychotherapy. Terminal cancer inpatients diagnosed as MDD by psychiatrists and transferred to receive psychotherapies in existential-cognitive aspects after signing letters of informed consent. The whole courses of psychotherapies were digital-recorded. Texts were the verbatim of psychotherapies. According to dasein hermeneutics, the researcher gained full understandings of what happened during the psychotherapies. Texts were analyzed by the method of Colaizzi's seven steps. There were twenty two valid texts of all four patients. The themes during intervention of psychotherapies include ensuring the patient's consciousness, facilitating self-awareness of illness, being aware of automatic negative thoughts, challenging to automatic negative thoughts, facilitating patients to be here and now, being with patients, discussing patients’ previous meanings of life, and facilitating patients to construct the present meanings of life. The factors of patients' changes after psychotherapies are therapist's empathy, empowerment of dignity, improvement of physical suffering, affect by other beings, patients' choices at present, integration of the meaning of life, reconstructing the meaning of being in the final stage of life, and power of love. The existential issues terminal cancer patients with major depressive disorder are death, self-awareness, dignity, meaning and meaninglessness, autonomy and choice, and relations. Through hermeneutic circle, we try to preliminarily construct existential-cognitive psychotherapy. Psychotherapy that combined existential and cognitive approaches among the terminal cancer patients with major depressive disorder was able to affect the patients' cognition of being in their final stage of life. The model of existential-cognitive psychotherapy might develop a new way to deal with these patients.

被引用紀錄


葉宏恩(2008)。影響安寧病房成效因素的探討〔碩士論文,國立臺北大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0023-2907200810332700

延伸閱讀