談癌症病人家屬照顧者心理衝擊與介入方案

Psychological Impact of Nursing Interventions for Family Caregivers of Patients with Cancer

方圓媛(Yuan-Yuan Fang) ； 洪佳黛(Chia-Tai Hung) ； 詹瑞君(Jui-Chun Chan) ； 李芸湘(Yun-Hsiang Lee)

《榮總護理》 34卷3期 (2017/09) Pp. 220-226

https://doi.org/10.6142/VGHN.34.3.220

摘要

癌症診斷不僅對病人造成諸多負向情緒的影響，對家屬來說，也會因家人罹癌而經歷一連串無助、焦慮、憂鬱及不確定感等錯綜複雜的情緒衝擊。由於癌症治療多轉由門診治療模式，病人返家後照護責任已落在家屬照顧者身上，生活面臨更多的壓力與考驗，這些影響也會再影響癌症病人的情緒。因此，家屬照護者也列入癌症照護品質提升的重點對象之一。本文整理2013至2016年緩解癌症家屬照顧者心理衝擊之隨機控制實證研究，瞭解癌症病人家屬照顧者的心理衝擊狀況及重要的影響因素，結果發現多元介入措施是現今的癌症照護趨勢，包括同時提供症狀照護技巧、壓力與情緒調節及社會支持等，對照顧者的心理衝擊具短期改善之效果。建議未來應著重介入措施長期成效之研究設計，以發展本土化家屬照顧者心理衝擊緩解之照護模式，建構更貼近本國癌症病人家屬照顧者之臨床照護指引。

關鍵字

癌症 ； 家屬照顧者 ； 心理衝擊 ； 介入方案

並列摘要

When they receive a cancer diagnoses, the psychological stability of patients with cancer and their family caregivers is threatened. Patients and their family caregivers experience a series of complex psychological effects such as hopelessness, anxiety, depression, and uncertainty. Because increasingly more cancer treatments are becoming accessible in outpatient departments, obligations and tasks related to patient care at home are often the responsibility of family caregivers, and this adds pressure and challenges to the lives of caregivers. In addition, because such a burden on caregivers has been proven to adversely affect patients' psychological perceptions, family caregivers have become a key target in improving the quality of cancer care. This review article aims to generate an understanding of the interventions used to reduce family caregivers' psychological burden and related critical factors. For this purpose, this article examines only grade A (level-I) evidence-based studies conducted in the preceding 5 years that performed randomized controlled trials to mitigate the psychological burden of family caregivers of patients with cancer. After 10 studies has been selected and organized, the findings showed that multiple interventions combining symptom management, adaptation to stress and emotion, and social support constituted a trend in cancer care. However, these studies have only analyzed the short-term effects of such interventions on mitigating caregivers' psychological burden. Therefore, further research is required to examine the longitudinal effects of interventions. A suitable clinical care guideline should be established for families in Taiwan who care for patients with cancer.

並列關鍵字

cancer ； family caregiver ； psychological impact ； intervention

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