為什麼我這麼努力，癌症還是復發？癌末病人的目標調適

Why Have I been Making Efforts to Treat, Cancer Still Recurrents? Terminal Cancer Patient's Goal Adjustment.

10.6537/TJHPC.2017.22(1).8

林亭妤(Ting-Yu Lin)；鄭逸如(Yih-Ru Cheng)；張琦郁(Chi-Yu Chan)；楊于婷(Yu-Ting Yang)；張安華(An-Hua Chang)

癌末病人 ； 自我調節理論 ； 目標調適 ； 安寧緩和醫療 ； terminal cancer patient ； self-regulation theory ； goal adjustment ； hospice palliative care

安寧療護雜誌

22卷1期（2017 / 03 / 01）

97 - 107

繁體中文

本文整理在安寧緩和醫療病房，臨床心理師陪伴癌末病人的歷程，帶出癌末病人重要的目標調適議題。癌症病人在被診斷癌症後，可能面臨到維持健康的目標與現實產生了落差，尤其當癌症復發，疾病持續進展，終至生命末期，病人將遭遇更多的困難。若病人不能隨著客觀病況的改變而適時調整，仍是以維持健康和治癒癌症為目標，則可能會有不甘和憤怒的情緒；反之，若病人能在延續生命價值和完整自我的前提下，不見得要放棄目標，在維持原目標的同時建立新目標，或是轉換原目標下的計畫方式，將有助於走向心理安適和善終。

In this article, we summarized the psychological care processes of a terminal cancer patient in a hospice ward. The processes brought us to concern about the critical issue of terminal cancer patients' goal adjustment. After cancer diagnosed, patients might face the gap between staying health and reality. In particular, when the recurrence and progression of cancer threaten their lives, patients will suffer lots of difficulties in reaching original goals. If terminal patients kept their goals to stay health and cure rather than adjusting their goals properly with the object statement of illness, they might be reluctant and angry. On the contrary, if terminal patients adjusted their goals properly, not only based on their current disease statement but also on the basis of continuing the value of life and complete themselves, they might get more psychological well-beings and come to a good dying.

1. Adler, A,黃光國（譯）(1989).自卑與超越.臺北:志文出版社.
2. Brandtstadter, J,Rothermund, K(2002).The life-course dynamics of goal pursuit and goal adjustment: a two-process framework.DEV REV,22,117-150.
3. Carver, CS,Scheier, MF(2000).Scaling back goals and recalibration of the affect system are processes in normal adaptive self-regulation: understanding "response shift"phenomena.SOC SCI MED,50,1715-1722.
4. Carver, CS,Scheier, MF(1990).Origins and Functions of positive and negative affect: A control-process view.PSYCHOL REV,97,19-35.
5. Carver, CS,Sutton, SK,Scheier, MF(2000).Action, emotion, and personality: Emerging conceptual integration.PERS SOC PSYCHOL B,26,741-751.
6. Hullmann, SE,Robb, SL,Rand, KL(2016).Life goals in patients with cancer: a systematic review of the literature.PSYCH-ONCOL,25,387-399.
7. Lam, WWT,Yeo, W,Suen, J(2016).Goal adjustment influence on psychological well-being following advanced breast cancer diagnosis.PSYCH-ONCOL,25,58-65.
8. Offerman, MPJ,Schroevers, MJ,van der Velden, L,de Boer, MF,Pruyn, JFA(2010).Goal processes and self-efficacy related to psychological distress in head and neck cancer patients and their partners.EUR J ONCOL NURS,14,231-237.
9. Schroevers, M,Kraaij, V,Garnefski, N(2008).How do cancer patients manage unattainable personal goals and regulate their emotions?.BRIT J HEALTH PSYCH,13,551-562.
10. Schroevers, MJ,Kraaij, V,Garnefski, N.(2011).Cancer patients’ experience of positive and negative changes due to the illness: Relationships with psychological well-being, coping, and goal reengagement.PSYCH-ONCOL,20,165-172.
11. Thompson, E,Stanton, AL,Bower, JE(2013).Situational and dispositional goal adjustment in the context of metastatic cancer.J PERS,81,441-451.
12. Wrosch, C,Scheier, MF,Carver, CS(2003).The importance of goal disengagement in adaptive self-regulation: when giving up is beneficial.SEL IDEN,2,1-20.
13. 白欣宜(2013)。臺北，臺灣大學心理學研究所。
14. 行政院內政部統計處。最新統計指標平均壽命/全體。2016 年 8 月 10 日，取自http://www.moi.gov.tw/stat/chart.aspx?ChartID=S0601
15. 楊格政(2010)。新北，輔仁大學心理學研究所。