心跳變異生理回饋在癌症存活者之療效

The Effect of Heart Rate Variability Biofeedback for a Cancer Survivor

10.6550/ACP.201712_11(2).0004

王三瑜(San Yu Wang)；林維君(Wei-Chun Lin)；林宜美(I-Mei Lin)；黃文聰(Wen-Tsung Huang)；馮雅瑄(Ya-Hsuan Feng)

癌症存活者 ； 心跳變異生理回饋 ； 生活品質 ； 身心症狀 ； cancer survivors ； heart rate variability biofeedback ； quality of life ； psychosomatic symptoms

臨床心理學刊

11卷1/2期（2017 / 12 / 01）

53 - 63

繁體中文

目的：探討心跳變異生理回饋（heart rate variability biofeedback, HRV-BF）在癌症存活者的生活品質與身心症狀之療效。方法：個案為50歲單身女性，診斷為降結腸惡性腫瘤，化療結束約三年，個案對疾病有許多反芻性焦慮伴隨身心症狀，醫師評估後安排每週一次、每次一小時的HRV-BF，共三次，並在訓練前後各進行一次身心壓力衡鑑，包括臨床晤談、心理量表，並將心電圖訊號轉換為自主神經功能指標。結果：HRV-BF後，個案的焦慮與憂鬱症狀改善、生活品質提升、身心症狀降低、自主神經平衡指標提升。整體呼吸可維持緩慢與規律的腹式呼吸，呼吸次數由15.33次／分降至5.33次／分。結論：HRV-BF有效改善癌症存活者的身心壓力症狀、負向情緒與提升生活品質。未來可增加樣本人數驗證HRV-BF在癌症存活者之療效。

Objective: This case study described the effect of heart rate variability biofeedback (HRVBF) for a cancer survivor. Methods: This case is a 50 years old female who was diagnosed with descending colon carcinoma. She has suffered from anxious apprehension and psychosomatic symptoms since the end of the chemotherapy three years ago. The client has received a psychophysiological assessment that included interview, the psychological questionnaires (Psychosomatic Symptoms Checklist, The World Health Organization Quality of Life-BREF, and Negative Emotions due to Chronic Illness Screening Test), and the examination of autonomic activation at pre-test and post-test. The raw signals of electrocardiograph were transformed to HRV as the index of the autonomic nervous system. The HRV-BF was administered 60 minutes each session weekly for 3 sessions. Results: The improvement in anxiety and depression, increased the life of quality, decreased psychosomatic symptoms, and increased the balance on the autonomic nervous system after HRV-BF training. Moreover, the stable, slow, deep, and regulatory of breathing patterns were maintain the abnormal breathing, the average breathing rate of this client was decreased from 15.33 breaths/min at pre-test to 5.33 breaths/min at posttest after HRV-BF. Conclusion: This case report revealed the beneficial effect of HRV-BF on decreasing the psychosomatic symptoms, negative emotion, and improved the quality of life for the client of a cancer survivor. Further study will be recruited more participants to confirmed the effect of HRV-BF for cancer survivors.

1. Burish, T. G.,Jenkins, R. A.(1992).Effectiveness of biofeedback and relaxation training in reducing the side effects of cancer chemotherapy.Health Psychology,11,17-23.
2. Burton, M.、Watson, M.、楊惠卿譯、張琦敏譯(2007)。癌症患者諮商手冊。新北市:心理。
3. Davis, H., IV(1986).Effects of biofeedback and cognitive therapy on stress in patients with breast cancer.Psychological Reports,59,967-974.
4. Harrington, C. B.,Hansen, J. A.,Moskowitz, M.,Todd, B. L.,Feuerstein, M.(2010).It's not over when it's over: Long-term symptoms in cancer survivors-A systematic review.The International Journal of Psychiatry in Medicine,40,163-181.
5. Huang, Y.-H.,Wu, C.-H.,Chen, H.-J.,Cheng, Y.-R.,Hung, F.-C.,Leung, K.-K.(2018).Quick screening tool for patients with severe negative emotional reactions to chronic illness: Psychometric study of the negative emotions due to Chronic Illness Screening Test (NECIS).Family Practice,35,34-40.
6. Kim, K. S.,Lee, S. W.,Choe, M. A.,Yi, M. S.,Choi, S.,Kwon, S. H.(2005).Effects of abdominal breathing training using biofeedback on stress, immune response and quality of life in patients with a mastectomy for breast cancer.Journal of Korean Academy of Nursing,35,1295-1303.
7. Lazarus, R. S.,Folkman, S.(1984).Stress, appraisal, and coping.New York:Springer.
8. Lehrer, P. M.,Gevirtz, R.(2014).Heart rate variability biofeedback: How and why does it work?.Frontiers in Psychology,5
9. Lehrer, P. M.,Vaschillo, B.,Zucker, T.,Graves, J.,Katsamanis, M.,Aviles, M.(2013).Protocol for heart rate variability biofeedback training.Biofeedback,41,98-109.
10. Lehrer, P. M.,Vaschillo, E.,Vaschillo, B.(2000).Resonant frequency biofeedback training to increase cardiac variability: Rationale and manual for training.Applied Psychophysiology and Biofeedback,25,177-191.
11. Lin, I.-M.,Fan, S.-Y.,Lu, H.-C.,Lin, T.-H.,Chu, C.-S.,Kuo, H.-F.(2015).Randomized controlled trial of heart rate variability biofeedback in cardiac autonomic and hostility among patients with coronary artery disease.Behaviour Research and Therapy,70,38-46.
12. Mao, J. J.,Armstrong, K.,Bowman, M. A.,Xie, S. X.,Kadakia, R.,Farrar, J. T.(2007).Symptom burden among cancer survivors: Impact of age and comorbidity.Journal of the American Board of Family Medicine,20,434-443.
13. O'Rourke, M. A.,Stokes, S.,Regina, F.,Susko, K.,Hendry, W.,Anderson, A.(2017).Heart rate variability (HRV) training for symptom control in cancer survivors.Journal of Clinical Oncology,35(Suppl. 5),148.
14. Pachman, D. R.,Barton, D. L.,Swetz, K. M.,Loprinzi, C. L.(2012).Troublesome symptoms in cancer survivors: Fatigue, insomnia, neuropathy, and pain.Journal of Clinical Oncology,30,3687-3696.
15. Schroevers, M. J.,Ranchor, A. V.,Sanderman, R.(2004).The role of age at the onset of cancer in relation to survivors' long-term adjustment: A controlled comparison over an eight-year period.Psycho-Oncology,13,740-752.
16. Shaffer, F.,Ginsberg, J. P.(2017).An overview of heart rate variability metrics and norms.Frontiers in Public Health,5
17. Stein, K. D.,Syrjala, K. L.,Andrykowski, M. A.(2008).Physical and psychological longterm and late effects of cancer.Cancer,112,2577-2592.
18. Tatrow, K.,Montgomery, G. H.(2006).Cognitive behavioral therapy techniques for distress and pain in breast cancer patients: A meta-analysis.Journal of Behavioral Medicine,29,17-27.
19. 林宜美、紀慧菁、Peper, E.、張娟鳳(2014)。聚光燈下的鹿：壓力性頭腦空白症候群與心身反應之關係。高雄行為科學學刊，4，115-140。
20. 姚開屏(2002)。台灣版世界衛生組織生活品質問卷之發展與應用。台灣醫學，6，193-200。

1. 何翎毓,王鶯璇(2021)。生理回饋於臨床治療及個人健康管理之應用。諮商與輔導，424，4-7+20。