四週正念介入方案對癌症病人失眠之影響效果初探

The Effectiveness of a Four-Week Mindfulness-Based Intervention for Cancer Patients on Insomnia: A Preliminary Study

10.6550/ACP.202406_18(1).0001

石世明(Shih-Ming Shih)；洪世凱(Shih-Kai Hung)；陳良政(Liang-Cheng Chen)；鄧閔鴻(Min-Hung Teng)

癌症 ； 失眠 ； 正念 ； 短期介入方案 ； 心理腫瘤照顧 ； cancer ； insomnia ； mindfulness ； short-term intervention ； psycho-oncology care

臨床心理學刊

18卷1期（2024 / 06 / 01）

1 - 17

繁體中文;英文

目的：失眠是影響癌症病人生活品質的重要因素，目前以非藥物處理此問題的方式有限，且難以考慮到癌症病人失眠的特殊性。本探索性研究包含發展與執行四週正念介入方案，據此評估方案對癌症失眠相關議題的介入結果。方法：透過在地區醫院進行三梯次的四週正念介入方案，最後共7位癌症病人完成此方案，透過失眠嚴重度量表、睡前激發量表、癌症病人心理適應量表、貝克焦慮與憂鬱量表，進行前後測比較。結果：病人的失眠嚴重度和睡前認知激發在介入後有下降趨勢，但未達統計顯著，焦慮、憂鬱和以憂思盤踞為主的心理調適模式，則有明顯改善，睡前認知激發與失眠嚴重度在前、後測的變化呈顯著正相關，焦慮、憂思盤據的變化亦與睡前身體激發變化呈顯著正相關。結論：考量癌症病人失眠特殊性的前提下，所設計的四週正念介入方案，對病人具有適用性，對專業照顧者具有運用的便利性，可作為提供腫瘤心理照顧服務的一項選擇。

Purpose: Insomnia is an important factor affecting the quality of life of cancer patients. At present, non-pharmacological interventions for this issue in Taiwan are limited, and it is difficult to consider the particularity of insomnia in cancer patients. This study proposes a four-week mindfulness-based intervention program and reports the results of this intervention on insomnia related issues for cancer patients. Methods: A total of 7 cancer patients completed the program from three stress reduction groups in a regional hospital. The effects of the program were evaluated with patient-report measures of the Insomnia Severe Index (ISI), the pre-sleep arousal scale (PSAS), the Mini-Mental Adjustment to Cancer (Mini-MAC) scale, Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI) scale. Results: ISI and PSAS scores indicated a downward trend of insomnia after intervention although no significant differences were found from baseline-to-post. The scores of BAI, BDI and anxious preoccupation subscale of Mini-MAC were significantly reduced. The differences between pre- and post PSAS scores were positively correlated with the pre- and post-changes of ISI scores. The differences between pre- and post-BAI and anxious preoccupation scores were positively correlated with the pre- and post-changes of pre- sleep somatic scores. Conclusions: This four-week intervention program designed under the premise of particularity of cancer insomnia is applicable to patients and could be easily applied by health care professionals. It is suggested that this four-week mindfulness intervention program could serve as one of the options for psycho-oncology care.