O'Hayer Catherine Virginia F, O'Hayer Kevin Mitchell, Sama Ashwin
Department of Psychiatry, Drexel University College of Medicine, Philadelphia, Pennsylvania.
Department of Medical Oncology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
J Pancreat Cancer. 2018 Jan 1;4(1):1-3. doi: 10.1089/pancan.2017.0021. eCollection 2018.
This case study examines the feasibility of application of an acceptance-based behavioral therapy, acceptance and commitment therapy (ACT), to a patient with end-stage metastatic pancreatic cancer, depression, and anxiety, as a form of integrative palliative care. ACT allowed the patient to identify her values of resuming her religious connection, improving relationships with family members and trusted friends, and organizing her affairs before death. As a result, the patient was able to remain engaged in cancer treatments despite side effects that she had previously deemed intolerable. She was able to move toward her values despite health-related and depression-related obstacles. Furthermore, she successfully reconnected with her religious faith, and with her parents, spent time with her family, and deepened relationships with close friends before her death. Her quality of life was much improved by a combination of ACT and cancer treatments, suggesting that ACT may be a feasible mental health adjunct for palliative care in end-stage pancreatic cancer. ACT was well received by this patient with metastatic pancreatic cancer, improving ability to cope with anxiety, depression, and treatment side effects, thereby accepting and managing her cancer more effectively.
本案例研究探讨了将基于接纳的行为疗法——接纳与承诺疗法（ACT）应用于一名晚期转移性胰腺癌伴抑郁和焦虑患者的可行性，作为综合姑息治疗的一种形式。ACT使患者能够明确自己的价值观，即恢复宗教联系、改善与家庭成员及信任的朋友的关系，以及在死前安排好自己的事务。结果，尽管患者之前认为某些副作用无法忍受，但她仍能继续接受癌症治疗。尽管存在与健康和抑郁相关的障碍，她仍能够朝着自己的价值观迈进。此外，她在去世前成功地重新找回了宗教信仰，与父母重新建立联系，与家人共度时光，并加深了与亲密朋友的关系。ACT与癌症治疗相结合，使她的生活质量得到了显著改善，这表明ACT可能是晚期胰腺癌姑息治疗中一种可行的心理健康辅助疗法。这位转移性胰腺癌患者对ACT反应良好，提高了应对焦虑、抑郁和治疗副作用的能力，从而更有效地接受和应对自己的癌症。
