• 四川大學華西醫(yī)院腫瘤中心（成都，610041）;

【摘要】　 隨著醫(yī)學模式從傳統(tǒng)的醫(yī)學模式向生物-心理-社會醫(yī)學模式轉(zhuǎn)變，心理因素越來越受到醫(yī)學界的重視，雖然腫瘤患者的心理痛苦問題普遍存在，但在臨床工作中卻常常被忽視。因此，需要選擇合適的篩查工具對腫瘤患者的心理痛苦進行評估，并根據(jù)評估結(jié)果結(jié)合相應的臨床表現(xiàn)實施恰當?shù)男睦砀深A和（或）心理治療，以降低腫瘤患者的心理痛苦水平，提高其生存質(zhì)量。

引用本文： 鄭儒君,李俊英. 腫瘤患者心理痛苦評估與治療研究進展. 華西醫(yī)學, 2011, 26(8): 1264-1267. doi: 復制

1. 　張葉寧, 張海偉, 宋麗莉, 等. 心理痛苦溫度計在中國癌癥患者心理痛苦篩查中的應用[J]. 中國心理衛(wèi)生雜志, 2010, 24(12): 897-902.
2. 　Fallowfield L, Ratcliffe D, Jenkins V,et al. Psychiatric morbility and its recognition by doctors in patients with cancer[J]. Br J Cancer, 2001, 84(8): 1011-1015.
3. 　韓靜, 劉均娥, 孟潔, 等. 癌癥患者心理困擾程度及相關(guān)原因分析[J]. 中華護理雜志, 2008, 43(6): 516-518.
4. 　魏曾曾, 王維利. 腫瘤患者心理困擾管理研究現(xiàn)狀及本土化思考[J]. 醫(yī)學與哲學(臨床決策論壇版), 2010, 31(9): 52-54.
5. 　褚倩, 于世英. NCCN憂傷治療臨床指引[J]. 循證醫(yī)學, 2007, 7(1): 38-53.
6. 　Shneidman ES. Perspectives on suicidology: further reflections on suicide and psychache[J]. Suicide & life-threatening behavior, 1998, 28(3): 245-250.
7. 　Berlim MT, Mattevi BS, Pavanello DP, et al. Psychache and suicidality in adult mood disordered outpatients in Brazil[J]. Suicide Life Threat Behav, 2003, 33(3): 242-248.
8. 　Mitchell AJ. Short screening tools for cancer-related distress: a review and diagnostic validity meta-analysis[J]. J Natl Compr Canc Netw, 2010, 8(4): 487-494.
9. 　Wang GL, Hsu SH, Feng AC, et al. The HADS and the DT for screening psychosocial distress of cancer patients in Taiwan. Psychooncology[J]. 2011, 20(6): 639-646.
10. 　Carr D, Goudas L, Lawrence D, et al. Management of cancer symptoms: pain, depression, and fatigue[M]. Rockville(MD): Agency for Healthcare Research and Quality(US), 2002: 9-19.
11. 　Zabora J, BrintzenhofeSzoc K, Curbow B, et al. The prevalence of psychological distress by cancer site[J]. Psychoonchology, 2001, 10(1): 19-28.
12. 　Adler NE, Page NEK. Cancer care for the whole Patient: Meeting Psychosocial Health Needs[M]. Washington(DC): National Academies Press(US), 2008: 219-240.
13. 　Bultz BD, Holland JC. Emotional distress in patients with cancer: the sixth vital sign[J]. Commun Oncol, 2006, 3(5): 311-314.
14. 　Moorey S, Greer S,Bliss J, et al. A comparison of adjuvant psychological therapy and supportive counseling in patients with cancer[J]. Psychooncology, 1998, 7(3): 218-228.
15. 　Gielissen MF, Verhagen CA, Bleijenberg G. Cognitive behavior therapy for fatigued cancer survivors: long-term follow-up. Br J Cancer, 2007, 97(5): 612-618.
16. 　Ahles TA, Saykin AJ. Candidate mechanisms for chemotherapy-induced cognitive changes[J]. Nat Rev Cancer, 2007, 7(3): 192-201.
17. 　Sood A, Barton DL, Loprinzi CL. Use of methylphenidate in patients with cancer[J]. Am J Hosp Palliat Care, 2006, 23(1): 35-40.
18. 　Kohli S, Fsher SG, Tra Y, et al. The effect of modafinil on cognitive function in breast cancer survivors[J]. Cancer, 2009, 115(12): 2605-2616.
19. 　Shaw EG, Rosdhal R, D’Agostino RB Jr, et al. Phase Ⅱ study of donepezil in irradiated brain tumor patients: effect on cognitive function, mood, and quality of life[J].J Clin Oncol, 2006, 24(9): 1415-1420.
20. 　Ferguson RJ, Ahles TA, Saykin AJ, et al. Cognitive-behavioral management of chemotherapy-related cognitive change[J]. Psycho-onchology, 2007, 16(8): 772-777.
21. 　Goodwin PJ, Leszcz M, Ennis M, et al. The effect of group psychosocial support on survival in metastatic breast cancer[J]. N Engl J Med, 2001, 345(24): 1719-1726.
22. 　Kissane DW, Grabsch B, Clarke DM, et al. Supportive-expressive group therapy for women with metastatic breast cancer: survival and psychosocial outcome from a randomized controlled trial[J]. Psycho-Oncology, 2007, 16(4): 277-286.
23. 　Kissane DW, Bloch S, Smith GC, et al. Cognitive-existential group psychotherapy for women with primary breast cancer: a randomized controlled trial[J]. Psychooncology, 2003, 12(6): 532-546.
24. 　Kissane DW, McKenzie M, Bloch S, et al. Family focused grief therapy: a randomized, controlled trial in palliative care and bereavement[J]. Am J Psychiatry, 2006, 163(7): 1208-1218.
25. 　Manne SL, Ostroff JS, Norton TR, et al. Cancer-related relationship communication in couples coping with early stage breast cancer[J]. Psychoonchology, 2006, 15(3): 234-247.
26. 　Breitbart W. Identifying patients at risk for, and treatment of major psychiatric complications of cancer[J]. Support Care Cancer, 1995, 3(1): 45-60.
27. 　American Pain Society Quality of Care Committee. Quality improvement guidelines for the treatment of acute pain and cancer pain[J]. JAMA, 1995, 274(23): 1874-1880.
28. 　Back AL, Arnold RM, Baile WF, et al. Approaching difficult communication tasks in oncology[J]. CA Cancer J Clin, 2005, 55(3): 164-177.
29. 　Ryan H, Schofield P, Cockburn J, et al. How to recognize and manage psychological distress in cancer patients[J]. Eur J Cancer Care(Engl), 2005, 14(1): 7-15.
30. 　Lawlor PG, Gagnon B, Mancini IL, et al. Occurrence, causes, and outcome of delirium in patients with advanced cancer: a prospective study[J]. Arch Intern Med, 2000, 160(6): 786-794.
31. 　Misono S, Weiss NS, Fann JR, et al. Incidence of suicide in persons with cancer[J]. J Clin Oncol, 2008, 26(29): 4731-4738.
32. 　Miller M, Mogun H, Azrael D, et al. Cancer and the risk of suicide in older Americans[J]. J Clin Oncol, 2008, 26(29): 4720-4724.
33. 　Stark D, Kiely M, Smith A, et al. Anxiety disorders in cancer patients: their nature, associations, and relation to quality of life[J]. J Clin Oncol, 2002, 20(14): 3137-3148.
34. 　Williams S, Dale J. The effectiveness of treatment for depression/depressive symptoms in adults with cancer: a systematic review[J]. Br J Cancer, 2006, 94(3): 372-390.
35. 　Wald TG, Kathol RG, Noyes R Jr, et al. Rapid relief of anxiety in cancer patients with both alprazolam and placebo[J]. Psychosomatics, 1993, 34(4): 324-332.
36. 　Fisch MJ, Loehrer PJ, Kristeller J, et al. Fluoxetine versus placebo in advanced cancer outpatients: a double-blinded trial of the Hoosier Oncology Group[J]. J Clin Oncol, 2003, 21(10): 1937-1943.
37. 　Rankin NM, Barron JA, Lane LG, et al. Psychosocial oncology services in New South Wales[J]. Aust Health Rev, 2011, 35(2): 156-163.
38. 　黃曉蘭. 影響化療患者心理健康相關(guān)因素調(diào)查與護理干預[J]. 臨床心身疾病雜志, 2008, 5(14): 472-474.
  1. 1. 　張葉寧, 張海偉, 宋麗莉, 等. 心理痛苦溫度計在中國癌癥患者心理痛苦篩查中的應用[J]. 中國心理衛(wèi)生雜志, 2010, 24(12): 897-902.
  2. 2. 　Fallowfield L, Ratcliffe D, Jenkins V,et al. Psychiatric morbility and its recognition by doctors in patients with cancer[J]. Br J Cancer, 2001, 84(8): 1011-1015.
  3. 3. 　韓靜, 劉均娥, 孟潔, 等. 癌癥患者心理困擾程度及相關(guān)原因分析[J]. 中華護理雜志, 2008, 43(6): 516-518.
  4. 4. 　魏曾曾, 王維利. 腫瘤患者心理困擾管理研究現(xiàn)狀及本土化思考[J]. 醫(yī)學與哲學(臨床決策論壇版), 2010, 31(9): 52-54.
  5. 5. 　褚倩, 于世英. NCCN憂傷治療臨床指引[J]. 循證醫(yī)學, 2007, 7(1): 38-53.
  6. 6. 　Shneidman ES. Perspectives on suicidology: further reflections on suicide and psychache[J]. Suicide & life-threatening behavior, 1998, 28(3): 245-250.
  7. 7. 　Berlim MT, Mattevi BS, Pavanello DP, et al. Psychache and suicidality in adult mood disordered outpatients in Brazil[J]. Suicide Life Threat Behav, 2003, 33(3): 242-248.
  8. 8. 　Mitchell AJ. Short screening tools for cancer-related distress: a review and diagnostic validity meta-analysis[J]. J Natl Compr Canc Netw, 2010, 8(4): 487-494.
  9. 9. 　Wang GL, Hsu SH, Feng AC, et al. The HADS and the DT for screening psychosocial distress of cancer patients in Taiwan. Psychooncology[J]. 2011, 20(6): 639-646.
  10. 10. 　Carr D, Goudas L, Lawrence D, et al. Management of cancer symptoms: pain, depression, and fatigue[M]. Rockville(MD): Agency for Healthcare Research and Quality(US), 2002: 9-19.
  11. 11. 　Zabora J, BrintzenhofeSzoc K, Curbow B, et al. The prevalence of psychological distress by cancer site[J]. Psychoonchology, 2001, 10(1): 19-28.
  12. 12. 　Adler NE, Page NEK. Cancer care for the whole Patient: Meeting Psychosocial Health Needs[M]. Washington(DC): National Academies Press(US), 2008: 219-240.
  13. 13. 　Bultz BD, Holland JC. Emotional distress in patients with cancer: the sixth vital sign[J]. Commun Oncol, 2006, 3(5): 311-314.
  14. 14. 　Moorey S, Greer S,Bliss J, et al. A comparison of adjuvant psychological therapy and supportive counseling in patients with cancer[J]. Psychooncology, 1998, 7(3): 218-228.
  15. 15. 　Gielissen MF, Verhagen CA, Bleijenberg G. Cognitive behavior therapy for fatigued cancer survivors: long-term follow-up. Br J Cancer, 2007, 97(5): 612-618.
  16. 16. 　Ahles TA, Saykin AJ. Candidate mechanisms for chemotherapy-induced cognitive changes[J]. Nat Rev Cancer, 2007, 7(3): 192-201.
  17. 17. 　Sood A, Barton DL, Loprinzi CL. Use of methylphenidate in patients with cancer[J]. Am J Hosp Palliat Care, 2006, 23(1): 35-40.
  18. 18. 　Kohli S, Fsher SG, Tra Y, et al. The effect of modafinil on cognitive function in breast cancer survivors[J]. Cancer, 2009, 115(12): 2605-2616.
  19. 19. 　Shaw EG, Rosdhal R, D’Agostino RB Jr, et al. Phase Ⅱ study of donepezil in irradiated brain tumor patients: effect on cognitive function, mood, and quality of life[J].J Clin Oncol, 2006, 24(9): 1415-1420.
  20. 20. 　Ferguson RJ, Ahles TA, Saykin AJ, et al. Cognitive-behavioral management of chemotherapy-related cognitive change[J]. Psycho-onchology, 2007, 16(8): 772-777.
  21. 21. 　Goodwin PJ, Leszcz M, Ennis M, et al. The effect of group psychosocial support on survival in metastatic breast cancer[J]. N Engl J Med, 2001, 345(24): 1719-1726.
  22. 22. 　Kissane DW, Grabsch B, Clarke DM, et al. Supportive-expressive group therapy for women with metastatic breast cancer: survival and psychosocial outcome from a randomized controlled trial[J]. Psycho-Oncology, 2007, 16(4): 277-286.
  23. 23. 　Kissane DW, Bloch S, Smith GC, et al. Cognitive-existential group psychotherapy for women with primary breast cancer: a randomized controlled trial[J]. Psychooncology, 2003, 12(6): 532-546.
  24. 24. 　Kissane DW, McKenzie M, Bloch S, et al. Family focused grief therapy: a randomized, controlled trial in palliative care and bereavement[J]. Am J Psychiatry, 2006, 163(7): 1208-1218.
  25. 25. 　Manne SL, Ostroff JS, Norton TR, et al. Cancer-related relationship communication in couples coping with early stage breast cancer[J]. Psychoonchology, 2006, 15(3): 234-247.
  26. 26. 　Breitbart W. Identifying patients at risk for, and treatment of major psychiatric complications of cancer[J]. Support Care Cancer, 1995, 3(1): 45-60.
  27. 27. 　American Pain Society Quality of Care Committee. Quality improvement guidelines for the treatment of acute pain and cancer pain[J]. JAMA, 1995, 274(23): 1874-1880.
  28. 28. 　Back AL, Arnold RM, Baile WF, et al. Approaching difficult communication tasks in oncology[J]. CA Cancer J Clin, 2005, 55(3): 164-177.
  29. 29. 　Ryan H, Schofield P, Cockburn J, et al. How to recognize and manage psychological distress in cancer patients[J]. Eur J Cancer Care(Engl), 2005, 14(1): 7-15.
  30. 30. 　Lawlor PG, Gagnon B, Mancini IL, et al. Occurrence, causes, and outcome of delirium in patients with advanced cancer: a prospective study[J]. Arch Intern Med, 2000, 160(6): 786-794.
  31. 31. 　Misono S, Weiss NS, Fann JR, et al. Incidence of suicide in persons with cancer[J]. J Clin Oncol, 2008, 26(29): 4731-4738.
  32. 32. 　Miller M, Mogun H, Azrael D, et al. Cancer and the risk of suicide in older Americans[J]. J Clin Oncol, 2008, 26(29): 4720-4724.
  33. 33. 　Stark D, Kiely M, Smith A, et al. Anxiety disorders in cancer patients: their nature, associations, and relation to quality of life[J]. J Clin Oncol, 2002, 20(14): 3137-3148.
  34. 34. 　Williams S, Dale J. The effectiveness of treatment for depression/depressive symptoms in adults with cancer: a systematic review[J]. Br J Cancer, 2006, 94(3): 372-390.
  35. 35. 　Wald TG, Kathol RG, Noyes R Jr, et al. Rapid relief of anxiety in cancer patients with both alprazolam and placebo[J]. Psychosomatics, 1993, 34(4): 324-332.
  36. 36. 　Fisch MJ, Loehrer PJ, Kristeller J, et al. Fluoxetine versus placebo in advanced cancer outpatients: a double-blinded trial of the Hoosier Oncology Group[J]. J Clin Oncol, 2003, 21(10): 1937-1943.
  37. 37. 　Rankin NM, Barron JA, Lane LG, et al. Psychosocial oncology services in New South Wales[J]. Aust Health Rev, 2011, 35(2): 156-163.
  38. 38. 　黃曉蘭. 影響化療患者心理健康相關(guān)因素調(diào)查與護理干預[J]. 臨床心身疾病雜志, 2008, 5(14): 472-474.