Psychotherapy among Terminal Cancer Patients with Major Depressive Disorder: the Preliminary Construction of Existential-Cognitive Model
| Autor: | Chun-Kai Fang, 方俊凱 |
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| Rok vydání: | 2005 |
| Druh dokumentu: | 學位論文 ; thesis |
| Popis: | 93 Background: It is difficult to manage terminal cancer patients with major deppressive disorder (MDD) in hospice palliative care. There were few literatures about psychotherapy among these patients. Some studies suggest that existential psychotherapy and cognitive therapy are effective for cancer patients of early stages. The purposes of the study include finding the main themes of terminal cancer patients with MDD in existential-cognitive viewpoints, treating these patients in psychotherapy, and trying to construct the model of existential-cognitive psychotherapy. Methods: Four terminal cancer inpatients diagnosed as MDD by psychiatrists and transferred to receive psychotherapies in existential-cognitive aspects after signing letters of informed consent. The whole courses of psychotherapies were digital-recorded. Texts were the verbatim of psychotherapies. According to Heidegger’s dasien hermeneutics, the researcher gained full understandings of what happened during the psychotherapies. Texts were analyzed by the method of Colaizzi’s seven steps. Results: There were twenty two valid texts of all four patients. Suicide is the main reason of psychiatric consultation. The main factors about terminal cancer patients with MDD include loss of ability, indignity, physical pain, automatic negative thought, disintegration of meaning of life, and meaninglessness of dasien. The themes during intervention of psychotherapies include ensuring the patient’s consciousness, facilitating self-awareness of illness, being aware of automatic negative thoughts, challenging to automatic negative thoughts, facilitating patients to be here and now, being with patients, discussing patients’ previous meanings of life, and facilitating patients to construct the present meanings of life. The factors of patients’ changes after psychotherapies are therapist’s empathy, empowerment of dignity, improvement of physical suffering, affect by other beings, patients’ choices at present, integration of the meaning of life, reconstructing the meaning of being in the final stage of life, and power of love. The existential issues terminal cancer patients with major depressive disorder are death, sellf-awareness, dignity, meaning and meaninglessness, autonomy and choice, and relations. Conclusions: Psychotherapy that combined existential and cognitive approaches among the terminal cancer patients with major depressive disorder was able to affect the patients’ cognition of being in their final stage of life. The model of existential-cognitive psychotherapy might develop a new way to deal with these patients. |
| Databáze: | Networked Digital Library of Theses & Dissertations |
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