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  • 學位論文

化療期間肺癌患者生活品質及其相關因素之探討

Quality of Life and Its Related Factors in Lung Cancer Patients Undergoing Chemotherapy

指導教授 : 吳麗敏

摘要


研究目的:探討化療期間肺癌患者生活品質及其相關因素。 研究方法:本研究採橫斷式相關性研究設計,在南部某2家醫學中心及1家區域醫院之胸腔科病房及化學治療室,選取大於40歲以上,經醫師診斷肺癌且正在接受化學治療之患者,共收案159人。研究工具包含:生活品質量表(QLQ C-30)、安德森症狀量表(MDASI)、簡式症狀評估量表(MSAS-SF)之心理層面與自我照顧行為量表。 研究結果:男性居多(N=89,56.0%),年齡分布42至86歲,其結果為生活品質功能構面以身體功能最佳,角色功能最差;安德森症狀總量表(MDASI)平均值為1.87(標準差=1.58),屬輕度程度,疲勞是最嚴重及常見的症狀;自我照顧標準化得分為80,屬較佳程度。照顧者為配偶、自我照顧次量表「食物選擇與營養維持」及「維持規律活動與睡眠」與生活品質呈現顯著正相關。年齡、癌症分期、安德森症狀總量表、簡式症狀評估量表(MSAS-SF)的心理層面與生活品質呈現顯著負相關。「症狀干擾生活程度」、「症狀心理層面」、「維持規律活動與睡眠」、「醫療的遵從」及「食物選擇與營養維持」是化療期間肺癌患者生活品質功能構面重要解釋因子,共解釋69.1%的變異量。 結論與應用:疲勞是最嚴重及常見的症狀,化療期間年輕、主要照顧者是配偶的患者對於生活品質有正向的影響,化療期間肺癌患者生活品質重要預測因子是「症狀干擾生活程度」、「症狀心理層面」、「維持規律活動與睡眠」、「醫療的遵從」及「食物選擇與營養維持」。臨床上除了加強提早認知及察覺疲勞症狀,以及評估症狀干擾生活程度之外,亦應注意及促進患者規律活動與提升睡眠品質自我照顧行為,尤其是年老及主要照顧者非配偶的患者,以進而提升患者生活品質。

關鍵字

肺癌 化學治療 症狀 自我照顧 生活品質

並列摘要


Aim: This study was to investigate the quality of life and its related factors in lung cancer patients undergoing chemotherapy. Methods: This was a cross-sectional, correlation study design. Participants, diagnosed with lung cancer undergoing chemotherapy, were selected in three hospitals in the southern Taiwan. 159 patients were included. Four questionnaires including quality of life (QLQ-C30), Anderson Symptom Inventory (MDASI), Memorial symptom assessment scale (MSAS-SF), and self-care scales were used to collect data. Results: (1) The mean score of MDASI was 1.87 (SD=1.58), which was categorized as mild degree of symptoms, and fatigue was the most severe and common symptom; the standardized score of the self-care questionnaire was 80, which indicated good level of self-care; (2) Spouses as caregivers and self-care showed significantly a positive correlation with quality of life; (3) Age, cancer stage, symptoms of physical and psychological symptoms showed a negative correlation with quality of life; (4) Degree of interference with life, the psychological symptoms , regular exercise and sleep, medical compliance, and food choice and nutrition maintenance of the subscales of self-care were important predictors for the functional quality of life in lung cancer patients undergoing chemotherapy, which explained 69.1% of the total variances. Conclusion: Younger patients and spouses as caregivers associated with better quality of life. This study identified 5 important predictors of quality of life. Early detection and management of fatigue were important. Health providers should encourage patents in regular exercise and sleep that could be emphasized to promote the quality of life among lung cancer patients, especially focusing on the elder and non-spouses as caregivers.

並列關鍵字

lung cancer chemotherapy symptom self-care quality of life.

參考文獻


Molassiotis, A., Lowe, M., Blackhall, F., & Lorigan, P. (2011). A qualitative exploration of a respiratory distress symptom cluster in lung cancer: Cough, breathlessness and fatigue. Lung Cancer, 71(1), 94-102. doi:10.1016/j.lungcan.2010.04.002
參考文獻
中文部分
王玉祥 (2009)•肺癌男女有別•癌症新探•35,14-15。
王淑怡(2008)•非小型細胞肺癌之症狀群集之探討(未發表的碩士論文)•台北:臺北醫學大學醫學科學研究所。

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