肺癌化學治療病患自我照顧行為及其相關因素探討

本研究探討肺癌化學治療病患自我照顧行為及其相關因素。研究目的為：（1）探討肺癌化學治療病患自我照顧行為的現況；（2）探討肺癌化學治療病患的個人屬性、疾病特性、症狀困擾、不確定感、社會支持自我照顧行為的相關性（3）探討肺癌化學治療病患自我照顧行為的重要解釋因子。本研究採相關描述性研究設計，以立意取樣的方式，在南部一所醫學中心及兩所地區醫院的門診化學治療門診及血液腫瘤科門診，選取18歲以上，經醫師診斷肺癌病患及有化學治療經驗之門診病人，共獲得有效研究問卷157份。研究工具為結構式問卷，包括症狀困擾量表、社會支持量表、疾病不確定感量表與自我照顧行為量表、個人特性及疾病特性。量表經信度及效度檢定，包括內在ㄧ致性、再測信度、專家效度與表面效度。研究資料以百分比、平均值、標準差、獨立樣本t檢定、單因子變異數分析、皮爾森積差相關分析及逐步複回歸分析。研究結果發現（1）研究對象的自我照顧行為得分指標為87.5，屬較佳程度；（2）化學治療次數2次者之自我照顧行為優於化學治療次數4次者（3）研究對象親友社會支持得分指標為92.8，屬較佳程度，親友社會支持越好者其自我照顧行為越好；（4）研究對象疾病不確定感得分指標為50.0，屬中等程度，疾病不確定感越高者其自我照顧行為越差；（5）親友社會支持、疾病不確定感及化學治療次數4次與5次對比組為自我照顧行為之重要解釋因子，共可解釋23.1％的肺癌化學治療病人自我照顧行為的總變異量。根據本研究結果，可作為增進肺癌化學治療病人自我照顧行為臨床實務與教育之參考。

關鍵字

肺癌；化學治療；症狀困擾；社會支持；疾病不確定感

並列摘要

The purposes of this study were to (1) understand the present self-care behavior condition of lung cancer patients undergoing chemotherapy; (2) explore the correlations between self-care behavior and each of the following factors like individual characteristics, disease characteristics, symptom distresses, uncertainty, and social support; (3) identify the important explanatory variables of self-care behavior in lung cancer patients undergoing chemotherapy.This study adopted a cross-sectional correlation design. The subjects were recruited by convenience sampling from outpatient department of three hospitals in Tainan City. They were patients aged above 18 and diagnosed of having lung cancer undergoing chemotherapy. A total of 157 valid questionnaires were acquired. Structured questionnaire was used for the study. Questions on individual characteristics and disease characteristics, symptom distresses scale, uncertainty scale, social support scale, self-care behavior scale were included. The reliability and validity of the questionnaire were evaluated for internal consistency, test-retest reliability, surface validity and content validity. Data analysis were performed by using percentage, mean, standard deviation, independent t-test, one-way ANOVA, Person’s correlation, and stepwise multiple regression analysis.Results showed that: (1) the score index of self-care behavior was 87.5, considered as a high level; (2) patients with twice chemotherapy experiences showed a better self-care behavior than patients with chemotherapy experiences for four times; (3) the score index of family support was 92.8, considered as a high level. The better the family social support, the better the self-care behavior; (4) the score index of uncertainty showed a moderate level of 50.0 implying that the higher the uncertainty, the worse the self-care behavior; (5) family social support, uncertainty of disease and contrasting chemotherapy experiences between four and five times were important explanatory variables to self-care behavior, and accounted for 23.1% of the total amount of variances. Results of this study could be used for future references in clinical nursing care and education on enhancing self-care behavior of lung cancer patients undergoing chemotherapy.