癌症各階段家庭功能對生活品質之影響-以頭頸癌為例

The Effect of Family Functioning on Quality of Life in Differential Course of Head and Neck Cancer

黃珮甄(Pei-Chen Huang)

指導教授 ： 黃君瑜

中原大學/理學院/心理學研究所/碩士(2012年)

https://doi.org/10.6840/cycu201200035

摘要

本研究目的在探討癌症疾病歷程中家庭功能及生活品質之變化，並瞭解各階段中家庭功能各向度對生活品質各範疇之影響力。研究對象包括頭頸癌患者及其家屬，並依據下列條件將參與者分別編為治療期、緩解期及追蹤期三組。各階段的特性為：(1)治療期：病人(含初診斷、復發、轉移)正在接受癌症治療時期，包括手術、放射與化學治療等；(2)緩解期：病人(含初診斷、復發、轉移)治療結束9個月內；(3)追蹤期：目前已結束癌症療程9個月以上，且可以暫時免於疾病，但仍需定期回診檢核身體狀況或控制治療後的副作用。研究工具採用家庭功能量表(Family Assessment Device)與台灣簡明版世界衛生組織生活品質問卷(WHOQOL-BREF，Taiwan version)，透過問卷調查法，獲得有效樣本112對(224份)。經由統計分析結果，歸納本研究的結論如下：(1)在治療期、緩解期、追蹤期中，七個家庭功能分量尺皆無顯著差異性；但相較於一般樣本發現，各階段的情感回應功能皆較差、治療期之行為控制功能弱且病患特別知覺有較差的家庭角色功能；(2)頭頸癌患者的生心理範疇之生活品質在治療期顯著低於追蹤期；(3)背景變項分析發現：教育年數愈高生活品質與家庭功能愈佳、配偶通常比起其他患者家屬知覺家庭的「溝通」及「角色」功能較弱、復發或第二原位癌的病患會比初發病人家庭的情感回應及整體功能較差；(4)家庭功能各向度與生活品質有顯著相關性，而回歸預測指出：行為控制、問題解決、情感回應、整體功能是重要的解釋和預測因子；(5)個體不同的生活品質會呈現不同的知覺功能差距，進一步的分析發現個體認知的功能狀態是影響其生活品質之重要因素。未來臨床上可透過相關背景變項篩選出需要關注之群體，並由上述重要的家庭預測因子做介入，以提升病患及其家人之生活品質。

關鍵字

家庭功能 ； 頭頸癌 ； 生活品質

並列摘要

The purposes of the present study are: (1) Examining the family functioning is associated with quality of life in a sample of cancer patient and their families. Also to probe which domain of family functioning could predict the quality of life; (2)Examining the changes of family functioning and quality of life in differential cancer period. The participants are the patient of cancer and one of their families. They were divided into three groups, treatment period, remission period and follow-up period. The inclusion criteria of each period are as follows:(1) Treatment period: Patients accept treatment; (2) Remission period: Nine months after the end of treatment; (3) Follow-up period: Cancer treatment has ended more than 9 months to 5 years, but still need to come back to hospital to check the body status or the treatment side effect. The major instrument contained Family Assessment Device (FAD) and Taiwan version of WHOQOL-BREF. The data for this study was mainly collected through questionnaire surveys, and the survey sample contains 112 pairs (224 Participants: include 112 patients &112 their family). The major findings were as follows: (a) There were not significant differences between three periods in seven subscale of family functioning; but compare to the normal family, it was poor affective responsiveness in each period, poor behavior control in treatment period, and patients perceived the poor family role function. (b) Patients’ physical health and psychological domains of QOL scores in follow-up period was better than the treatment period. (c) Background variables analysis: high level of education person had higher quality of life and better family functioning; spouse usually perceived "communication" and "role" functions are weak, the family with patients of recurrence or second primary cancer had poor affective responsiveness and general function than the family with the patient that was first onset. (d) There were significant correlations between family function and QOL; And behavior control, problem solving, affective responsiveness , and general function can effectively predict QOL. (e) Different quality of life will show a different gap of the perceived family function, and it found that viewpoint of individuals affect their quality of life. Future, the results were helpful to identify factors of family functioning that were important for intervention to improve the quality of life of patients and their family in the clinical.

並列關鍵字

Quality of life ； Family functioning ； Head and Neck Cancer

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