乳癌術後輔助性化學治療病人之症狀群集

Exploring the Symptom Clusters of Breast Cancer Patients with Adjuvant Chemotherapy in Taiwan

阮瓊慧(Chiung-Hui Juan)

指導教授 ： 林秋菊

共同指導教授 ： 侯明鋒(Ming-feng Hou)

高雄醫學大學/護理學院/護理學系研究所/碩士(2010年)

https://doi.org/10.6832/KMU.2010.00061

摘要

本研究目的旨在了解乳癌病人術後輔助性化學治療期間的症狀群集現象，並探究其基本屬性的相關因素，以期提供臨床腫瘤護理人員未來進一步建構護理措施的參考。研究設計採縱貫性之描述性相關性研究，以立意取樣，共收案74人。以簡式回憶症狀評估量表(Memorial symptom assessment scale short form, MSAS-SF)來收集術後輔助性化學治療四次療程的資料，並納入分析。所得資料以描述性統計、皮爾森相關法、單因子變異數分析及t檢定、因素分析、群集分析等方法進行分析。研究結果歸納如下(一)在症狀的嚴重度平均分數最高的五個症狀依次為擔憂、覺得難過、掉髮、覺得焦躁不安、噁心等(平均分數: 1.78-2.03分，計分範圍: 0-4分，5點計分法)。在症狀的盛行率最高的五個症狀依次為擔憂、覺得難過、口乾、缺乏活力、噁心等。在症狀發生總數部份為4-32個症狀，平均為20.35個症狀。(二)在症狀困擾總分與症狀發生總數的相關性上具有高度的正相關(r= .868)。(三)症狀群集以因素分析及群集分析所得三個群集，顯示症狀與症狀間確實有關聯性較高的群集現象，症狀群集的結果為群集一「情緒困擾相關症狀群」包含五個症狀為覺得焦躁、覺得緊張、擔憂、覺得難過、不像自己；群集二「口腔不適相關症狀群」包含三個症狀為口乾、口腔不適/潰瘍、睡眠障礙；群集三「胃腸道相關症狀群」共九個症狀依次為：缺乏食慾、味覺改變、腹脹、難以集中注意力、缺乏活力、噁心、嘔吐、頭暈、昏昏欲睡。研究結果提供了乳癌病人術後化學治療期間症狀群集現象的實證資料，讓醫療照護人員在評估化療個案時，可以運用症狀群集的概念去做全面性的評估，適時提供符合病患所需的介入措施，以阻斷或減緩下一個症狀的發生，幫助病人完成治療的療程並維持生活品質。

關鍵字

乳癌 ； 化學治療 ； 症狀群集

並列摘要

The purpose of this study was to explore the symptom clusters of breast cancer patients with adjuvant chemotherapy. The prospective, longitudinal and correlation design methods was used. Seventy-four participants were recruited in this study. The Memorial Symptom Assessment Scale Short Form (MSAS-SF) was applied to collected symptoms for four chemotherapeutic courses. Data was analyzed by descriptive statistics, Pearson correlation, one-way ANOVA and t-test, factor analysis, cluster analysis.
The major findings of this study was summary as follows:（1）The most severe symptoms were worrying, feeling sad, hair loss, feeling irritable, nausea(range:1.78-2.03, possible range=0-4). The highest prevalence symptoms were worrying, feeling sad, dry mouth, lack of energy, nausea. The mean number of symptoms was 20.35(range 4-32 symptoms, possible range=0-32) .（2）The severity of symptoms were significantly positive correlation with number of symptoms.（3）Factor analysis and cluster analysis demonstrated three symptom clusters: Emotional-related symptoms (5 symptoms, including worrying, feeling sad, feeling nervous, feeling irritable, I don`t look like myself). Mouth-related symptoms (3 symptoms, including dry mouth, mouth sores, difficulty sleeping).Gastro- intestinal related symptoms (9 symptoms, including lack of appetite, lack of energy, nausea, vomiting, difficulty concentrating, feeling drowsy, feeling bloated, dizziness, change in the way food tastes).
These results may provide doctors and nurses symptoms cluster model to assess symptoms distress and clarify symptoms correlation during patients receiving chemotherapy. Further, nurse could figure out appropriate intervention to relief or decrease next symptom occurrence.

並列關鍵字

Symptom clusters ； Breast cancer ； Adjuvant chemotherapy

參考文獻

參考文獻

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