- 期刊
臺灣癌症病人家屬善終觀念之研究
Exploration of Perceptions of a Good Death in Cancer Patients' relatives in Taiwan
摘要
研究目的：本研究旨在探究癌症病人家屬的善終觀念，和不同背景變項之間的關係，以提供醫療人員在臨床實務的參考。材料與方法：本研究採量化問卷調查之方法進行，並以立意取樣邀請癌症第三期到第四期別的癌症病人的家屬作為研究之對象。其最終完成有效問卷之受試者人數共100位。問卷內容包含四個部分，分別為個人基本資料、死亡意義問卷、短版善終概念問卷、以及附加的三個題組。資料內容使用SPSS 20.0軟體進行描述性分析、獨立樣本T檢定、單因子變異數分析、卡方檢定和皮爾森積差相關等統計方法進行資料分析。結果：癌症病人的家屬最高分的五項善終屬性為「免於疼痛和身體不適」、「在睡夢中死亡」、「自然的死亡」、「不是家人的負擔」、「信任醫師」。癌症病人的家屬選擇臨終和死亡地點為家裡和住院安寧病房的人數各半、對於預後告知的方式，偏好「醫師要開始討論及告知詳細狀況」的人士占73%。女性相較男性、年齡越長者、單身相較已婚的病人家屬、育有1名的子女個數、曾有癌症治療經驗、一年內有喪親經驗和國小學歷教育程度的癌症病人家屬，於善終概念的不同題項上有顯著的差異（p<0.05）。癌症病人家屬自身健康狀況的好壞及育有1名子女個數的癌症病人的家屬對癌症照護看法有顯著的差異（p<0.05）。假設病人還有1－2個月預期壽命，其家屬在不同預後告知的方式偏好於善終概念的不同題項上有顯著差異（p<0.05）。結論：本研究結果分析出癌症病人家屬認為重要的善終觀念，以及對於影響善終觀念的因素，可做為未來臨床服務、教育與研究的參考。
並列摘要
Purpose: This study aims to explore the correlation between cancer patients' relatives' conception of a good death and different background variables, so as to provide references for medical personnel in clinical practice. Methods: The study was conducted by quantitative questionnaire method, and invited family members of stage III and stage IV cancer patients as the study targets by purposive sampling. The number of subjects who finally completed the valid questionnaire was 100. The content of the question paper includes four parts, which are personal basic information, death meaning justice question paper, short version of a good death concept question paper, and three additional topic groups. Data collected was statistically analyzed via SPSS 20.0 statistics software, including the methods of descriptive analysis, student t-test, one way ANOVA, chi-squared test and Pearson product-moment correlation. Result: The 5 domains of a good death concept with highest points are 'being free from physical distress', 'dying as one sleeps', 'dying a natural death', 'not being a burden to others', 'trusting physician'. Similar numbers of cancer patients' relatives chose 'Home' and 'PCU' as their end-of-life care and dying place. 73% of the participants chose 'Physicians to initiate a discussion and inform me in detail' as their preference for prognostic disclosure. Females compared to males, older persons, single versus married family members, number of children with 1 child, experience of receiving cancer treatment, bereavement experience within one year, and primary education level has found significant differences(p<0.05) on a good death concept. Relatives with different physical and health condition and number of children with 1 child have significant differences(p<0.05) on end-of-life care belief. Hypothesizing that the patient still has a life expectancy of 1-2 months, there are different preferences of prognostic disclosure have significant differences(p<0.05) on a good death concept. Conclusion: The results of this study analyzed the important concepts of a good death in cancer patients' relatives, as well as the factors that affect the conception of a good death, which can be used as a reference for future clinical services, education and research.