- 期刊
癌症青少年與青年於化學治療期間接受整合照護之成效初探
The effects of integrated nursing care on adolescents and young adults with cancer undergoing chemotherapy: A preliminary study
摘要
研究目的：復原力是協助癌症青少年與青年正向適應癌症的能力，化學治療造成的症狀困擾是阻礙其發展復原力的因素之一，因此本研究以不愉快症狀理論設計整合照護並檢驗其成效。研究方法：本研究採單組前後測設計，於台灣北部兩大醫學中心以方便取樣選取13至25歲且正進行化學治療的癌症青少年與青年為研究對象，並於住院接受化學治療前一天開始進行每日30分鐘，連續4天的整合照護。以結構式問卷於3個時間點收集量性資料，並以SPSS 22.0版軟體進行描述性統計及廣義估計方程式（GEE）分析。研究結果：共計23人參與本研究，平均年齡17.21歲（SD=2.90），以罹患惡性腫瘤者居多（n=20,87.0%）。復原力的分數於第一次後測時下降，但於第二次後測時雖較前測略為上升，但未達統計意義（p=.269）。症狀困擾於第一次後測時上升，但第二次後測仍較前測為高，且達統計意義（p=.034）。青少女的復原力較青少男為差（B=-6.581, p=.011）；罹患惡性腫瘤者的復原力較罹患白血病者為差（B=-7.509, p=.007）；家庭支持高者，隨著年齡愈長則復原力愈佳（B=1.464, p=.009）。結論：本研究雖然未能呈現整合照護的成效，但已確認復原力的相關因素包括性別、疾病診斷、家庭支持與壓力感受，研究團隊並針對整合照護的設計與實施時機提出檢討與建議。
並列摘要
Purpose: Resilience is the ability to help adolescents and young adults with cancer adapt to the disease positively. Symptoms induced by chemotherapy are one of the factors obstructing the development of resilience. This study aimed to design integrated care based on the unpleasant symptom theory and examine its effectiveness. Methods: This study adopted a single-group pretest-posttest design. Convenience sampling was used to recruit adolescents and young adults aged 13 to 25 undergoing chemotherapy at two major medical centers in northern Taiwan. Integrated nursing care was provided for 30 minutes daily over four consecutive days, starting one day before the patients for chemotherapy in the hospitalization period. Quantitative data were collected at three-time points using structured questionnaires, and descriptive statistics and Generalized Estimating Equation (GEE) analyses were conducted using SPSS 22.0 software. Results: Twenty-three participants were included in this study, with an average age of 17.21 years (SD = 2.90). Most participants had malignant tumors (n = 20, 87.0%). Resilience scores decreased at the first posttest but slightly increased at the second posttest, though the change was not statistically significant (p = .269). Symptom distress increased at the first posttest and remained higher than the pretest at the second posttest, reaching statistical significance (p = .034). Female adolescents had lower resilience than males (B = -6.581, p = .011); participants with malignant tumors had lower resilience than those with leukemia (B = -7.509, p = .007). Higher family support was associated with better resilience with increasing age (B = 1.464, p = .009).Conclusion: Although the effectiveness of integrated care was not demonstrated, the study identified factors associated with resilience, including gender, disease diagnosis, family support, and perceived stress. The research team provided recommendations for refining the design and timing of integrated care implementation.