- 學位論文
第IA期肺癌病人手術後半年的睡眠品質與其生心理問題之相關性探討
Sleep Quality and Its Relationship with Physical and Psychological Problems in Stage IA Lung Cancer Patients in Six Months Postoperatively
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摘要
研究背景：睡眠困擾是肺癌病人普遍存在的困擾，且與生理症狀、心理困擾及生活品質息息相關，隨著國人健康意識提升，肺癌已正式納入第五類的癌症篩檢，第IA期肺癌病人數日漸增加，其中不少病人存在睡眠障礙的問題。然而當前多數的研究仍著重於晚期肺癌的族群，較少聚焦於第IA期肺癌族群的睡眠問題。 研究目的：本研究旨在探討第IA期肺癌病人手術後滿半年的睡眠品質、疾病治療特性、生理症狀嚴重度、心理困擾之現況及之間的相關性。 研究方法：本研究採橫斷式設計，2022年9月至2023年6月在台灣北部某醫院之胸腔外科門診、腫瘤科門診，以立意取樣納入151位手術後滿半年的第IA期肺癌病人。資料收集包括人口學特徵、疾病治療特性、睡眠品質、癌症相關症狀及擔心癌症復發。研究資料以描述性統計、卡方檢定、曼惠特尼U檢定及史皮爾曼相關性分析進行探討。 研究結果：超過七成(70.9%) 的病人手術後半年睡眠品質不佳(PSQI＞5分)；手術後半年睡眠品質不佳與手術前主觀睡眠品質(r=0.54)、肺癌特定症狀(r=0.53)、癌症整體症狀(r=0.51)、疲憊(r=0.49)、呼吸困難(r=0.47)、疼痛(r=0.40)、咳嗽(r=0.35)、擔心癌症復發總分(r=0.28)等呈顯著正相關(P＜0.01)；手術前主觀睡眠品質差的病人，相較於手術前主觀睡眠品質佳的病人，不僅手術後睡得更差，生理症狀的嚴重度及擔心癌症復發的心理壓力也更高(P＜0.01)。 結論與建議：睡眠品質不佳是第IA期肺癌病人常見且需要被重視的問題，未來的研究可更仔細評估其關鍵導因，進一步提供相關措施來改善睡眠問題，不僅要讓病人活得久，更要讓病人活得好!
並列摘要
Purposes: Poor sleep quality is an omnipresent problem among lung cancer survivors. However, limited attention has been paid to sleep quality among stage IA lung cancer patients. The objectives of this study were (1) to identify sleep quality, physical symptoms, as well as psychological distress, and (2) to explore essential factors associated with sleep quality. Methods: This cross-sectional study was conducted in the outpatient departments of thoracic surgery and oncology at a Northern Taiwan hospital. A total of 151 eligible subjects diagnosed with stage IA lung cancer, approximately six months postoperatively, were recruited through purposive sampling after obtaining approval from IRB and securing informed consent from participants. Demographic information, disease details, sleep quality, cancer-related symptoms, and fear of cancer recurrence were assessed. Data analyses encompassed descriptive statistics, the Chi-squared test, Mann-Whitney U-test, and Spearman’s correlation. Results: A considerable proportion (70.9%) of participants suffered from sleep impairments (PSQI scores >5). Postoperative sleep quality showed significant associations with subjective sleep quality preoperatively, lung cancer-specific symptoms, cancer-related symptoms, fatigue, dyspnea, pain, cough, and fear of cancer recurrence (r = 0.54, 0.53, 0.51, 0.49, 0.47, 0.40, 0.35, and 0.28, respectively; P < 0.01). Noticeably, Patients reporting poor subjective sleep quality preoperatively continued to experience more sleep disturbance, physical symptoms and psychological distress postoperatively (P < 0.01). Conclusions: Considering the prevalence of sleep disturbance among stage IA lung cancer survivors, future studies are strongly suggested to implement interventions to help patients assess relevant factors that can enhance sleep quality and overall quality of life.
參考文獻
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