社群軟體教育介入在肺癌病人的症狀困擾、社會支持及因應之成效

肺癌病人因罹病及治療造成症狀困擾，社會支持與因應策略有助於改善及適應。隨著網路與智能型手機的普及，病人可透過社群平台提供醫療相關資訊，滿足照顧需求。因此，本研究之目的為1. 探討社群軟體教育對肺癌病人之症狀困擾、社會支持及因應策略之成效。2. 分析肺癌病人使用社群軟體教育的意願、頻率、效用及滿意度。本研究採用類實驗性研究設計，透過立意取樣法，在中部某醫學中心招募160位肺癌病人。根據研究對象的意願及社群軟體使用情形，將其分為實驗組及對照組。對照組持續採用目前的照護模式，而實驗組加上LINE社群，建立訊息傳遞管道。每週提供一則與肺癌相關照護單元維持續10週。研究工具以問卷調查法，包括基本資料、疾病資料、症狀困擾量表(Functional Assessment of Cancer Therapy-Functional Lung Symptom Index-17, Chinese version 2.0, FACT-FLSI-17 Chinese version 2.0)、社會支持量表(Social Support Scale)及簡式因應策略量表(Brief Coping Orientation to Problems Experienced, Brief COPE)等量表。實驗組需要填寫社群軟體使用調查表。資料收集時間點分別在收案時(前測)、完成第5次課程(第6週，中測)以及完成10次課程後(第11週，後測)。所有數據分析使用SPSS 26.0套裝軟體進行。進行描述性統計以分析各變項的分布情形，同時使用廣義估計式(generalized estimating equations, GEE)方法檢驗不同組別在不同時間點上在症狀困擾、社會支持及因應策略的差異。研究結果顯示，兩組病人在基本資料及疾病資料並無顯著差異。社群軟體教育介入後，兩組病人的症狀困擾、社會支持及因應策略，並未隨時間改變而有所不同。然而，在醫護人員社會支持方面，實驗組明顯優於對照組。實驗組病人對社群軟體使用意願和滿意度皆相當都好，其中以「癌症飲食原則」單元獲得最高的使用評價。以上研究結果有助於未來設計肺癌病人社群軟體教育時提供參考。

關鍵字

肺癌；社群軟體；教育介入；症狀困擾；社會支持；因應策略

並列摘要

Lung cancer patients often experience symptoms and challenges resulting from their illness and treatment. Social support and coping strategies play a crucial role in improving their well-being and adaptation. With the widespread use of the internet and smartphones, patients can utilize social media platforms to access medical information and fulfill their caregiving needs. Therefore, the purposes of this study are as follows: 1. To investigate the effects of social software education problem on symptom distress, social support, and coping strategies among lung cancer patients. 2. To analyze the willingness, frequency, utility, and satisfaction of lung cancer patients in utilizing social software education. This study employed a quasi-experimental research design and recruited 160 lung cancer patients from a medical center in the central region using purposive sampling. Based on the subjects' willingness and usage of social media platforms, they were divided into an experimental group and a control group. The control group continued with the current care model, while the experimental group engaged in a LINE social media community to establish a communication channel. Each week, a lung cancer-related care module was provided and maintained for 10 weeks. Research tools included questionnaire surveys, encompassing basic information, disease data, the Functional Assessment of Cancer Therapy-Functional Lung Symptom Index-17 (Chinese version 2.0, FACT-FLSI-17 Chinese version 2.0), Social Support Scale, and Brief Coping Orientation to Problems Experienced (Brief COPE). The experimental group additionally completed a survey on their social media usage. Data collection occurred at three time points: baseline (pre-test), after the 5th session (week 6, mid-test), and after completing 10 sessions (week 11, post-test). Statistical analysis was conducted using SPSS 26.0 software. Descriptive statistics were utilized to analyze the distribution of variables, and the Generalized Estimating Equations (GEE) method was employed to examine differences in symptom distress, social support, and coping strategies across different groups and time points. The research findings revealed that there were no significant differences in baseline demographic and disease data between the two groups. Following the intervention of social software education problem, no significant changes were observed over time in symptom distress, social support, or coping strategies for both groups. However, the experimental group exhibited a significant improvement in social support from healthcare professionals compared to the control group. The experimental group showed high levels of willingness and satisfaction in utilizing the social media platform, with the "Cancer Dietary Guidelines" module receiving the highest utilization rating. These research outcomes offer valuable insights for designing future lung cancer patient social software education problem programs.