口腔癌病患社會支持、憂鬱焦慮之探討與社會支持介入之影響

Impact of Social Support Service on the Anxiety and Depression of Oral Cavity Cancer Patients

闕昀珮(Yun-Pei Chueh) ； 張東杰(Joseph T. Chang) ； 林秀峰(Hsiu-Fong Lin) ； 游靜宜(Ching-Yi Yu) ； 鄭夙芬(Su-Fen Cheng) ； 康仲然(Zhone-Ran Kang) ； 陳一豪(I-How Chen)

《台灣耳鼻喉頭頸外科雜誌》 46卷6期 (2011/12) Pp. 329-339

https://doi.org/10.6286/2011.46.6.329

摘要

背景：本研究以縱貫性方式來探討口腔癌病患在不同病程之社會支持與焦慮憂鬱狀況，以及社會支持與焦慮憂鬱二者之關係，並進一步了解社會支持介入對病患之影響。方法：本研究以初次診斷並經外科手術之口腔癌病患為主，於病患手術前（TI）、術後由加護病房轉至普通病房5日內（T2）、出院時（T3）及診斷後6個月（T4），進行「社會支持量表」與「醫院焦慮與憂鬱量表」評估，並將研究封象分為3組，以比較社會支持介入對研究封象之影響。本研究自2008年1月至2009年12月，於林口長庚醫院進行收案，有效樣本數為108名。結果：本研究發現基本屬性中以「年齡」、「教育程度」、「宗教信仰」、「收入」、「家庭形態」、「家庭階段」、「主要照顧者」等為家庭支持之預測變項。口腔癌病患在手術前及術後由加護病房轉出5日內其焦慮憂鬱狀況高於出院及診斷後6個月，另研究對象出院時， 其疾病診斷為第四期之病患，焦慮憂鬱高於其他病患。社會支持介入之研究對象其在診斷後6個月（T4）醫療人員社會支持感較其他研究對象高。研究對象出院返家後若能持續社會支持介入，可減緩研究對象焦慮憂鬱之狀況。本研究對象之社會支持與焦慮憂鬱狀況呈現負相關。結論：研究對象的基本資料及家庭狀況可作為社會支持的評估依據，研究對象在不同病程其焦慮憂鬱狀況有所差異，社會支持介入能提昇研究對象對整體醫療人員之社會支持感，並能夠減緩焦慮憂鬱。（台耳醫誌 2011；46：329－339）

關鍵字

口腔癌 ； 社會支持 ； 焦慮 ； 憂鬱 ； 社會支持介入

並列摘要

BACKGROUND: The purpose of this study is to understand the relationship between the sense of social support and the anxiety as well as depression of oral cavity cancer patients under diverse demographic variables and different progress of disease. Furthermore, this study also explores the changes of patients' sense of social support and the anxiety as well as depression after social support intervention.METHODS: The patients are randomized into three groups. Group A: conventional support system as patient needs, Group B: group A method combined with hospital volunteer and Group C: integral social support program consisting of conventional system, volunteer and scheduled social worker visits. Every patient receives four times of evaluation. There are 1) T1: before radical surgery, 2) T2: patient discharged from intensive care unit to regular ward after radical surgery, 3) T3: before discharge and 4) T4: 6 months after treatment. The evaluation tools use social support rating scale (SSRS) that includes family support and hospital support and hospital anxiety and depression scale (HADS). The study was approved by institution review board. One hundred and eight patients entered the study From Jan. 2008 to Dec. 2009, 108 patients entered the study. Most patients have advanced stage disease and received combined modalities treatment.RESULTS: Age, education, religion belief, family income, family stage and family status are important determined factors for SSRS score. Most patients have moderate depression status at different time point and improve with time go by. Patients had worse HADS score at T1 and T2 compared to T3 and T4, patient with stage IV disease have worse score at T3 and T4 compared to other stage patients. SSRS score had negative correlation with HADS score. Group C patients had a trend of better HADS and SSRS score.CONCLUSION: Most oral cavity cancer patients have depression during treatment and recovery course. Different disease status patients at different time points had various degree of depression. With the help of the integral social support system, oral cavity cancer patients may get better improvement of depression. (J Taiwan Otolaryngol Head Neck Surg 2011; 46:329-339)

並列關鍵字

oral cavity cancer ； social support ； anxiety ； depression ； social support intervention