婦癌病患於化學治療期間症狀困擾及護理指導需求之探討

Distress Symptoms and Health Education Demands during among Gynecologic Oncology Patients Undergoing Chemotherapy

鄭惠鑫(Hui-Hsin Cheng) ； 陳雅惠(Ya-Hui Chen) ； 王琦(Chi Wang) ； 廖梅珍(Mei-Chen Liao)

《腫瘤護理雜誌》 8卷2期 (2008/12) Pp. 45-57

https://doi.org/10.6880/TJON.200812_8(2).05

摘要

本研究為橫斷式相關性研究，目的為探討婦癌病患於化學治療期間症狀困擾程度與個人基本屬性、疾病特性、對化學治療認知程度之相關性，並了解病患希望獲得護理指導的方式。方法：以立意取樣於北部某醫學中心婦癌病房，共徵求90位病患的同意，以結構式問卷進行資料收集，問卷內容包括：症狀困擾、基本屬性、疾病特性、化學治療認知程度及護理指導需求等，並使用SPSS/Windows統計軟體進行資料分析。結果：1.症狀困擾以噁心、嘔吐最嚴重，性方面的影響得分最低；分居／離婚／喪偶者以疲倦、失眠較嚴重，且最需要心理支持。2.化學治療認知程度方面以知道定期門診追蹤的重要性得分最高，症狀處理方面，以對性方面的影響最不清楚。3.越清楚症狀處理，較易改善疲倦與失眠；但症狀如：便秘、腹瀉、口腔潰瘍、血小板降低及手腳麻等病患雖知道處理方法，卻仍無法獲得改善。4.護理指導方式偏好現場立即口頭護理指導、衛教單張的提供、依個別性提供定時持續追蹤等最為主要。結論：可作為婦癌病患接受化學治療住院期間、出院護理指導計畫及持續性護理照顧的參考，對分居／離婚／喪偶者尤其注重其心理支持之提供，並據此進一步探討婦女面對癌症時的相關議題。

關鍵字

婦癌病患 ； 症狀困擾 ； 護理指導需求

並列摘要

The purpose of this research was to understand the levels of distress symptoms and the socio-demographic data and disease characteristics of gynecologic cancer patients undergoing chemotherapy, and the correlation between these factors and the patients' level of understanding of chemotherapy, and to understand what kinds of nursing guidance patients expect. A cross-sectional correlational design was used. The questionnaires concerned socio-demographic data, disease characteristics, levels of knowledge of chemotherapy, symptom distress and health education demands. Ninety patients were selected by convenience sampling from the inpatient wards at one medical center in northern Taiwan. The most severe distress symptoms were nausea and vomiting, while the least severe was adjustment in sexual relationship. Among those who were divorced, separated or whose spouse had died, the most severe form of distress symptoms and those needing the most psychological support were fatigue and insomna. As far as knowledge of chemotherapy was concerned, understanding of the importance of regular follow-up scored the highest, symptom care the lowest, while effect in sexual relationships was the most unclear. The better the patients understood symptom care, the better they reduced fatigue and sleeping difficulties, but relief was not found from side-effects such as constipation, diarrhea, oral ulcer, neutropenia, and neuronal, even though patients knew how to deal with them. Immediate oral education is the most favored form of guidance, followed by education sheets and occasional, continual tracking in accordance with individual needs. This article might serve as a reference in the planning of nursing guidance and continual nursing care for gynecological cancer patients both during and after their hospital stay. It particularly emphasizes the provision of psychological support for those who are separated or divorced, or whose spouse has died.

並列關鍵字

gynecological cancer patients ； distress symptoms ； health education needs