癌因性疲憊之概念分析

Cancer-Related Fatigue: A Concept Analysis

郭蓁蓁(Chen-Chen Kuo) ； 王秀紅(Hsiu-Hung Wang) ； 周汎澔(Fan-Hao Chou)

《腫瘤護理雜誌》 18卷1期 (2018/06) Pp. 91-105

https://doi.org/10.3966/168395442018061801008

摘要

癌因性疲憊是癌症生存者困擾之首，所帶來的困擾與痛苦，比疼痛對日常生活干擾更大，嚴重者可能會造成治療中斷、產生無望感、甚至萌生輕生的念頭。本文以Walker與Avant概念分析步驟進行癌因性疲憊概念分析，釐清其定義特徵為：(1)個人主觀且複雜的感受；(2)發生快、能量消耗大、精疲力竭程度較高且持續時間長；(3)無法透過睡眠和休息來緩解或改善；以及(4)對身心社會健康造成負面影響。其前置因子為：(1)疾病因素；(2)治療因素；(3)共病因素。而後果為：(1)干擾日常生活功能；(2)影響個人生活品質；(3)造成治療中斷或延長治療期；(4)造成心理負面的衝擊；以及(5)影響癌症存活。期望此概念分析有助於護理人員對癌因性疲憊的瞭解，並能依據實證工具之台灣版簡明疲憊量表評估其嚴重程度，教導癌症病人及家屬認識癌因性疲憊的症狀，適切的提供具實證基礎的運動介入措施來改善癌因性疲憊，以確保癌症病人獲得優質照護。此外，可做為護理主管未來規劃癌因性疲憊病人臨床照護指引的參考，讓癌症病人從罹癌開始即可學習如何與癌因性疲憊共存，以維護個人最佳的生活品質。

關鍵字

癌因性疲憊 ； 概念分析 ； 疲憊 ； 慢性疲憊症候群

並列摘要

Cancer-related fatigue (CRF) is one of the most common symptoms in cancer survivors. The CRF related discomfort and suffering sometimes brings greater obstruction of life than the cancer itself, which even results in treatment interruptions, lack of social interaction, sense of hopelessness and suicidal attempt. This paper applied the Walker & Avant's concept analysis process to verify concept definition of CRF. The identified attributes of CRF include: (1) the individual's subjective and complex feelings, (2) the rapid onset, massive energy drainer, higher level of exhaustion and longer duration of CRF, (3) the inability to improve or relieve by rest or sleep, and (4) possible damages to one's physical and psychosocial health. The identified antecedents of CRF include: (1) disease factors: underlying neoplastic disease, cancer progression, anemia, and cachexia, (2) therapy factors: surgery, chemotherapy, radiotherapy, hormone therapy, and biologic agents, and (3) comorbidity factors: pain, emotional disorders, sleep disorders, infection, and malnutrition. The identified consequences of CRF include: (1) the interference in the daily living activities, (2) impacts on personal quality of life, (3) interrupted or delayed treatment, (4) negative psychological impacts, and (5) an overall impact on cancer survival. The paper can help the nurses to better understand CRF, assess its severity based on the empirical tool with the Brief Fatigue Inventory-Taiwanese Version (BFI-T), and show the patient and family how to utilize interventions to improve cancer patients' quality of life. Furthermore, it can be used as a reference for future CRF education guideline for nurse managers, who can assess the cancer patient and family for better CRF symptoms identification early on during the disease progression.

並列關鍵字

cancer-related fatigue ； concept analysis ； fatigue ； chronic fatigue syndrome

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