- 期刊
支持性照護計劃對使用EGFR-TKIs之非小細胞肺癌病人皮膚疾患與生活品質成效追蹤
The Effects of Supportive Care Programs on Skin Disorders and Quality of Life in Patients With Non-Small Cell Lung Cancer Using EGFR-TKIs
摘要
背景：肺癌病人接受表皮生長因子受體酪胺酸激酶抑制劑（EGFR-TKIs）治療，易造成皮膚副作用且與生活品質問題，然其縱貫性變化觀察則較闕如。目的：了解肺癌病人服用EGFR-TKIs藥物後之皮膚疾患，並檢視支持性照護對皮膚疾患與生活品質之成效。方法：採類實驗設計，立意取樣以122位初診斷肺癌首次接受標靶治療者為研究對象，先收對照組61位，再收實驗組61位，兩組於標靶治療前進行資料收集與皮膚照護衛教，分別於服藥後二週（Time 1, T1）、六週（Time 2, T2）、十週（Time 3, T3）及二十四週（Time 4, T4）進行四次後測，實驗組於每次後測後，重複提供支持性照護。測量工具為皮膚副作用及嚴重度評估表、皮膚疾患生活品質量表。結果：整體皮膚疾患於第六週呈現較嚴重，其發生率依序為皮膚瘙癢、丘疹膿皰疹、皮膚乾燥及甲溝炎。以平均數比較顯示實驗組四次後測整體生活品質和症狀、功能和情緒等構面得分均優於對照組。經概化估計方程模式（GEE）檢視組別與時間之成效，顯示治療後第六週，實驗組的整體生活品質（p = .002）、功能（p = .000）和情緒（p = .021）構面顯著優於對照組。結論／實務運用：支持性照護介入在治療後第六週起顯著有效改善接受EGFR-TKIs藥物治療肺癌病人之生活品質。本結果建議於肺癌病人接受治療六週期間應密切追蹤病人皮膚疾患，及時提供支持性照護，進而改善病人生活品質。
並列摘要
Background: Patients with non-small cell lung cancer (NSCLC) treated with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are often exposed to diverse skin disorders and decrease in quality of life. Thus far, the longitudinal follow-up on the skin change is rare. Purpose: To understand the skin diseases of NSCLC patients on EGFR-TKIs, and to examine the effect on quality of life from the supportive care programs. Methods: This is a quasi-experimental study. 122 patients with NSCLC were enrolled in this study and divided into two groups (experimental and controlled group). During a 24 weeks of the experimental course, data collection and patient education on skin care was done (pre-treatment) first, followed by four times of evaluations (post-treatment) after medication at the second week point (Time 1, T1), sixth week (Time 2, T2), tenth week (Time 3, T3) and the twenty-fourth week point (Time 4, T4), respectively. The experimental group received repeated post-treatment supportive care for 4 times. The outcome measurements criteria included the skin treatment side effects and severity assessment, and quality of life. Results: The incidence of skin disorders was highest in the sixth week, such as, acneiform rash, itchy skin, pruritus, dry skin (xerosis), and paronychia. The GEE model showed that after six weeks of EGFR-TKIs, the experimental group did significantly better in the overall quality of life (p = .002), functional dimension (p = .000), and emotional dimension (p = .021) than the controlled group at same period. Conclusions/Practical Implications: Supportive care can effectively improve the quality of life of NSCLC patients receiving EGFR-TKIs during the sixth week after treatment. It is recommended that patients should be closely monitored to receive timely supportive care.