衛生教育對肝癌化療病患心理社會調適之影響

The Effects of Health Education on Psychosocial Adjustment for Hepatocellular Carcinoma Patients under Chemotherapy

李碧月(Pi-Yueh Lee) ； 柯成國(Chen-Guo Ker) ； 李來涼(Lai-Liang Lee) ； 應純哲(Jeremy C Ying)

《福爾摩莎醫務管理雜誌》 1卷1期 (2005/06) Pp. 45-54

https://doi.org/10.6771/FJHA.200506.0045

摘要

目的：癌症病患在面對疾病的衝擊及身體功能改變是一種複雜的心理機轉的因應過程，伴隨而來是身心社會功能遭受破壞。因應各種積極的治療下，隨即產生的問題則是化療所引起的副作用或合併症，相對也為病患帶來各種身心社會各個層面的困擾。護理人員如能掌握病患求診與治療的過程，給予正確的衛生教育，協助病人不斷的調適，不僅能讓病患面對複雜的治療過程，對抗疾病所帶來的生命威脅，亦將有助於病患有信心接受治療，而獲得更好的醫療照護品質。方法：本研究採用類實驗法，於2003年12月至2003年3月在高雄市某區域教學醫院門診化療室收案，以50位接受化療的肝癌病患為研究對象，探討肝癌化療病患介入衛生教育後之心理社會調適之成效。結果：研究結果發現肝癌化療病患在衛生教育介入後，其心理社會調適程度介於「輕度障礙」至「中度障礙」之間。在衛生教育介入之前病患調適最差的兩項為心理困擾調適與疾病照顧調適，而病患經過衛生教育介入後，其前後測在統計上達到顯著性差異，因而證實衛生教育的介入對肝癌化療病患之心理社會調適具有成效。結論：研究結果可供臨床護理人員在照顧肝癌病患時，針對化學治療所引起的心理社會調適問題而提供之衛教內容及自我照顧活動的參考。

關鍵字

肝癌 ； 化學治療 ； 衛生教育

並列摘要

Objectives: Cancer patients encountered complicated bio-psychological obstacles, due to the impact of disease and dysfunction of the body. Chemotherapy and various aggressive therapies would generate several side effects and/or complications, which bothered the cancer patients in numerous aspects. If healthcare givers (nurses, in particular) can take control of the process of therapeutic treatment, offer patients with accurate health education, and continuously assist patients making adjustments during the treatment, then they would be able to help the patients endure complicated and painful process of therapy, deal with the obstacles posed by the disease, and enhance patients' quality of life. Methods: This study adopted a quasi-experimental design, and the subjects were 50 HCC patients received chemotherapy at a major regional teaching hospital in the city of Kaohsiung, during the time period from December 2003 to March 2004. The purpose of this study was to investigate the differences of bio-psychosocial perceptions of HCC patients before and after the intervention of a well-designed health education program. Results: The study results revealed that psychosocial adjustments among the subjects were ”mild handicap” and ”moderate handicap” after the intervention. Moreover, this study found significant differences between the pre- and post-intervention of health education, in terms of the adjustments to psychological burden and self-care for disease. Conclusions: The findings of this study would be able to serve as references for clinical nursing professionals, regarding psychosocial counseling and self-care activities suggestion to HCC patients on chemotherapy.

並列關鍵字

hepatocellular carcinoma ； chemotherapy ； health education