影響口腔癌病人手術後心理困擾之因素

Factors Associated with Psychological Distress among Postoperative Oral Cancer Patients

陳淑卿(Shu-Ching Chen) ； 林佳靜(Chia-Chin Lin)

《馬偕護理雜誌》 2卷1期 (2008/01) Pp. 16-26

https://doi.org/10.29415/JMKN.200801_2(1).0002

摘要

本研究目的為：（1）探討口腔癌病患手術後的焦慮、憂鬱、及疾病衝擊的心理困擾狀態，（2）探討影響口腔癌病患手術後的焦慮、憂鬱、及疾病衝擊心理困擾的因素。研究採橫斷式相關性設計，以方便取樣於北部某醫學中心的耳鼻喉科及重建整形外科病房，採方便取樣針對診斷口腔癌接受手術的病患，以基本資料表、醫院焦慮憂鬱量表、事件衝擊量表結構式問卷作資料之收集，共收得72位病患，資料採用SPSS/Windows 15.0統計軟體作資料統整與分析，主要以平均值、標準差、次數分配、百分比、及皮爾森積差相關等統計方法分析。研究結果：（1）口腔癌病患手術後有中等程度的焦慮、憂鬱、疾病衝擊心理困擾；（2）口腔癌病患的身體活動功能狀態、自我照顧能力越差、腫瘤分期越高，其焦慮程度越高；（3）口腔癌病患的身體活動功能狀態、自我照顧能力越差、腫瘤分期越高，其憂鬱程度越高，年齡越大，憂鬱程度越低；（4）口腔癌病患的年齡越大、有宗教信仰者，疾病衝擊困擾越低，腫瘤分期越高，其疾病衝擊困擾越高。因此，應加強臨床護理人員對於病患心理困擾的評估能力及敏感度，尤其是當病患在得知癌症診斷之後緊接著接受手術治療，多重的壓力源，此階段病患的情緒狀態衍生出來的照護需求。

關鍵字

口腔癌 ； 心理困擾 ； 焦慮 ； 憂鬱 ； 疾病衝擊

並列摘要

This cross-sectional study was designed to assess the level of and factors associated with psychological distress, including of anxiety, depression, and disease impact, among patients with oral cancer after surgery. A convenience sample of 72 subjects was recruited from the Otolaryngology and Plastic and Reconstructive ward of a medical center in northern Taiwan. Structured interviews were conducted to collect basic demographic data and by using the Hospital Anxiety and Depression Scale and the Impact of Event Scale of the Eastern Cooperative Oncology Group. Descriptive statistics and Pearson correlation were used for data analysis. Overall, the patients had moderate levels of anxiety, depression, and disease impact-related distress. A lower performance status, poor self-care ability, and higher tumor stage were associated with anxiety and with depression, but older patients were less likely to be depressed. The impact of the disease was lower among older patients and those who expressed religious faith, but it was greater in those with a higher tumor stage.These findings may be useful for nurses to strengthen their sensitivity to and ability to assess the psychological distress that may occur after surgery in patients with oral cancer. An understanding of the various factors involved in the distress may assist in providing emotional support for these patients.

並列關鍵字

oral cancer ； psychological distress ； anxiety ； depression ； disease impact