非晚期肝癌存活者之因應策略與D型人格特質之相關性探討

The Relationship between Coping Strategies and Type D Personality in Non Late Stage Hepatocellular Carcinoma Survivors

武芮竹(Ruei-Jhu Wu) ； 賴裕和(Yeur-Hur Lai) ； 許金川(Jin-Chuan Sheu) ； 孫秀卿(Shiow-Ching Shun)

《台灣癌症醫學雜誌》 2卷3期 (2015/09) Pp. 213-223

https://doi.org/10.6323/JCRP.2015.2.3.04

摘要

研究目的：肝癌具高復發性，而造成存活期因應的挑戰。因此，本研究旨在瞭解其因應策略與人格特質之相關性，並分析影響因應策略之相關因素。研究方法：採橫斷式相關性研究，取樣於台北市某醫學中心肝膽腸胃內科及外科門診收案。研究工具包含基本屬性與疾病問卷、D型人格量表、症狀困擾量表及簡明因應量表，並以相關性統計及廣義估計方程式進行資料分析。研究結果：情緒焦點因應策略是最常使用之因應策略；受訪163名個案中有31人（19%）為D型人格，其使用情緒焦點策略顯著少於非D型人格。女性、非D型人格者、年紀較輕、教育程度愈高、罹患B型肝炎時間較長、症狀困擾程度較輕、信仰基督／天主教者，較常使用情緒焦點因應；年紀較輕、罹患B型肝炎時間較長、症狀困擾程度較輕、教育程度愈高較會使用問題焦點因應；但年齡較輕者，也較易使用功能不良型因應策略。結論：三種不同焦點因應策略之相關因素各有不同。整體而言，建議臨床上可篩檢具D型人格特質患者，同時教導如何處理症狀困擾，以協助其正向因應疾病。同時，針對因應策略不佳之年輕高危險群，主動給予關懷及協助。

關鍵字

肝癌 ； 因應策略 ； 人格特質

並列摘要

Background: Owing to the high recurrence rate of hepatocellular carcinoma, coping with the disease in the survival period can be challenging. The aims of this study were to explore the association between coping strategies and personality and to identify factors associated with coping strategies. Methods: A cross-sectional correlated design was used and patients were recruited by convenience sampling from wards and outpatient departments at a medical center in Taipei. A set of structured questionnaires was used to collect data including patients' demographic and disease information, Symptom Distress Scale, Type D Scale-14 and the brief COPE scale. Data were analyzed by descriptive statistics and generalized estimating equations. Results: Emotion-focused strategies were the most frequently used strategies. Among the 163 participants, 31 patients had type D personality (19%) and tended not to use emotion-focused strategies. Factors associated with patients using emotion-focused strategies included female gender, non-type D personality, younger age, higher level of education, Christian/Catholic, longer duration as HBV carrier, and lower level of symptom distress. Factors associated with patients using problem-focused strategies included younger age, higher level of education, longer duration as HBV carrier, and lower level of symptom distress. Younger age was also associated with patients using malfunction strategies. Conclusions: This study showed that different factors were associated with the three types of coping strategies. We recommend that patients be screened for type D personality, so that those with higher levels of distress when managing their symptoms can be helped to have a positive coping process. Health care providers should also proactively take care of younger patients with mal-adaptation.

並列關鍵字

hepatocellular carcinoma ； coping strategy ； personality