頭頸部癌症病患在接受治療期間的症狀問題、事件衝擊及生活品質之探討

The Symptom Problems, Impact of Event and Quality of Life in Head and Neck Cancer Patients Receiving Therapy

黃采薇(Tsai-Wei Huang) ； 王銘志(Ming-Chih Wang)

《弘光學報》 51期 (2007/11) Pp. 11-28

https://doi.org/10.6615/HAR.200711.51.02

摘要

本研究主要探討頭頸部癌症病患在治療期間其症狀問題、事件衝擊與生活品質間之相關。研究方法採橫斷式調查，共收集25位正接受治療之頭頸部癌症病患，利用基本量表、頭頸癌問卷EORTC Quality of Life Head and Neck Module(EORTC QLQ-H&N 35)、事件衝擊量表(Impact of event scale-Chinese, IES-C)及視覺類比量表-整體生活品質為研究工具。研究統計利用百分比、平均值、標準差、無母數分析之Mann-Whiney U Test及Spearman's相關檢定等方法。研究結果：(1)頭頸癌病患之症狀問題依其嚴重程度先後為：唾液黏稠問題、口乾問題、吞嚥問題、病識感及張口問題等；(2)有使用止痛劑的病人在頭頸部疼痛、吞嚥問題及唾液黏稠問題上，仍較無使用止痛劑病人嚴重；(3)在事件衝擊量表部分，病人在逃避反應(avoidance)中的”我想到這件事時，盡量讓自己不激動”，及經驗重現(intrusion)中的”我常不自主的就會想起這件事”分數最高；(4)性生活問題(r=-0.668, p=0.000)、頭頸部疼痛(r=-0.42, p=0.035)及吞嚥問題(r=-0.42, p=0.036)與整體生活品質間呈現顯著負相關，亦即症狀愈嚴重，生活品質愈差；(5)本研究之頭頸部癌症病患之整體生活品質呈現中等程度(M=59.0,SD=31.9)，而基本資料、事件衝擊量表與整體生活品質間均無明顯統計上差異。本研究結果可提供臨床醫護人員提供病患合適之護理措施，尤其在止痛劑之使用、症狀問題之解決及面對疾病或治療事件衝擊的影響上，以期能提升病患在治療期間之生活品質程度。

關鍵字

頭頸癌 ； 症狀問題 ； 事件衝擊量表 ； 生活品質

並列摘要

In this cross sectional study, we evaluated the quality of life, impact of event and symptoms in head and neck cancer patients during treatment. The demographic data, symptoms and impact of event were further evaluated. There were 25 subjects included into this study. The questionnaire included visual analogue scale-quality of life, EORTC Quality of Life Head and Neck Module(EORTC QLQ-H&N35), and Impact of Event Scale- Chinese(IES-C). The statistical analysis was conducted by the Mann-Whiney U Test and Spearman's correlation tests. The results showed that: (1) the most distress symptoms were sticky saliva, dry mouth, swallowing problem, feeling of uncomfortable and problem of open mouth; (2) The patients who used anesthesia drugs complained more severed symptoms liked pain, swallowing problem, and sticky saliva than non-anesthesia patients; (3) In IES-C, the avoidance part ＂I avoided letting myself get upset when I thought about it or was reminded of it＂ and the intrusion part ＂I though about it when I didn’t mean to＂ have high score; (4) Sexuality, pain and swallowing problem showed a negative impact on the global quality of life; (5) The global quality of life was medium level. There were no significance with global quality of life, demographic data and IES-C. The results provided clinical information to understand the quality of life impact of head and neck cancer patients. By including the risk factors assessment in the nursing care, we could provide better nursing intervention and improve the quality of patient care.

並列關鍵字

head and neck cancer ； impact of event scale ； symptom problem ； quality of life

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