- 學位論文
非肌肉侵犯性膀胱癌患者睡眠品質與相關因素之探討
Sleep Quality and Related Factors in Patients with Non-muscle Invasive Bladder Cancer
摘要
研究背景：非肌肉侵犯性膀胱癌患者長期存活率較高，但其疾病治療過程，需經過密集且具侵入性的膀胱鏡檢查追蹤與膀胱內藥物灌注治療，可能影響病人的睡眠品質，過去對此方面之研究較有限。 研究目的：本研究主要探討非肌肉侵犯性膀胱癌病人之 (1) 症狀嚴重度、心理困擾與睡眠品質現況，(2) 瞭解影響病人睡眠品質的相關因素。 研究方法：本研究為一橫斷式研究，以五年內診斷非肌肉侵犯性膀胱癌之病人為收案對象，於臺灣北部某醫學中心之泌尿科門診進行資料蒐集，採一次性的結構式問卷訪談，評估病人之症狀嚴重度、心理困擾與睡眠品質現況，資料以SPSS軟體進行分析，以敘述性統計描述人口學特質、疾病與治療特性、症狀嚴重度、心理困擾與睡眠品質現況，以曼—惠特尼U 檢定與卡方檢定分析睡眠品質與各變項間之相關性與差異，並以羅吉斯迴歸分析影響睡眠品質之重要因素。 研究結果：本研究受訪者共131 人（85 名男性、46 名女性），匹茲堡睡眠品質量表 (Pittsburgh Sleep Quality Index, PSQI) 總分平均為6.7 分 (SD = 3.9)，其中，55% 之患者有睡眠品質不佳 (PSQI >5) 的情形。以羅吉斯迴歸進行分析，結果顯示非肌肉侵犯性膀胱癌患者睡眠品質之顯著影響因素包含：「罹病前主觀睡眠品質較差」、「接受過較多次膀胱鏡檢查」、「較高程度的疲倦」、「較高程度的解尿時有疼痛或灼熱感」以及「較高程度的害怕復發」。 結論：本研究為針對非肌肉侵犯性膀胱癌患者進行之第一篇睡眠品質相關研究，結果顯示超過半數的非肌肉侵犯性膀胱癌患者有睡眠品質不佳的問題，且影響患者睡眠品質的重要因素是多面向的。未來建議可針對顯著影響因子進行縱貫性研究，以瞭解患者疾病歷程中各階段睡眠品質之變化，期能及早提供適當介入，進一步提升整體照護品質。
並列摘要
Background: Patients with non-muscle invasive bladder cancer (NMIBC) have relatively long survival time. Due to the intensive intravesical instillation, intrusive cystoscopy follow-up examinations, as well as physical and psychological distress related to the disease and treatments, these factors might influence patients’ sleep quality. However, relatively little research has explored the issue. Purpose: The purposes of the study were to (1) investigate the current status of symptom severity, psychological distress and sleep quality; and (2) identify the above factors as well as disease-treatment related factors of their association with sleep quality in patient with NMIBC. Methods: A cross-sectional study was conducted to recruit patients with NMIBC from a medical center in North Taiwan. Eligible subjects were NMIBC patients diagnosed within 5 years. Patients were assessed of their symptom severity (pain, fatigue, and urinary symptoms), psychological distress (future worry and fear of recurrence), and sleep quality. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI). Data were analyzed through descriptive statistics, Mann-Whitney U test, Chi-square test, and logistic regression. Result: A total of 131 patients (85 males, 46 females) were recruited. The mean score of PSQI was 6.7 (SD = 3.9). More than half of the subjects (55.0%, n= 72) had relatively poor sleep quality (PSQI >5). The results of logistic regression revealed that “having poor previous sleep quality”, “receiving more times of cystoscopy”, “higher level of fatigue”, “higher level of having pain or a burning feeling when urinating”, and “higher level of fear of recurrence” were factors significantly related to poor sleep quality in NMIBC patients. Conclusion: The results showed NMIBC patients’ sleep quality is a problem needs to be cared. Factors related to the problems should also be assessed and concerned. Future research to develop and test appropriate interventions are strongly suggested to improve theses patients’ sleep quality.
參考文獻
延伸閱讀
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