乳癌患者之健康知能與健康照護結果之相關性研究

Related health literacy and health care outcomes of research in the breast cancer patients

張秀雲(Hsiu-Yun Chang)

指導教授 ： 湯澡薰

臺北醫學大學/公共衛生暨營養學院/醫務管理學研究所/碩士(2010年)

https://doi.org/10.6831/TMU.2010.00078

摘要

健康民眾2020（Healthy People 2020）將健康知能及自我照護能力列為國家級目標之一，健康知能不足的民眾因對健康訊息的理解力差，健康知識不足，未遵從治療，或無法有效與醫師溝通而影響健康狀況，導致失能及慢性病的盛行率高，預防保健的利用率低，醫療照護費用較高，可能缺乏疾病知識，展現較差的照護與較差的照顧行為。國內女性乳癌發生率與死亡率逐年增加，而術後合併症可能出現在20 年後。有研究結果顯示，上肢有問題的病人相較於無上肢併發
症的病人其生活品質顯著較差。唯有輔導病人如何預防合併症的發生，及早發現，早期治療，才有助於提升他們的生活品質。
本研究係對台北市某醫學中心須執行手術治療之90 位乳癌婦女，採立意抽樣的方式收集，調查其健康知能程度，並且於手術前及手術後進行手臂圍測量及復健運動方法之衛教，了解其手術後自我照護結果以及術後整體生活品質之相關性。使用的統計方法包括描述性統計、t 檢定、單因子變異數分析與事後薛費氏檢定等方法，以SPSS18.0 版軟體進行統計分析。
研究結果發現，病患是否會主動搜尋與手術相關訊息及是否習慣閱讀醫療保健訊息等變項，與健康知能狀態有顯著性的相關，然而健康知能與健康照護及整體生活品質並無統計上的顯著關連性。
整體看來健康知能高低與自我照護結果似乎沒有直接的影響，這攸關乎臨床上醫師的不斷叮嚀、甚而用電話追蹤確認交代過的醫囑、整個醫療團隊的緊密連結及追蹤時間的長短，都是可能會影響到患者照護結果的相關因素，因而，未來若能增加樣本數及延長追蹤個案的時間，甚而，納入不同屬性的醫療院所或不同區域的民眾，可能會有不同結果的呈現。

關鍵字

知能 ； 健康知能 ； 自我照護 ； 乳癌 ； 淋巴水腫

並列摘要

Background:According to the report of AHRQ shows that healthy consciousness shortage will be absolutely negative influence on the disease recovery and patient safety. Health
literacy is seen by scholar in order to predict healthy status and important index sign after recovery. The incidence rate of female breast cancer is the first place in the survey of National cancers. One of them, the surgery is the choice of majority. By the same case study, breast cancer patient survival rates reaches average 60 percent in ten years, zero period of breast patient or even close to 100 percent in the rest of their lives for coexistence with breast cancer and its complications. To sum up, only to
understand the extent of health knowledge and relevant factors, to counseling patients on how to prevent the occurrence of complications, early detection, early treatment, it will help improve theirs life of quality.
Purpose:1. The influence related factors for breast cancer surgical patient’s the healthy literacy. 2. The influence for breast cancer surgical patient’s the healthy literacy more or less. 3. The influence of breast cancer surgical patient’s literacy more or less for healthy life quality.
Methods:This research focus on the 90 women who have to accept surgical breast cancer treatment in the Medical Hospital Center of Taipei. Adopt the collection way of
purpose sampling, it will investigate the level of health literacy. Before the surgical and after that, we will offer them the education courses about measure theirs arm rounds and rehabilitation exercise methods, and analysis on the related of the result for surgical self-carrying and the life quality after surgery. Usage of the statistical
methods, including descriptive statistics, t test, and single factor variation number analyze to examine, Scheffe's test etc, and statistical analysis of SPSS18.0 version.
Results:The research found that patients actively search for surgery-related information or medical and health information have significantly related, but health literacy, health care and overall quality of life there no significantly correlated on statistics.
Conclusion:It seems that health literacy level, the results of self care have not directly affected, the clinical doctor’s ordered, even patient’s confirm delivery by telephone, keep it touch with the all medical team and the long or short of following time , it would be influence on the factors of patient’s care results. Thus in the future, if increase the sampling cases even following the cases for long period, even collects the different attributes of hospitals or the people from other regions , it would presents the significantly results.

並列關鍵字

literacy ； health-literacy ； self-care ； breast cancer ； lymphedema

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