肺癌與慢性阻塞性肺部疾病患者之憂鬱相關因素探討

Comparison of Related Factors for Depression in Patients with Lung Cancer and Chronic Obstructional Pulmonary Disease

王麗華(Li-Hua Wang)

指導教授 ： 蔡欣玲

臺北醫學大學/護理學院/護理學研究所/碩士(2005年)

摘要

本研究目的在比較肺癌患者與慢性阻塞性肺部疾病患者的憂鬱相關因素。 本研究採取橫斷式比較設計(cross-sectional comparison design)，以立意取樣(purposive sampling)方式，於北部某醫學中心醫院之胸腔科及腫瘤科病房進行收案，61位肺癌患者以及30位慢性阻塞性肺部疾病患者為有效樣本。以貝氏憂鬱量表（Beck Depression Inventory；BDI）、簡易疼痛評估量表（Pain Assessment Form；PAF）、WHOQOL – BREF台灣簡明版生活品質問卷、症狀困擾量表和日常生活活動量表，為研究工具收集資料。 研究結果：一、慢性阻塞性肺部疾病組個案的疼痛程度高於肺癌個案。二、肺癌患者的生活品質程度高於慢性阻塞性肺部疾病組個案。三、以強迫進入法之線性回歸分析法進行統計分析，症狀困擾與日常生活活動功能對肺癌個案憂鬱的影響大於生活品質對於憂鬱的影響。而生活品質對慢性阻塞性肺部疾病個案憂鬱的影響較為顯著。四、若以逐步法之線性回歸分析法進行分析，結果呈現影響肺癌組個案憂鬱的因素主要為症狀困擾，其次為日常生活活動功能；而影響慢性阻塞性肺部疾病組個案憂鬱的最主要因素為生活品質，其次則為症狀困擾。 本研究建議：一、未來研究可就慢性阻塞性肺部疾病患者的疼痛性質加以探討。二、在內外科病房的臨床實務中，將憂鬱症篩檢列為常規檢查事項，並舉辦憂鬱症相關教育訓練。三、在護理教育課程中，應增加內外科病患憂鬱症相關知識，了解生理與心理融合照護的重要性。

關鍵字

肺癌 ； 慢性阻塞性肺部疾病 ； 憂鬱 ； 疼痛 ； 生活品質 ； 症狀困擾 ； 日常生活活動功能

並列摘要

Abstract Title of Thesis: Comparison of Related Factors for Depression in Patients with Lung Cancer and Chronic Obstructional Pulmonary Disease Institution: Graduate Institute of Nursing, Taipei Medical University Author: Li-Hua Wang Thesis directed by : Sing-Ling Tsai, Professor of Taipei Veterans General Hospital The aim of the study is to compare the depression related factors between lung cancer patients and chronic obstructive pulmonary disease patients (COPD). This is a cross-sectional comparison design. A purposive sampling frame was used in this study. Sixty-one lung cancer patients and thirty COPD patients were recruited from the inpatient settings of departments of chest and oncology at the medical center hospital. The data was collected through using the questionnaires of Beck Depression Inventory (BDI), Pain Assessment Form(PAF), WHOQOL–BREF Quality of Life Questionnaire of Taiwan Version, Symptom Distress Rating Scale, and Daily Activities Rating Scale. The results of the study were (1) The level of pain was higher among patients with COPD than patients with lung cancer, (2) The level of quality of life was higher among patients with lung cancer than patients with COPD, (3) according to enter method of linear regression test, lung cancer patients were more affected by symptom distress and daily activities than by quality of life. On the other hand, COPD patients were more affected by quality of life than other factors, (4) according to stepwise method of linear regression test, the most important factor of depression for lung cancer patients was symptom distress, followed by daily activities. For COPD patients, the most important factor of depression was quality of life, followed by symptom distress. The study suggested that (1) the future study needs to explore the characteristics of the pain of patients with COPD, (2) the screen of depression can be included in the nursing practice in the inpatient settings of medical and surgical departments, (3) knowledge about depression needs to be included in nursing education in order to help nurses understand the importance of caring patients’physical and psychological problems.

並列關鍵字

Chronic obstructive pulmonary disease ； Lung cancer ； Depression ； Symptom Distress ； Quality of life ； Pain ； Daily activities function

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