探討運用伸展運動與癌痛衛教於改善癌症病患疼痛經驗之成效

The Effect of Stretching Exercise and Pain Education on Cancer Patients’ Pain Experience

洪佳黛(Chia-Tai Hung)

指導教授 ： 賴裕和

臺北醫學大學/護理學院/護理學研究所/碩士(2005年)

摘要

疼痛為癌症病患最常面臨的症狀，是多層面的複雜經驗，因此疼痛處理需要多方的處置方式，故本研究目的擬探討及比較癌痛衛教、癌痛衛教加伸展運動訓練與病房照顧對癌症病患疼痛改善的效果。 本研究從94年2月至94年6月，共4個月，於北部2所醫學中心之腫瘤相關病房選取研究對象，研究設計採類實驗法，以隨機分派將符案病患分為（1）衛教組，每天接受10-15分鐘的癌痛衛教方案並連續五天（實驗組Ⅰ，12人），（2）衛教+伸展組，每天接受15分鐘的癌痛衛教及執行15分鐘伸展運動連續5天（實驗組Ⅱ，12人），（3）控制組為接受一般病房常規照顧(12人)，共36人，所有的個案在研究期間（共28天）接受4次評量，分別為前測（T0）、第6天（第一次後測，T1）、第14天（第二次後測，T2）、第28天（第三次後測，T3）。 分別以簡明疼痛量表－臺灣版（Brief Pain Inventory Short Form Taiwanese [BPI - T)]）評估疼痛強度及疼痛干擾，疼痛及麻醉性止痛藥信念（Pain and Opioid Analgesic Beliefs Scale - Cancer [POABS - CA]）評估研究對象之疼痛及麻醉性止痛藥信念、情緒量表簡明版（Profile of Mood State short Form [POMS-SF]）及以10分數字量表（Numeric rating scale [NRS]）評估疲憊、焦慮與憂鬱情緒困擾。研究結果以描述性統計、單因子變異數分析、重複測試變異數分析等統計方法執行資料分析。 本研究結果發現，經過一個月的追蹤：（1）經過介入方案後，測量衛教+伸展組之過去24小時的疼痛干擾日常生活、情緒、與他人關係、睡眠及生活樂趣，有顯著改善；（2）兩組實驗組之研究對象在接受癌痛衛教後，不正確疼痛及麻醉性止痛藥信念得分減少與控制組得分比較，達到顯著差異。 本研究結果顯示，癌痛衛教可改善癌患不正確的疼痛及麻醉性止痛藥信念，癌痛衛教配合伸展運動可減少研究對象之疼痛干擾，並增加癌痛病患的活動能力。

關鍵字

癌症疼痛、疼痛信念、癌痛衛教、伸展運動、負向情緒困擾、疲憊

並列摘要

Pain is a frequently symptom in cancer patients and needs many different ways to manage its characters with multiple dimensions. The Structured pain education program has been shown to reduce the severity of this symptom in cancer patients and stretching exercise has been detected to improve other pain experiences. Therefore, this randomized controlled study aimed to assess the effects of two therapies on cancer patients with pain experience. Appropriated cancer patients were assigned to three groups, including (1) pain education group, accepted 10- 15 min per day for 5 days (Experimental group I, n= 12), (2) pain education plus stretching exercise group, 15 min education and 15 min exercise for 5 following day (Experimental groupⅡ, n= 12), (3) standard care control group, accepted usual ward routine care (control group, n= 12). All cases were carried out and evaluated in four times, (Pretest [T0], Day 6 [T1], Day 14 [T2], and Day 28 [T3]) for four weeks ( total 28days). Pain intensity, Pain interferences with daily life, beliefs about pain and opioids, mood status, and fatigue of all cases were evaluated by the Brief Pain Inventory Short Form Taiwanese (BPI-T), Pain and Opioid Analgesic Beliefs Scale – Cancer (POABS-CA), Profile of Mood State short Form (POMS-SF), and Numeric rating scale (NRS). Data were analyzed by using descriptive statistics, one - way ANOVA, and Repeated measure ANOVA. The result showed that (1) pain interferences with general activity, mood, relations with other people, sleep, and enjoyment of life were significantly improving in following evaluation in experimental groupⅡ, (2) there were significantly statistic difference between two experimental groups and control group on beliefs about pain and opioids. In conclusion, the result indicated that, after complete treatment, pain education plus stretching exercise could improve cancer patients’ daily life, and patients who had received structured pain education, had significantly less negative beliefs about pain and opioids than the control group. These interventions should be practiced effetely in clinical nursing care for cancer patients.

並列關鍵字

cancer pain, pain belief, pain education, stretching exercise, mood disturbance, fatigue

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