子宮內膜異位症與子宮腺肌症婦女的經痛經驗及其對生活品質之探討

Dysmenorrhea Experience and Its Impacts on Quality of Life in Women With Endometriosis and Adenomyosis

洪媺惠(Mei-Hui 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(2004年)

摘要

本研究目的在探討及比較子宮內膜異位症與子宮腺肌症婦女經痛的經驗及其對生活品質的影響。本研究採取橫斷式的研究設計，以立意取樣方式得共選取155人，經手術或病理切片的診斷分為三組：輕度子宮內膜異位組為20人，中、重度子宮內膜異位組為80人，子宮腺肌症組為55人。統計以描述性統計、單因子變異數分析(one way ANOVA)及事後檢定(Scheffe’s post hoc )。研究結果發現：(1) 子宮腺肌症比子宮內膜異位症在經痛情感層面及整體疼痛強度較強，在經痛天數、經痛年數持續時間較久; (2)子宮腺肌症比子宮內膜異位症在整體生活品質和五大層面生活品質(疼痛、控制和無力感、情緒安適、社會支持、自我形象) 上有較大的影響; (3)經痛情感層面愈強、整體疼痛強度愈強、疼痛部位數量愈多及年齡愈大者，對整體生活品質的影響愈大，呈現正相關，可解釋整體生活品質之總變異量的35.5%，其中經痛情感層面對整體生活品質有最大的解釋力。此研究結果期能增加健康照護人員對子宮內膜異位症及子宮腺肌症病患經痛經驗的瞭解，對提昇該群婦女之照護預期有實質貢獻。

關鍵字

子宮內膜異位症 ； 子宮腺肌症 ； 疼痛 ； 經痛 ； 生活品質

並列摘要

The aims of the cross-sectional study were to compare the experiences of dysmenorrhea and the impacts on the quality of life (QOL) in women with endometriosis and adenomyosis. A total of 155 women were recruited. Study subjects were classified into 3 groups based on their diseases status: stage I and II endometriosis (n=20), stage III and IV endometriosis (n=80), and adenomyosis (n=55). The descriptive statistics, ANOVA, Pearson’s correlations, and multiple regression were used to analyze the data. The results showed that (1) women with adenomyosis had significantly higher levels affective pain, total pain intensity and longer pain duration, days duration of dysmenorrhea, and years duration of dysmenorrhea than women with endometriosis and adenomyosis; (2) women with adenomyosis perceived higher impacts on overall QOL and the five sub-dimensions of QOL thanwomen with endometriosis; (3) the affective aspect of pain, total pain intensity, number of pain site and age could positively predict the overall QOL and could explain 35.5% variance of total QOL. The findings suggest that dysmenorrhea is still a critical problem to women with endomentriosis and adenomyosis. Health care providers should put more attention on this issue and to enhance their life quality.

並列關鍵字

Endometriosis ； Adenomyosis ； pain ； Dysmenorrhea ； Quality of life

參考文獻

林淑玲 (2001)．子宮內膜異位症對婦女婚姻生活之影響．碩士論文，台北:國立陽明大學。 林笑 (1994)．骨性關節炎病患生活品質及其相關因素之探討．護理研究，2(4)，371-378。

侯嘉音 (2000)．子宮內膜異位女性的生活經驗．未發表的碩士論文，高雄:高雄醫學大學。 陳明哲 (2000)．淺談子宮內膜異位症．中華民國內膜異位症婦女協會會刊，7(12)，5-6。

陳瓊瑤 (2000)．乳癌生存者生活品質及其相關因素之探討．未發表的碩士論文，台北:長庚大學。 張明揚 (1998)．不孕症又發現子宮內膜異位症怎麼辦．中華民國內膜異位症婦女協會會刊，5(11)，4-5。(二)

英文部分 Aaronson , N. K. (1993). Assessment of quality of life and benefits from adjuvant therapies in breast cancer. Recent Results in Cancer, 127, 201-210.

Abbey, A., & Andrews, F. M. (1985). Modeling the psychological determinants of life quality. Social Indicator Research, 16, 1-34.