結腸直腸癌癌症存活者的健康生活型態、身體活動度與生活品質之相關性探討

本研究旨在探討結腸直腸癌癌症存活者其健康生活型態、身體活動度與生活品質之關係，並進一步探討生活品質之預測因子。本研究採用橫斷式描述性研究設計，以結構式問卷進行資料收集，問卷內容分為病歷紀錄資料、個案基本資料表、癌症存活者健康計畫行為量表、IPAQ國際身體活動量表－自填長版、世界衛生組織生活品質問卷-台灣簡明版(WHOQOL-BREF)。採立意取樣，於南部某醫學中心之大腸直腸科病房區收案，選取共110位結腸直腸癌患者。以SPSS 23.0套裝軟體進行分析，以描述性統計、t檢定、單因子變異數分析、皮爾森相關分析、與階層迴歸分析結腸直腸癌癌症存活者在健康活動型態、身體活動度及生活品質各層面的現況與相關影響。本研究結果顯示研究對象生活品質整體得分為58.34分。在生活品質的四個範疇中，於環境範疇部分最高、次高為社會關係範疇，而心理健康範疇評價得分最低。身體功能狀態 (Karnofsky performance scale, KPS) 與生活品質整體得分，為顯著中度正相關，其r值為0.47 ( P=0.000)。行為意圖(r=0.48、P=0.000)、感知行為控制(r=0.41、P=0.000)及健康行為(r=0.33、P=0.000)與生活品質整體得分為低至中度顯著正相關，其r值為0.33-0.48。身體活動強度以走路與生活品質整體得分最高，為顯著低度正相關 (r=0.37、P=0.000)，身體活動目的以休閒與生活品質整體得分次高，為顯著低度正相關 (r=0.36、P=0.000)。能顯著預測生活品質之變項為KPS(β=0.33，P=0.000)及身體活動強度為走路 (β=0.18，P=0.031)，此二預測因子可有效解釋依變項生活品質達40％變異量(P=0.000)。身體功能狀態越好，病人的整體生活品質也更佳。行為意圖、感知行為控制及健康行為越佳，整體生活品質越好。身體活動度部分以走路之強度及以休閒為目的時間越高，生活品質整體越佳。健康促進不應僅侷限於健康民眾達到增進健康的目標，結腸直腸癌癌症存活者應提升整體健康狀態，來讓自己在未來與疾病共存的期間，避免因體力衰弱，產生失能，甚至疾病復發等影響。期望藉此研究結果，除了提供醫護專業人員對於結腸直腸癌病人做為臨床衛教時機之參考，亦能增加結腸直腸癌存活者照護品質與涵蓋面，使其得到實質的幫助。

關鍵字

結腸直腸癌；癌症存活者；健康生活型態；身體活動度；生活品質

並列摘要

The purpose of this study was to explore the relationship between healthy lifestyle, physical activity and quality of life in colorectal cancer survivors, and to investigate the predictors of quality of life. This study was a cross-sectional descriptive study. The questionnaires were divided into medical records, demography data, Health Planned Behavior Questionnaire for Cancer Survivors, IPAQ International Physical Activity Scale- self-administered long version, and WHO Quality of Life Questionnaire-Taiwan Brief Edition (WHOQOL-BREF). A total of 110 patients were recruited in the colorectal ward of a medical center in the south of Taiwan. SPSS 23.0 software package was used to analyze the data by descriptive statistics, t-test, ANOVA, Pearson correlation analysis and hierarchical regression analysis. The study results showed that the total score of quality of life of subjects was 58.34. Among the four categories of quality of life, the environmental category was the highest and followed by social relationship category, while the lowest was mental health category. And Karnofsky performance scale (KPS) was significant moderate positive correlated with the total score of quality of life, with an r value of 0.47 (P = 0.000). Behavior intention (r = 0.48, P = 0.000), perceived behavior control (r = 0.41, P = 0.000) and health behavior (r = 0.33, P = 0.000) were Low to moderate significant positively correlated with the total score of quality of life. In intensity of physical activity, walking with a significant low positive correlation (r = 0.37, P = 0.000) in total score of quality of life. In purpose of physical activity, leisure ranked second place with a significant low positive correlation (r = 0.36, P = 0.000) in total score of quality of life. The significant predictors of quality of life were KPS (beta = 0.33, P = 0.000) and walking (beta = 0.18, P = 0.031), those two could effectively explain the 40% variation of quality of life (P = 0.000). The better physical function of patient, the better overall quality of life patient had. The better behavioral intention, perceived behavioral control and healthy behavior, the better overall quality of life patient had. And in physical activity, the harder walking strength and more time for leisure, the better overall quality of life. Health promotion should not be limited to healthy people to achieve the goal of developing health. Colorectal cancer Survivors should improve their overall health status to avoid physical weakness, disability and even reoccurrence of cancer and coexistence with disease. We expect that this study will not only provide medical professionals a evidence in clinical health education for patients with colorectal cancer, but also increase substantial help on the quality and coverage of care for colorectal cancer survivors.

並列關鍵字

colorectal cancer ； cancer survivors ； healthy lifestyle ； physical activity ； quality of life

參考文獻

Center, M. M., Jemal, A., & Ward, E. (2009). International trends in colorectal cancer incidence rates. Cancer Epidemiol Biomarkers Prev, 18(6), 1688-1694. doi: 10.1158/1055-9965.epi-09-0090

Torre, L. A., Bray, F., Siegel, R. L., Ferlay, J., Lortet-Tieulent, J., & Jemal, A. (2015). Global cancer statistics, 2012. CA Cancer J Clin, 65(2), 87-108. doi: 10.3322/caac.21262

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