- 學位論文
婦癌婦女症狀困擾、社會支持、靈性安適 與生活品質之相關性研究
Symptom Distress, Social Support, Spiritual Well-being and Quality of Life Among Women with Gynecologic Cancer
摘要
全球因婦科癌症死亡人數逐年提高，婦科癌症儼然成為全球性的疾病負擔，癌症患者在疾病不同階段產生多重症狀困擾， 而不同程度的社會支持以及靈性安適會對個人生活品質產生影 響。本研究以橫斷式相關性研究設計，探討婦癌婦女之症狀困 擾、社會支持、靈性安適與生活品質之相關性。採立意取樣， 於台中某醫學中心進行收案，共招募 105 位符合收案條件之婦 癌婦女進行問卷調查，問卷包括:人口學特性、台灣簡明版世 界衛生組織生活品質問卷、中文修訂症狀困擾量表版、簡式中 文版社會支持量表及靈性安適量表，問卷資料以 IBM SPSS Statistics 26 版套裝軟體進行描述性、相關性、差異性及複迴歸 分析。研究結果顯示在生活品質四大範疇中，以「環境」範疇 之生活品質(Mean=15.07, SD=2.47)得分最高，「心理」範疇 之生活品質(Mean=14.1, SD=2.74)得分最低。有主要照顧者 較無主要照顧者之社會支持得分較高，且與社會支持呈正相關; 治療狀況在症狀困擾上有顯著差異，其中尚未治療的婦癌婦女 之症狀困擾程度高於完成治療之婦癌婦女。症狀困擾與靈性安 適、生活品質之四個範疇呈負相關;社會支持與靈性安適及生 活品質之四個範疇呈正相關。症狀困擾、社會支持、靈性安適 為生活品質的重要預測因子，在生活品質之生理範疇中，症狀 困擾及社會支持總計 33.8%的變異量;在生活品質之心理範疇 中，靈性安適、社會支持及症狀困擾總計 48.5%的變異量;在 生活品質之社會關係範疇中，社會支持總計 38.3%的變異量; 在生活品質之環境範疇中，靈性安適及社會支持總計 39.7%的 變異量。建議將症狀困擾、社會支持與靈性安適之議題納入護理教 育中，提升醫療人員對相關議題之關注並能及時評估，提供適 切之社會支持與靈性關懷，提供完整且多元的醫療照顧，以提 升臨床照護品質，進而增進個案之生活品質。
並列摘要
With an increasing mortality rate worldwide, gynecological cancer has become a global health challenge. While cancer patients suffer from multiple symptoms at different stages of treatment, providing them with different levels of social support and spiritual well-being can positively affect their quality of life. This was a cross-sectional study that explored the relationship between symptoms, social support, spiritual well-being, and quality of life of women with gynecological cancer. A total of 105 patients who were recruited from a large medical center in Taichung City, Taiwan, using the purposive sampling method. Subsequently, multiple questionnaire surveys were conducted, including a demographic characteristics survey, the Taiwanese version of the World Health Organization Quality of Life-Brief, the Symptom Distress Scale-Chinese Modified Form, the Interpersonal Support Evaluation List-Short Form, and the Functional Assessment of Chronic Illness Therapy–Spiritual Well-being Scale. The descriptive, correlation, difference, and multiple regression analyses of the questionnaire data were performed using the IBM SPSS Statistics Version 26.0 software package. The results showed that the environmental domain had the highest mean score, whilst, psychological domain had the lowest mean score. Symptom distress was significantly negatively correlated with spiritual well-being and four domains of quality of life. Social support was significantly positively correlated with spiritual well-being and four domains of quality of life. Spiritual well-being was significantly positively correlated with four domains of quality of life. In addition, the social support score of patients with primary caregivers was higher than that of those without, indicating that the factor of primary caregiver was positively correlated with social support. Furthermore, there were significance differences in the symptom distress of patients with different treatment statuses. Specifically, the symptom distress of women with uncreated gynecological cancer was higher than that of those who completed treatment. In addition, symptom distress and social support were predictors of the psychological domain of quality of life, accounting for 33.8% of the variance. Spiritual well-being, social support and symptom distress were predictors of the psychological domain of quality of life, accounting for 48.5% of the variance. Social support was predictor of the social relationship domain of quality of life, accounting for 38.3% of the variance. Spiritual well-being and social support were predictors of the environmental domain of quality of life, accounting for 39.7% of the variance. The current study provides a comprehensive picture for nurses and healthcare professionals to understand the factors associated with quality of life among gynecological cancers patients. Health care professionals should assess the levels of symptom distress, social support and spititual wellbeing of patients in order to provide appropriate and timely help to improve their quality of life.