安寧共同照護模式於癌症病人在生活品質、憂鬱與靈性需求之成效

The effects of hospice shared-care model on quality of life, depressive levels, and spiritual needs for patients with cancer.

初秀珍(Shiow-Jen Chu)

指導教授 ： 高家常

義守大學/醫學院/醫務管理學系/碩士(2020年)

摘要

目的:探討安寧共同照護模式於癌症病人生活品質、憂鬱程度及靈性需求之成效
方法:採類實驗，前、後測設計，於南部某一區域醫院之癌症末期病人、年滿 20 歲，同意參與研究者為收案條件。提供研究對象 (N=30) 每週 2~3 次訪視，為期二週的安寧共同照護。問卷資料包括基本資料、中文版癌症生活品質核心問卷、台灣憂鬱量表、中文版癌症患者靈性需求量表。以描述性統計及廣義線性模式分析資料。
結果:在接受共照後生活品質之功能構面後測（Mean ± SD = 56.50 ± 5.81）低於前測（Mean ± SD = 69.17 ± 9.52, p <0.001）。症狀面構面後測（Mean ± SD = 52.57 ± 5.47）低於前測（Mean ± SD = 63.42 ± 9.28, p <0.001）。整體健康生活品質後測（Mean ± SD = 71.19 ± 15.86）高於前測（Mean ± SD = 41.67 ± 11.73, p <0.001）。憂鬱程度後測（Mean ± SD = 12.87 ± 4.91）低於前測（Mean ± SD = 28.97 ± 8.54, p <0.001）。整體靈性需求後測（Mean ± SD = 3.03 ± 0.47）高於前測（Mean ± SD = 1.48 ± 0.86, p <0.001）。
結論:安寧共同照護模式介入可以在症狀面、整體健康生活品質、憂鬱程度及靈性需求有改善，但於功能構面未提升。

關鍵字

安寧共同照護 ； 癌症病人 ； 生活品質 ； 憂鬱程度 ； 靈性需求

並列摘要

Purpose: The study was performed to assess the effects of hospice shared-care model on quality of life, depressive levels, and spiritual needs for patients with cancer.
Methods: This study adopted a quasi-experimental design with a single group using the comparison between a 2-week interval at a regional and teaching hospital in southern Taiwan. Inclusion criteria included patients (N=30) who aged over 20 and agreed to participate in the study. The questionnaires used for the study included personal information, the Quality of Life Questionnaire-Chinese version (QLQ-C30), the Taiwanese Depression Scale (TDQ), and Chinese Version of Spiritual Interests Related to Illness Tool (C-SpIRIT). Data strategies were descriptive statistics and generalized estimating equation.
Results: After the 2-week intervention, the scores showed significant differences between pre-test and post-test in the following subscales: the QLQ-C30:(1) the functional subscale (Mean ± SD = 69.17 ± 9.52 vs. 56.50 ± 5.81, p < 0.001) , (2) the symptoms subscale (Mean ± SD = 63.42 ± 9.28 vs. 52.57 ± 5.47, p < 0.001) , and (3) the global health status (Mean ± SD = 41.67 ± 11.73 vs. 71.19 ± 15.86, p < 0.001) , the overall TDQ scale (Mean ± SD = 28.97 ± 8.54 vs. 12.87 ± 4.91, p < 0.001), and the overall C-SpIRIT scale (Mean ± SD = 1.48 ± 0.86 vs. 3.03 ± 0.47, p < 0.001).
Conclusion: The hospice shared-care model is beneficial to improve the symptoms and global physical conditions of quality of life, depressive levels, and spiritual needs on patients with cancer, but it doesn’t seem to be beneficial to the functional status of quality of life.

並列關鍵字

hospice shared-care, cancer patients ； quality of life ； depressive ； spiritual needs

參考文獻

崔宛玉、林寬佳、黃惠璣（2013）．口腔癌手術病人於住院期間身體心像改變及其因應行為探討．護理暨健康照護研究，9(2)，127-138。doi:10.6225/JNHR.09.2.127

中文文獻

李英芬、李佩怡、劉景萍、任珮君、謝瑞坤、蔡麗雲 ( 2012 )．安寧共同照護介入對非安寧病房之癌末病人及其家屬之照護成效探討．馬偕護理雜誌，6(2)，14-27。

王麗惠、劉芹芳 ( 2005 )．生活品質概念分析於護理之應用．高雄護理雜誌，22(2)，41-50。

王淑貞、胡文郁、謝至鎠（2017）．老人安寧緩和療護的需求及處置探討．領導護理，18(2)，3-12。doi:10.29494/LN.201706_18(2).0001