婦癌婦女焦慮憂鬱及生活品質之相關因素探討

Correlation Among Anxiety, Depression, and Quality of Life in Women With Gynecologic Cancer

葉月珍(Yueh-Chen YEH) ； 黃曉峰(Sheau-Feng HUANG) ； 呂建興(Chien-Hsing LU)

《護理雜誌》 66卷6期 (2019/12) Pp. 43-53

https://doi.org/10.6224/JN.201912_66(6).07

摘要

背景：焦慮和憂鬱是婦科癌症婦女在治療過程常有的情緒困擾，常會危及婦女的身心健康而影響生活品質。目的：探討婦科癌症婦女的焦慮、憂鬱、社會支持及生活品質的影響因素。方法：採橫斷式相關性研究，以方便取樣選取中部某醫學中心共111位婦科癌症婦女為研究對象。以「基本資料表」、「臺灣簡明版世界衛生組織生活品質問卷」、「社會支持量表」及「醫院焦慮憂鬱量表」進行資料的收集。結果：本研究樣本具有中等程度的生活品質（3.46; SD = 0.73），41.4 %婦癌婦女有焦慮傾向、24.3 %有憂鬱傾向，四個範疇的平均分數以生理健康範疇得分最高（14.93; SD = 2.24），依序為環境健康（14.76;SD = 1.97）、社會關係（14.13; SD = 2.33）和心理健康（13.92; SD = 2.44）。焦慮、憂鬱、婚姻狀況和社會支持等變項可有意義的解釋生活品質總變異量之18.5%－37.0%。焦慮為最重要的解釋因子，可預測四個範疇的生活品質。結論／實務應用：建議醫療團隊成員能加強對婦科癌症婦女早期評估其焦慮、憂鬱及社會支持、增加對婦女情緒狀況之敏感度、提供及時的支持性照護，並對其需求提供衛教與適時轉介，以及提供婦女所需之照護措施，以維持其生活品質。

關鍵字

焦慮 ； 憂鬱 ； 婦癌 ； 生活品質 ； 社會支持

並列摘要

Background: Anxiety and depression are common emotional distresses experienced by women during gynecologic cancer treatment. These often have dangerous effects on physical and mental health and may impact quality of life (QoL). Purpose: To investigate the factors influencing anxiety, depression, social support, and QoL in women with gynecologic cancer. Methods: This was a cross-sectional correlational study. A total of 111 women with gynecologic cancer receiving treatment at a medical center in central Taiwan were selected as subjects using convenience sampling. A demographic characteristics questionnaire, the World Health Organization Quality of Life-Brief-Taiwan version (WHOQOLBREF- Taiwan version) questionnaire, the International Support Evaluation List (ISEL), and the Hospital Anxiety and Depression Scale (HADS) were used for data collection. Results: Of the 111 subjects, 41.4% and 24.3% had tendencies for anxiety and depression, respectively, and a moderate QoL score (mean = 3.46; SD = 0.73). The physical health domain had the highest mean QoL score (14.93; SD = 2.24), followed by environmental health (14.76; SD = 1.97), social relationships (14.13; SD = 2.33), and psychological health (13.92; SD = 2.44). Anxiety, depression, marital status, and social support respectively explained 18.5%-37.0% of the total variation in QoL scores. Of the four QoL domains examined in this study, anxiety was the most significant predictor of QoL. Conclusion/Implications for Practice: It is recommended that healthcare professionals strengthen the early assessment of anxiety, depression, and social support in women with gynecologic cancer. In addition, sensitivity towards emotional status should be increased in these cases. Healthcare professionals should provide care, support, and timely completion of referrals. Finally, psychological and social support and related interventions should be provided based on patient needs in order to maintain QoL.

並列關鍵字

anxiety ； depression ； gynecologic cancers ； quality of life ； social support

參考文獻

張世柔、戈依莉（2012）．子宮頸癌婦女生活品質測量工具介紹．長庚科技期刊，16，83–92。[Chang, S. J., & Ko, Y. L. (2012). The concept of quality of life and its assessment tools in women with cervical cancer. Chang Gung Journal of Sciences, 16, 83–92.] https://doi.org/10.6192/CGUST.2012.6.16.9

曲幗敏、蔡玉鳳、蘇僅涵、林聿品、黃金瑩、陳美碧（2019）．探討護理人員與癌症病人對病人之症狀困擾、情緒困擾及靈性安適評估之一致性．源遠護理，13（1），29–40。[Chu, K. M., Tsai, Y. F., Su, C. H., Lin, Y. P., Huang, C. Y., & Chen, M. B. (2019). Exploring of nurses' and cancer patients' agreements of assessment in patients' symptom distress, emotional distress, and spiritual well-being. Yuan-Yuan Nursing, 13(1), 29–40.] https://doi.org/10.6530/YYN.201903_13(1).0004

Tsai, L. Y., Wang, K. L., Liang, S. Y., Tsai, J. M., & Tsay, S. L. (2017). The lived experience of gynecologic cancer survivors in Taiwan. The Journal of Nursing Research, 25(6), 447–454. https://doi.org/10.1097/JNR.0000000000000229

姚開屏（2002）．台灣版世界衛生組織生活品質問卷之發展與應用．台灣醫學，6（2），193–200。[Yao, K. P. (2002). Development and applications of the WHOQOL-Taiwan version. Formosan Journal of Medicine, 6(2), 193–200.] https://doi.org/10.6320/FJM.2002.6(2).09

陳君儀、鄭麗珍（2014）．影響癌友生活品質因素的研究：檢視增權條件的調節效果．台灣公共衛生雜誌，33（4），410–427。[Chen, C. Y., & Cheng, L. C. (2014). An examination of the direct and mediating effects of empowerment factors on the quality of life among cancer survivors. Taiwan Journal of Public Health, 33(4), 410–427.] https://doi.org/10.6288/TJPH201433103020