以視覺遮斷法降低病童化學治療期間腸胃道症狀困擾之成效

Visual Interdiction as an Intervention for Alleviating Gastrointestinal Symptom Distress in Children Receiving Chemotherapy

沈青青(Ching-Ching Sheng) ； 謝枝華(Chih-Hwa Hsieh) ； 吳沾(Jane Wu) ； 郭玲娟(Ling-Chuan Kuo) ； 羅琬真(Wan-Chen Lo) ； 田怡清(Yi-Ching Tien) ； 黃鈴雅(Ling-Ya Huang)

《榮總護理》 32卷4期 (2015/12) Pp. 332-342

https://doi.org/10.6142/VGHN.32.4.332

摘要

化學治療產生的副作用常是癌症病人最擔憂的事項之一，尤其是腸胃道症狀在化學治療期期間會隨著天數增加而加劇，甚至影響病人繼續治療的意願；本研究目的在了解化學治療期間的症狀困擾程度並探討「視覺遮斷法」之應用成效。採類實驗研究法，研究對象選自某醫學中心接受化學治療之6-18歲病童及其父母，以視覺遮斷法－「點滴瓶/袋的新衣」為介入措施，並採用「兒童版治療引起症狀困擾量表」進行資料收集，共收案63名，其中實驗組33名，對照組30名。結果發現癌症病童在化學治療前最困擾的症狀為脫髮及食慾不佳，隨著治療的進行，腸胃道症狀困擾程度越來越高。兩組病童在腸胃道症狀困擾程度雖未達統計上的顯著差異，但實驗組在食慾不佳、噁心及嘔吐之症狀困擾程度均較對照組低；由化學治療期間症狀困擾程度前後差異檢定，發現對照組自化學治療第二天開始，食慾不佳及噁心之困擾程度即顯著高於化學治療前，而實驗組則僅於化學治療第三天噁心的症狀困擾程度顯著高於化學治療前。因此，病童於化學治療期間以「點滴瓶/袋的新衣」進行視覺遮斷，可對轉移其腸胃道不適的症狀有所幫助，期能將之運用於臨床照護，以提升住院照護品質。

關鍵字

視覺遮斷法 ； 癌症 ； 病童 ； 化學治療 ； 症狀困擾

並列摘要

The side effects of chemotherapy are major concerns of patients with cancer. Particularly, gastrointestinal symptoms can be pronounced over several days and caused a high degree of distress during chemotherapy, affecting the willingness of patients to receive treatment. The purpose of this study was to understand the degree of symptom distress during chemotherapy and investigate the effectiveness of visual interdiction. The study had a quasi-experimental study design, and research samples were obtained from a medical center for children aged 6- 18 years undergoing chemotherapy and their parents. New clothes for the IV fl uid bottle/bag were applied as an intervention, and a child version of a scale for measuring distress caused by treatment symptoms was used. Information was gathered from 33 children in an experimental group and 30 in a control group. The results revealed that among children with cancer, the chemotherapy symptoms most frequently causing distress were hair loss and poor appetite, and as the treatment progressed, gastrointestinal symptoms increasingly caused distress. Although no significant difference was observed between the two groups in gastrointestinal symptom-related distress, the experimental group exhibited lower degrees of distress caused by a poor appetite, nausea, and vomiting compared with the control group. Differences were observed in symptom distress during, before, and after chemotherapy; in the control group, starting from the second day of chemotherapy, the degree of distress caused by a poor appetite and nausea was significantly higher than that before chemotherapy, whereas the experimental group exhibited significantly higher distress related to nausea starting on the third day of chemotherapy. Therefore, using new clothes for the IV fluid bottle/bag as a visual interdiction during chemotherapy is beneficial in alleviating the distress caused by gastrointestinal symptoms, and thus can be applied in clinical care to improve the quality of care in hospitals.

並列關鍵字

visual interdiction ； cancer ； children ； chemotherapy ； symptom distress

參考文獻

謝枝華、柯識鴻、龔怡萍、吳沾(2009)．化學治療病童噁心嘔吐之改善方案．腫瘤護理雜誌，9(1)，23-35。

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