Predictors of Complementary and Alternative Medicine Use in Adult Patients with Cancer

台灣成年癌症病人使用輔助另類療法之預測因子探討

朱芳瑩(Fang-Ying Chu)

《慈濟技術學院學報》 23期 (2014/09) Pp. 17-35

摘要

背景：輔助另類療法是以非西醫療法為主的各種療癒方式，在全世界已經廣泛地被使用，而癌症患者是主要的使用族群。以國人十大死因中，癌症是首位，但隨著國人日趨著重於健康養生的觀念，很多的癌症患者會使用輔助另類療法增進個人身心靈的舒適狀態，因此臨床醫療人員需要了解癌症患者使用輔助另類療法的使用情形與相關因素。目的：本研究的目的主要是探討成年癌症患者使用輔助另類療法的情形與預測子。方法：本研究採橫斷式的問卷調查法，問卷資料以面對面訪談方式收集，母群體之樣本為20歲以上之門診癌症病患。資料收集後以數字編碼輸入電腦，以SPSS 19.0版本進行統計分析，樣本的基本屬性，臨床資料與使用輔助另類療法的情形以描述性統計分析包括次數、百分比與平均數來分析，而以Logestic regression來檢測患者使用輔助另類療法的預測因子。結果：總共有553位患者參與本研究，但有94位患者未能完成問卷訪談，有效問卷為459份，故問卷回收率達83%。這其中有325位女性病患，134位為男性，大約有68%的患者表示在確定診斷後曾經使用輔助另類療法，而使用最多的前三種為中醫（57%）、營養保健食品（40.7%）與運動（30.8%），使用的主要因素為增加免疫能力，促進身心的舒適狀態和預防癌症復發。一半以上的患者表示，使用的訊息來源是來自於親友，但使用的滿意程度為5.5分（最高分為7分）；而Logistics regression迴歸分析中得知年紀、教育程度、家庭收入與癌症期數皆與使用輔助另類療法有相關。結論：本研究顯示輔助另類療法已經非常的廣泛被癌症病患所使用，醫療專業人員應須主動提供相關的訊息，尤其是護理人員為臨床的主要照顧者，有責任提供有關於輔助另類療法的知識給患者，並需引導患者安全的使用輔助另類療法，以促進醫療照護之品質。

關鍵字

輔助另類療法 ； 成年癌症 ； 因素

並列摘要

Background: Use of complementary and alternative medicine (CAM) among oncology patient populations is increasing worldwide. At present, there is little data to indicate which types of CAMs are in use among Taiwanese adult cancer patients. Purpose: To describe the use of CAM among Taiwanese adult cancer patients and to identify the predictors of CAM use. Methods: A cross-sectional survey was used for the study. Data were collected using a structured questionnaire and face-to-face interviews. This cross-sectional study was based on a convenience sample of outpatients from two medical centers with oncology/hematology clinics in Taiwan. Data were coded and analyzed using the software Statistical Package for the Social Sciences (SPSS Version 19.0). Descriptive statistics were used to summarize sample characteristics, clinical data, and CAM use results. The logistic regression was used to examine the predictive factors of CAM use. Results: A total of 553 patients were selected for the study but 94 did not complete the interviews. In total, 325 female and 134 male patients completed the survey interview, resulting in a response rate of 83%. Approximately, 68% (n=312) of patients reported that they had used some form of CAM since being diagnosed with cancer. The most popular types of CAM were Chinese medicine (57.0%), dietary supplements (40.7%), and physical movement (30.8%). The primary reason for using CAM, reported by the patients, was to boost the immune system (60.3%). This was followed by improving physical and psychological well-being (26%), and prevention of recurrence (18%). The majority of patients (50.1%) received information about CAM from friends and family. The mean score of patients' perceived satisfaction with CAM use was 5.5 (SD=1.63) out of a maximum score 7, which indicated an overall high level of satisfaction. The average level of perceived effectiveness with CAM use among the patients was 5.63 (SD=1.52). The logistic regression model showed that age, educational level, household income, and cancer stage were independent predictive factors of CAM use. Conclusions: Complementary and alternative medicine is widely used among Taiwanese adult cancer patients and has perceived beneficial effects. Implications for practice: Health professionals require further education regarding the appropriate and safe use of CAM for patients. Nurses are in a key position to not only provide knowledge and information about CAM but also to develop guidelines about CAM use for cancer patients. The integrative health care will support cancer patients in improving their quality of life.

並列關鍵字

adult cancer patients ； complementary and alternative medicine ； predictors