肺癌病患化療期間之疲憊軌跡

Patterns of Fatigue in Lung Cancer Patients during Chemotherapy

黃怡菁(Yi-Ching Huang) ； 唐婉如(Woung-Ru Tang) ； 史麗珠(Lai-Chu See) ； 余志騰(Chih-Teng Yu)

《腫瘤護理雜誌》 5卷2期 (2005/12) Pp. 15-27

https://doi.org/10.6880/TJON.200512_5(2).02

摘要

本研究以縱貫式研究來瞭解肺癌病患於化學治療期間之疲憊變化，研究對象為北部地區某醫學中心胸腔內科之肺癌病患，共收取9位符合收案標準之病患，研究方法以單一視覺量表收集病患每天疲憊的感受，來瞭解整個化學治療期間疲憊之波動情形及化療前後的差別。統計方法除採用描述性及推論性統計，並因應資料來自同一個案重複測量的特性，運用廣義估計方程式(GEE: Generalized Estimation Equations)來增加分析。研究結果顯示，疲憊在整個化學治療週期中具有波動性變化。多數的病患其疲憊感通常在化療後隔天或返家後才出現。隨著治療的進行，疲憊在每一次化療後會有一個短暫的偏高，並於下次化療前漸漸降至最低，而化療後的疲憊程度會明顯比化療前嚴重。由整個化療療程來看疲憊，發現病患的疲憊感從第一次化療至第三次化療會漸升高，約第三次化療後的波動程度有緩降的情形，並於之後再升高。而嘔吐、發燒、呼吸困難等干擾症狀則常在化療後出現，且與疲憊亦達顯著相關，這可以解釋為何病患在化療後的疲憊會呈現短暫的攀升，而造成疲憊波動的現象。

關鍵字

肺癌 ； 疲憊軌跡 ； 化學治療

並列摘要

The purpose of this study was to understand the comprehensive change in fatigue of lung cancer patients during the course of chemotherapy by a long longitudinal research. Subjects of the study were lung cancer patients sampled from the Department of Pulmonary Medicine of a medical center in north Taiwan. A total of 9 patients fulfilling the sampling criteria were selected. The whole research collected data about patients' fatigue feeling everyday using the Visual Analog Scale to understand the fluctuation of fatigue during the entire period of chemotherapy, as well as the difference before and after the chemotherapy. Apart from descriptive and inferential statistics, Generalized Estimation Equations (GEE) were also used to supplement analysis considering the nature of the data being collected repeatedly from the same cases. Results of the research showed that fatigue had fluctuant changes during the entire course of chemotherapy. Most patients had a fatigue feeling the day after the chemotherapy episode or after they returned home. As the therapy progressed, fatigue tended to be heightened transiently after each episode of chemotherapy, which gradually receded to the minimum before the next episode. Besides, fatigue after the chemotherapy episode was significantly more severe than before the episode. Considering the course of chemotherapy, it was found that patients' fatigue feeling increased gradually from the first episode to the third episode, marginally declined after the third episode, and then rose again. Interferential symptoms like vomiting, fever, dyspnea often happened after the chemotherapy, and their relation to fatigue was also significant. This explained why the transient rise of fatigue after a chemotherapy episode was the cause of fatigue fluctuation.

並列關鍵字

lung cancer ； fatigue pattern ； chemotherapy