口腔癌術後病患出院前對其疾病不確定感之探討

Uncertainty about Disease for Post-Operation Oral Cancer Patients upon Discharge

楊蓓菁(Bey-Jing Yang) ； 邱碧如(Pi-Ru Chiu) ； 石富元(Fuh-Yuan Shih)

《輔仁醫學期刊》 6卷2期 (2008/06) Pp. 53-68

摘要

目的：本研究目的乃基於重視癌症病患的疾病不確定感處理為護理照顧上重要的議題，來探討口腔癌術後病患之疾病不確定感，與其個人屬性或就醫資料是否有影響，從而分析造成不確定感的危險因子。方法：以「Mishel疾病不確定感量表」中文版結構式問卷測量北市某醫學中心住院之口腔癌病患疾病不確定感，共回收有效問卷80份。研究資料以描述性統計、t檢定、變異數分析找出個人屬性與就醫資料對疾病不確定感是否有影響，而以邏輯迴歸方式，來探究疾病不確定感的高危險群。結果：病患無工作、術後無法從事原工作、經濟狀況不夠用、無宗教信仰、自覺疾病非常嚴重、疾病復發、末期癌症或住院天數長者，其疾病不確定感較高；無工作、無宗教信仰或癌症復發等三變項，可獨立做為高疾病不確定感的危險因子。結論：本研究發現口腔癌病患術後疾病不確定感之高危險群及其相關影響因素，有助於護理人員及早提供適當之措施，減少病患的不確定感，提昇護理品質。

關鍵字

口腔癌 ； 手術 ； 不確定感 ； 護理

並列摘要

Purpose: The uncertainty of cancer patients is an important issue in nursing care. The purpose of this research was to explore the risk factors such as personal attributes, medical condition, and others that influence the uncertainty of post-operative oral cancer patients. Methods: In this study, a modified structured questionnaire of the Chinese version of 'Mishel's Uncertainty in Illness Scale' was applied to measure patients' uncertainty in a medical center in Taipei. Survey responses were obtained from 80 patients. The data collected were analyzed by descriptive statistics, t-test, ANOVA, and logistic regression. Results: The results showed that patients who had no job or had lost their job after surgery, had financial problems, had no religious beliefs, self-esteemed serious illness, recurrence of cancer, end stage of cancer, prolonged hospitalization patients had higher uncertainty. Three predictive risk factors were joblessness, no religion, and the recurrence of cancer. Conclusions: This research can help nurses identify highrisk oral cancer patients who have uncertainty so that nursing interventions can be initiated early, in order to improve the quality of nursing care.

並列關鍵字

oral cancer ； surgery ； uncertainty ； nursing