本研究目的為探討影響肝癌病患希望程度的相關因素,以及暸解希望程度與疾病評價及社會支持的相關性。本研究以中部某地區教學醫院胃腸肝膽內科病房為研究地點,以立意方式取樣,研究對象需符合:(1)診斷為肝癌,且明確知道自己罹患肝癌之病患;(2)年滿18歲;(3)意識清楚,能以國台與溝通,且識字者;(4)無精神疾病診斷者。本研究採橫斷式描述相關性研究設計,使用Herth(1992)的希望指標(HHI)、賴(1998)的癌症症狀困擾量表(SDS-CMF)、Kessler(1998)的疾病評價量表(CAHS)及Weiss’s(1974)的社會支持滿意度量表(PRQ85 Part I),所測得的CVI值:HHI .08、SDS-CMF .28、CAHS .78、PQR 85 Part I .83;Cronbach`s α:HHI .91、SDS-CMF .89、CAHS .70、PRQ 85 Part I .86,由研究者一對一訪談肝癌住院病患共80人。 研究結果發現(1)肝癌病患的希望平均分數為23.21分,屬於中等程度的希望。(2)影響肝癌病患希望程度的人口學變項包括性別與宗教信仰,女性肝癌患者的希望程度顯著高於男性的肝癌患者,有宗教信仰的肝癌患者希望程度較高。(3)肝癌病患的疾病評價方式以「挑戰」為主,疾病評價方式與癌症症狀困擾程度及癌症分期具有顯著差異性,然而,希望程度與疾病評價方式不具差異性。(4)肝癌病患的希望程度與社會支持滿意度不具相關性,但是,肝癌病患的社會支持滿意度與年齡呈正相關,與罹病月數及總教育年數呈負相關;另外,肝癌病患的社會支持網絡與希望程度呈正相關,且社會支持網絡與總教育年數及癌症症狀困擾程度呈正相關,與年齡呈負相關。 本研究結果可提供護理人員了解影響肝癌病患希望程度的因素,藉此可依據患者個別的差異,提供個別化的護理照護,進而提升患者之希望感。
The purpose of this study is to investigate the factors affecting hope level in hepatocellular carcinoma patients, and the relationship between hope, disease appraisal and social support. The subjects were selected based on the judgment from gastroenterology & hepatobiliary wards of a teaching hospital in central Taiwan. The qualified patients should be aware of having and diagnosed as hepatocellular carcinoma, older than 18 years of age, clear consciousness, speaking Mandarin and Taiwanese, without psychological disorder. Cross-sectional study design is used to analyze Herth Hope Index (HHI: Herth, 1992). We use Symptom Distress Scale-Chinese Modified Form (SDS-CMF: Li, 1998), Cognitive Appraisal of Health Scale (CAHS: Kessler, 1998), and Personal Resource Questionnaire (PRQ85 Part I: Weiss, 1974) to obtain CVI value: HHI .08, SDS-CMF .28, CAHS .78, PRQ 85 Part I .83; Cronbach`s α: HHI .91, SDS-CMF .89, CAHS .70, and PRQ 85 Part I .86 of 80 patients based on one to one interview. The average score of patient's hope is 23.21, characterized as medium hope. Demographic factors include gender and religion. Hepatocellular carcinoma patients, females and with religion, have higher hope. The disease appraisal is based on 'challenge'. There are significant difference among the disease appraisal, cancer symptom distress and cancer stage. However, no significant difference is found between the disease appraisal and hope level. The satisfaction at social support does no associate with hope level but has a positive relation to age, decreased duration of disease and years of education. Social network is correlated to high hope level, years of education, cancer symptom distress, and younger age. According to the factors affecting hope level in hepatocelluar carcinoma patients, the stuff can realize the difference between individuals and offer specific nursing care to improve the patient's hope sense.