癌症病患病情告知與否及健康控制信念與希望程度之相關性探討

Relationships among diagnostic disclosure , health locus of control , and levels of hope in cancer patients

蔡秀芬(S. F. Tsay)

指導教授 ： 林佳靜

臺北醫學大學/護理學院/護理學研究所/碩士(2001年)

摘要

本研究旨在探討癌症病患病情告知、健康控制信念(內在健康控制信念、強而有力他人健康控制信念、機運健康控制信念)、希望程度三者間之相關性。研究採橫斷式相關設計，以方便取樣方式，於北部四家區域教學醫院以上之門診或住院診斷為癌症的病患進行量性問卷訪談，研究工具包括：病患基本資料表、多層面健康控制信念量表、希望指標量表、及病歷記錄，所收集的資料以百分比、平均值、標準差、t檢定、ANOVA、Chi-square、皮爾森積差相關分析等方法進行資料分析。研究所得重要結果如下： 本研究共收集樣本數124人，（1）有79.0 %的癌症病患知道自己罹患癌症的診斷，其中病患知道診斷的時間距離填寫問卷之時間，以0-3個月佔最多數，為52.0 %。（2）癌症病患之健康控制信念特色，結果顯示研究對象較傾向於強而有力他人健康控制信念。（3）癌症病患之希望程度，整體而言，其平均數為35.56（SD=7.74），結果顯示研究對象具有中上程度之希望；而門診病患的希望程度顯著高於住院病患。（4）內在健康控制信念與希望程度呈顯著正相關，機運健康控制信念與希望程度呈顯著負相關，知道病情者的希望程度顯著高於不知道病情者，知道病情者的健康控制信念傾向於內在健康控制信念。 本研究結果有助於護理人員及腫瘤醫療工作團體瞭解台灣癌症病患病情告知的情形及癌症病患多層面健康控制信念的特色與希望程度，根據本研究的結果建議，在家屬及醫師的支持下，於癌症病情告知前，先瞭解病患的健康控制信念等相關資料，以針對不同人格特質的病患，選擇最恰當的癌症病情告知方式，期待當病患獲知罹患癌症時，能給予適當的支持系統，維持並提昇其希望程度，能有效地處理癌症所帶來之衝擊，與家屬及腫瘤醫療工作團體共同從病患的身體、心靈、社會的整合照顧走出低潮。

關鍵字

癌症 ； 病情告知 ； 健康控制信念 ； 希望

並列摘要

The purpose of this study was to explore relationships among diagnostic disclosure, health locus of control, and levels of hope in cancer patients. A cross-sectional correlational design was used in this study. Eligible subjects were patients who had been diagnosed with cancer and over 18 years old. Patients were recruited using convenience sampling from the inpatient wards and outpatient unitsat four teaching hospital in Taipei. The following research instruments were used to measure the variables in this study : Background Information Form, Multidimensional Health Locus of Control Scale (MHLCS), Herth Hope Index (HHI), and patient’s medical record. Data were analyzed by using descriptive statistics, t tests, ANOVA test, Chi-square, and pearson’s correlation. The major findings of this study are as follows : One hundred and twenty-four subjects were recruited. (1)There were 79.0% cancer patients knowing their own diagnosis and the time among 0~3 months occupied the most. (2) The characteristics of health locus of control tend to powerful others health locus of control. (3) Cancer patients had medium levels of hope and outpatients average were significantly higher than those of the in-patients. (4) In the health locus of control and levels of hope, internal health locus of control was significantly positively related to the levels of hope. Chance health locus of control was significantly negatively related to the levels of hope. In the diagnostic disclosure and levels of hope, knowing their own diagnosis were significantly higher than those of the unknowing their own diagnosis. In the health locus of control and diagnostic disclosure, knowing their own diagnosis tend to have higher levels of internal health locus of control. The major finding of this study was to help nurses to understand the diagnostic disclosure in cancer patients and the characters of multidimensional health locus of control and the levels of hope. The result of this study suggested that it is necessary to find an appropriate way to tell cancer patients about their disease and to increase patients’ levels of hope.

並列關鍵字

cancer ； diagnostic disclosure ； health locus of control ； hope

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