透過您的圖書館登入
IP:44.203.58.132
  • 學位論文

A preliminary Study of Pain Education and Cognitive Reconstruction Training for Cancer Pain Management

癌痛衛教與認知重建訓練對癌症疼痛控制成效初探

指導教授 : 賴裕和 博士
若您是本文的作者,可授權文章由華藝線上圖書館中協助推廣。

摘要


本研究目的是在比較疼痛衛教、疼痛衛教加認知重建訓練與接受一般病房照護對癌痛改善之效果探討。研究設計採類實驗法,於北部某教學醫院腫瘤相關病房選取符案病患共計39位,以隨機分派將符案病患分為實驗組(I)接受疼痛衛教方案(14人)、實驗組(II)接受疼痛衛教加認知重建訓練方案(13人)及接受一般病房常規照護的對照組(12人),實驗組I及實驗組II進行連續五天之介入性方案措施,研究資料以簡明疼痛量表-台灣版疼痛及麻醉性止痛藥信念量表、情緒狀態量表-簡明版及疼痛負向想法檢視量表收集,利用SPSS統計軟體進行描述性統計、配對t檢定、單因子變異數分析、重複測試變異數分析評價介入方案的效果。 研究結果發現:(1)衛教組及衛教認知重建組之疼痛強度、疼痛干擾情形、疼痛認知信念、焦慮、憂鬱及疲憊狀況,在研究後均有改善,(2)衛教認知重建訓練組之疼痛自我控制程度增加,而衛教組及控制組則下降,(3)衛教認知重建訓練組之負向想法之在研究後減少,(4)控制組之憂鬱狀況無顯著改變,而焦慮及疲憊狀況則有增加情形。本研究結果顯示,衛教及認知重建訓練可降低病患疼痛強度、疼痛干擾、改善病患疼痛信念、焦慮、憂鬱、疲憊情緒困擾及減少負向想法,使癌症病患獲得更好的疼痛控制。 關鍵字:癌症疼痛、疼痛信念、疼痛干擾、焦慮、憂鬱、疲倦、疼痛衛教、認知重建訓練、疼痛負向想法

並列摘要


The purpose of the study were to compare the effects of pain education, pain education plusing cognitive-reconstruction training, and usual care on cancer patients’ pain experiences. Quasi-experimental design was used in the current study. Eligible cancer patients with pain(N=39), were randomly assigned to three groups, including(1)pain education group, 15 minutes education for 5 consecutive days(Experimental group I, n=14),(2)pain education plus cognitive reconstruction training for 5 consecutive days(Experimental group II, n=13),(3)control as usual care(control group n=12). Data were collected by using Brief Pain Inventory- Taiwanese(BPI-T), Pain and Opioid Analgesics Belief Scale- Cancer(POABS-CA), Profile of Mood State Short Form(POMS- Anxiety , Depression ,and fatigue), and Negative Thinking of Pain. Data were analyzed using paired t-test, ANOVA, and repeated measures ANOVA. The results showed that(1)the average pain intensity, pain interfere, negative effect of pain belief, anxiety, depression and fatigue level were reduced in patients receiving the pain education and pain education plus cognitive reconstruction training,(2)there was significantly statistical increased self-control of pain in patients receiving the pain education plusing cognitive reconstruction training comparing to receiving pain education and control group,(3)the negative thinking of pain score were reduced significantly in patients receiving the pain education plus cognitive reconstruction training,(4)the anxiety and fatigue level was also increased in control group. In conclusion the results suggest that pain education and cognitive reconstruction training are all effectively improving cancer patients’ pain problem. These interventions should be further applied to cancer pain management. Key words:cancer pain、pain beliefs、pain interfere、anxiety、depression、fatigue、pain education、cognitive reconstruction、negative thinking of pain

參考文獻


蔡麗雲、顧乃平、張澤芸、賴裕和(2000). 癌痛病患的焦慮、憂鬱及其相關因素之探討. 新台北護理期刊,3(1),23-33。
楊文琪(1996). 接受化學治療之血液腫瘤病患期身心社會困擾與自我照護、社會支持的相關性探討. 未發表的碩士論文,台北:國立陽明大學。 陳美伶(民1997). 醫院焦慮憂鬱量表-中文版 . 未發表。 陳佩英、史麗珠、王正旭、賴裕和、張獻崑、陳美伶(1999). 疼痛對癌症病患焦慮與憂鬱之影響. 台灣醫學,3(4),373-382。
謝麗鳳、林佳靜、賴裕和、鄒宗山(1998). 癌症家屬對止痛劑的擔心與病人疼痛控制的相關性 . 護理研究,6(4), 327-332。
參考資料 中文部分 林佳靜、陳淑如、謝麗鳳(1997). 疼痛護理 . 護理雜誌,44(1),37-47。
顧乃平(1996). 治療癌症疼痛的倫理考量. 護理雜誌,43(1),29-34。

延伸閱讀