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  • 學位論文

臺灣版安德森症狀量表於癌症青少年之運用: 症狀評估與健康相關生活品質之探討

Use of the M. D. Anderson Symptom Inventory: Assessment of Cancer Symptoms and Health-related Quality of Life in Taiwanese Adolescent Cancer Patients

指導教授 : 林佳靜教授
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摘要


研究目的:癌症青少年經常受苦於許多的癌症症狀,而癌症症狀又與健康相關生活品質息息相關。因此,本研究目的為探討癌症青少年的癌症症狀與健康相關生活品質。 研究一:使用修定的台灣版安德森症狀量表,評估108位癌症青少年的癌症相關症狀經驗,以建立該量表之心理計量屬性。本量表以主成分因素分析斜交轉軸法決定其建構效度,症狀群集分析得到腸胃症狀與一般症狀兩個群集,其結果與因素分析結果相同。該量表同時效度與台灣生活品質量表相同屬性的配對題目呈現顯著相關。已知團體效度在低、高身體功能狀態兩組的癌症青少年呈現顯著差異。信度測試具高度內在一致性,再測信度於35位癌症青少年間隔三天之測試為可接受程度。治療組癌症青少年的症狀嚴重度,依序為缺乏食慾、嗜睡與疲憊,完成治療組症狀嚴重度依序為健忘、嗜睡與缺乏食慾。本研究結果發現修定的台灣版安德森症狀量是一個具有良好信、效度的癌症青少年症狀評估工具。 研究二:本研究為探討120位癌症青少年的健康相關生活品質。主要結果包括癌症青少年身體生理功能角色受限面向之健康相關生活品質得分最低,身體疼痛面向之健康相關生活品質得分最高;治療組健康相關生活品質平均得分低於完成治療組,並且呈現顯著性差異;不同癌症診斷中,以惡性淋巴癌的健康生活品質得分最高,惡性肉瘤(含惡性骨肉瘤)的得分最低。低身體生理功能狀態與低血素值癌症青少年的健康相關生活品質愈低;癌症復發者的健康生活品質低於無復發者,但兩者無統計上顯著差異;有癌症年齡愈大其健康相關生活品質得分愈低,在性別間則無顯著差異;癌症相關症狀愈嚴重,其健康相關生活品質得分愈低。 總結:本研究支持修訂的臺灣版安德森症狀量表,能作為癌症青少年癌症相關症狀的評估工具,其健康相關生活品質的結果,可協助醫療人員作為下一步臨床試驗與癌症治療的參考依據。

並列摘要


Purpose: Adolescents with cancer suffer significantly from symptoms. Cancer-related symptoms are closely linked to quality of life. Thus, the purpose of this study was to use the M. D. Anderson Symptom Inventory to assess cancer symptoms and health-related quality of life (HRQoL) in Taiwanese adolescent cancer patients. Stage A: We assessed cancer symptoms experienced in by a sample of 108 adolescent cancer patients using the Taiwanese version of the M. D. Anderson Symptom Inventory (MDASI-T), and establisheded its the psychometric properties of this instrument. Construct The construct validity was determined using a confirmatory factor analysis with oblimin rotation. Concurrent The concurrent validity demonstrated moderate correlations between the MADSI-T subscale scores and the Medical Outcome Study (MOS) 36-Item Short-Form Health Survey. Known-group validity was established by comparing MDASI-T scores between adolescent cancer patients with a low functional status and those with a high functional status (Karnofsky Performance Status scores of ≤ 70 or and > 70, respectively). The alpha coefficient alpha of the symptoms severity and interference subscales demonstrated good internal consistency. There was acceptable test-retest stability of the MDASI-T in 35 adolescents over a 3-day interval. The most severe symptoms experienced by cancer adolescents in this sample were a lack of appetite, drowsiness, and fatigue. Stage B : With a cross-sectional design, 120 adolescents with cancer were recruited from two medical centers. The role-physical domain of HRQoL received the lowest score in adolescent cancer patients, and bodily pain domain of HRQoL received the highest score. Adolescence who were receiving cancer treatment had significantly poorer HRQoL than the off-treatment group. The health-related quality of life mean scores were significantly positively correlated with performance status and hemoglobin levels. Older survivors showed a lower levels of HRQoL. Conclusions: This study provides evidence that the MDASI-T is a reliable and valid instrument for measuring cancer-related symptoms in Taiwanese adolescents with cancer. The results from this study assist clinicians better understand the status of symptom distress and quality of life and provide important implications in promoting quality of life for adolescents with cancer.

參考文獻


Tseng HM, Lu JR, Tsai YJ. Assessment of health-related quality of life in Taiwan (II): norming and validation of SF-36 Taiwan version. Taiwan J Publ Health 2003;22:512-518 [in Chinese].
Lu JR, Tseng HM, Tsai YJ. Assessment of health-related quality of life in Taiwan (I): development and psychometric testing of SF-36 Taiwan version. Taiwan J Publ Health 2003;22:501-511 [in Chinese].
行政院衛生署.衛生統計台灣地區主要死亡原因統計.2006台北:行政院衛生署。
姚開屏.健康相關生活品質概念與測量原理之簡介.台灣醫學會2004;6 (2):183-200。
蔡文哲.兒童癌症的社會心理問題.台灣醫學2001;5(4):440-3。

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