支持性關懷對口腔癌病人接受治療後憂鬱情緒與社會互動之成效

The effects of supportive caring on depressive emotion and social interaction in patients with oral cancer after surgery

劉芝萓(Chih-Yi Liu)

指導教授 ： 林佑樺

義守大學/醫學院/護理學系/碩士(2018年)

摘要

目的：本研究目的在檢視支持性關懷介入對改善口腔癌術後病人憂鬱情緒及社會互動的成效。

方法：本研究採雙組前、後測實驗設計。從南部某準醫學中心招募合乎研究條件的樣本，並以隨機分派（根據患者的入院優先順序）將參與者分配到兩組。實驗組除了一般常規性護理外，再接受支持性關懷（n = 50），對照組接受一般常規性護理（n = 50）。成果指標使用CESD(The Center for Epidemiological Studies of Depression)量表測量憂鬱程度、社會互動量表測量社會互動狀況。病人於出院後第一次回診時(T0）執行前測，待問卷填寫完畢後再進行相關諮詢及居家衛教指導，在第三個月（T1）回診時再進行後測。支持性關懷計劃包括於術後第一次回診治療期間提供精神性支持、資源轉介、營養支持及轉介，之後每月一次，連續提供3次，每次大約會談40分鐘。

結果：憂鬱情緒實驗組前測平均得分為25.92，後測為7.56，對照組前測平均得分為28.32，後測為18.04；社會互動實驗組前測平均得分為58.14，後測為10.77，對照組前測平均得分為63.92，後測為28.46。經Wilcoxon檢定顯示，兩組病人的憂鬱情緒及社會互動平均得分均顯著降低( all p < .001)。兩組病人的憂鬱情緒平均得分前、後測差值比較有顯著差異（z = -4.81，p <.001）；兩組病人的社會互動狀況平均得分前、後測差值比較亦有顯著差異（z =-2.43，p < .05）。

結論和臨床應用：本研究證實支持性關懷有助於改善口腔癌病人手術後的憂鬱情緒及社會互動，醫護團隊人員應該注意口腔癌病人的術後的情緒狀態，繼續維持以提高護理的照護品質，並視為病人護理計劃中的一部分，以促進病人出院後之社會互動狀況。

關鍵字

口腔癌 ； 支持性關懷 ； 憂鬱情緒 ； 社會互動

並列摘要

Objective: The purpose of this study was to examine the effects of supportive caring on depressive emotion and social interaction status among oral cancer patients underwent surgery.

Method: The case study applied experimental design. Eligible sample recruited from a hospital in Kaohsiung, and using randomized sampling (based on patients’ admission priority order) distribute participants to two groups. The experimental group is receiving regular caring and additional supportive caring (n=50), and the control group has receiving regular care (n=50). The measurement outcomes included CESD(The Center for Epidemiological Studies of Depression) and Social Interaction Scale (SIS).Baseline data collection was at first clinical follow up (T0) after discharge from hospital, and followed up at the third month (T1) after discharge.

Result: The average score of experiment group’s depression level on emotion is 25.92(T0) and 7.56(T1). The average score of controling group’s depressve emotion has 28.32(T0) and 18.04(T1). The average score of experiment group’s social interaction has 58.14(T0) and 10.77(T1). The average score of controling group’s social interaction has 63.92 (T0) and 28.46(T1). According to Wilcoxon test, it showed that both of the melancholic mood and the average score of social interactions were significantly lower in both groups (all p < .001). The difference of mean scores for patients with melancholic mood were compared pre and post-test (T0-T1), and the Mann-Whitney U test showed that the average score of the experimental group (decrease 17.95) was significantly lower than control group (decrease 10.28) (z = -4.81, p < .001). The difference of mean score of social interaction of pre and post-test (T0-T1), Mann-Whitney U test showed that the experimental group's average score (decline 47.1) was significantly lower than the control group (decrease 35.46) (z = -2.43, p <.05).

Conclusions and clinical application: This study has confirms that supportive care could help to improve depressiive emotion and social interaction after surgery in patients with oral cancer. Medical team members should pay attention to the postoperative emotional state of patients with oral cancer andimprove patients’ social intertaction.

並列關鍵字

oral cancer ； supportive caring ； depressive emotion ； social interaction

參考文獻

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壹、中文部份

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