電腦化問卷及圖表式回饋對於青少年癌症患者照護需求、症狀困擾、自我管理與生活品質改善之成效

The Effectiveness of Utilizing Computerized Assessment and Graphic Outcome to Evaluate Symptom Distress, Care Needs, Self-management, and Quality of Life of Adolescents with Cancer

李姿嫺(Tzu-Hsien Lee)

指導教授 ： 吳維紋

國立臺灣大學/醫學院/護理學研究所/碩士(2021年)

https://doi.org/10.6342/NTU202100394

摘要

全球每年約有三十萬位兒童及青少年診斷罹癌，而在台灣確診癌症的兒童中，青少年佔了約35%。在照護癌症青少年的過程中，最終目標便是維持或提升他們的生活品質，因此如何評估及改善生活品質的影響因子變得相當重要。而現今隨著科技的進步，電腦化問卷越來越普及，並開始使用於癌症青少年上，然而過去研究較少討論電子化測量工具及圖表式結果對於改善他們生活品質及相關影響因子之成效為何。故本研究目的為探討青少年癌症患者使用電子化問卷合併圖表式結果之回饋後，對於症狀困擾、照護需求、自我管理、生活品質之成效，以及他們對於此工具的接受度為何。本研究採用實驗性之前驅研究，於北部兩間醫學中心小兒血液腫瘤病房進行收案，共有41位13-19歲正在接受治療且住院中之癌症青少年參與研究，並使用「症狀困擾量表」、「照護需求量表」、「自我管理量表」、及「生活品質量表」作為測量工具，再以描述性統計、配對T檢定、單因子共變數分析(Analysis of covariance；ANCOVA)來進行資料分析。
研究結果顯示，(1)實驗組之後測照護需求（p<0.05）及生活品質（p<0.05）較前測有顯著改善。(2)青少年癌症患者對電子化問卷合併圖表式結果的接受度高，並認為此工具簡單好操作，且認同在改善症狀困擾、照護需求、自我管理、生活品質感到非常有幫助。由上述統計結果發現，此工具除了能提升青少年癌症患者的自我了解，醫護人員也能透過此工具更具體的評估病人狀況，並針對結果進行進一步的處置。本研究可作為未來對青少年癌症患者採用電子化問卷及圖表式結果進行臨床評估及介入措施之參考。

關鍵字

青少年 ； 癌症 ； 電子化問卷 ； 圖表式結果 ； 症狀困擾 ； 照護需求 ； 自我管理 ； 生活品質

並列摘要

There are about 300,000 children diagnosed with cancer each year worldwide. In Taiwan, nearly 35% of newly diagnosed cancer children are adolescents. The final goal of providing nursing care to the cancer adolescents is to enhance their quality of life. Therefore, how to accurately assess and improve the factors which can affect cancer adolescents’ quality of life become very important. Moreover, as technology advances nowadays, computer-based questionnaires are becoming more prevalent, and are increasingly implemented on evaluating cancer adolescents. However, there is a paucity of research about the effectiveness of using computer-based questionnaires and graphic outcomes to evaluate hospitalized cancer adolescents. The aim of this study was to investigate the effectiveness of utilizing Computerized Assessment Graphic Outcome (CAGO) to evaluate symptom distress, care needs, self-management, and quality of life of adolescents with cancer, and the acceptability of CAGO in cancer adolescents. CAGO includes four electronic questionnaires and a graphic outcome of the result. The researcher will explain the result to the experimental group and encourage them to discuss it with the nurses, in order to foster a better nurse-patient communication. An experimental research design was used in this study, and a sample of 41 cancer adolescents between the ages of 13-19 was recruited. The instruments utilized to assess the cancer adolescents included Symptom Distress Scale, Care Needs Scale, Partner in Health Scale, and Pediatric Quality of Life Inventory. Moreover, descriptive statistics, paired t-test, and analysis of covariance were used for data analysis.
The results showed that: (1) The experimental group had significant improvement on their care needs (p<0.05) and quality of life (p<0.05). (2) CAGO was a highly acceptable method for cancer adolescents to use, and they found CAGO was not only easy to use, but also can help them improve their symptom distress, care needs, self-management, and quality of life. The findings indicated that CAGO may serve as a reference for clinical assessment and intervention, in order to help cancer adolescents to better understand their condition. Moreover, health care providers can use CAGO as the instrument to assess cancer adolescents with more specificity and provide appropriate care in order to improve their quality of life.

並列關鍵字

adolescents ； cancer ； computerized questionaries ； graphic outcome ； symptom distress ； care needs ； self-management ； quality of life

參考文獻

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