癌症家屬的心理威脅感、因應型態與知覺病人的性格特質對其真相告知意願的影響－以頭頸部癌症家屬為例

The influence of psychological threat, coping style and perceived personality trait upon the head and neck cancer patients’ family members’ truth telling attitude.

王興豪(Xing-Hau Wang)

指導教授 ： 黃君瑜

中原大學/理學院/心理學研究所/碩士(2012年)

https://doi.org/10.6840/cycu201200023

摘要

研究背景與目的：癌症是影響國人健康很重要的一個議題，多數的文獻資料都聚焦於病患本身，然而對於家屬的討論較少。而在癌症家庭的互動過程當中，常被討論到的就是是否要告知病人實情。因此本研究使用壓力因應與認知評估模式，來了解頭頸部癌症的家屬在針對不同情境時的真相告知意願，並討論癌症威脅感、死亡威脅感、因應型態與知覺到病人的性格特質等變項與告知意願之關聯性。

研究方法：本研究採橫斷式研究設計，資料來源為桃園地區某醫學中心。在經過醫院倫理委員會審查同意後，針對頭頸部癌症病患之家屬進行資料收集。本研究參與者包括61位配偶與39位子女。研究工具包括基本資料表、真相告知意願調查表、簡明因應量表、五大性格量表神經質分量表和威脅指標－台灣版。統計方法使用卡方檢定、單因子共變數分析與區辨分析，針對本研究假設進行考驗。

研究結果：本研究發現，頭頸部癌症之家屬整體的告知意願偏高，在癌症診斷與治療計畫的真相告知意願比病程相關訊息（發現轉移、復發或末期）等情境來得高。病患與家屬的親屬關係以及病患教育水準不同在家屬的真相告知意願上會有所差異。而逃避因應型態和死亡威脅感和家屬的真相告知意願有關聯，在區辨分析中發現，本研究所使用之各變項對不同告知意願組別有中度預測力。

結論：本研究嘗試將真相告知以心理計量之量化方式測量，且發現因應型態、死亡威脅感和親屬關係與其真相告知意願的關聯，為真相告知意願領域提供新的訊息，然而因本研究僅針對頭頸部癌症之家屬做了解，建議未來研究可針對不同癌症診斷族群進行探討，且亦可針對親屬關係與真相告知意願之關聯性可能受到何種變項影響作進一步釐清。

關鍵字

癌症威脅 ； 真相告知 ； 癌症家屬 ； 死亡威脅 ； 因應型態 ； 區辨分析

並列摘要

Background and purpose：Cancer is an important issue in Taiwan, because it would affect a person’s health very much. Although many informations focued on the patient and the disease, fewer informations were put an eye on their caregivers and families. Truth telling is the most common topic when we talk to cancer family communication. In this study, we’ll use the stress coping and cognive appraisal model to understand the the truth telling attitude through different situation of head and neck cancer patient’s relatives. Also, we’ll try to find out how the threat of disease, the threat of death, coping style, and perceived personality trait of nervous influence the truth telling attitude.
Methods：This study was a corss sectional design, and the data collection was from a medical center in Taoyuan after the Institutional Review Board’s agreement. Subjects were the relatives of the patients who diagnosised the head and neck cancer, included 61 spouses and 39 children. The instruments are the basic information questionnaire, Truth Telling Attitude Survey, Brief COPE, NEO-FFI neurosis factor and the Threat Index – Taiwan version. The statistical analysis included Chi- square, ANOVA and discrimant analysis.
Results：This study discovered the overall attitude of the head and neck cancer patient’s relatives are very high. After the compare attitude of different situation, the attitude toward diagnosis and the therapy plan are higher than the attitude toward prognosis related information (included the tumor metastasis, tumor recurred or the terminal cancer). Also this study found that the different relationship which is spouse or child and the patient’s education level would have a significant different between the high, medium and low attitude group. Furthermore, the avoidance coping style and the threat of death were influential variables when trying to discriminate different truth telling attitude. And the variables in this study had a middle correct rate through discriminate analysis.
Conculsion：This study tried to measure the truth telling attitude through the psychometric and quantity method, and found that coping style, threat of death and relationship had an influence on it. This study offered some new information in truth telling attitude. Further study can try to measure the truth telling attitude on different cancer diagnosis and also try to figure out what kind of psychological variable would contribute the difference truth telling attitude between spouses and child.

並列關鍵字

truth telling ； cancer family ； threat of death ； threat of cancer ； coping style ； discriminant analysis

參考文獻

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