慢性C型肝炎病患接受干擾素與Ribavirin合併治療之症狀困擾、憂鬱與生活品質之探討

Distress, Depression and Quality of Life in Patients with Chronic Hepatitis C Treated with Interferon and Ribavirin

黃俐綾(Li-Ling Huang) ； 宋琇鈺(Hsiu-Yu Sung) ； 劉麗芳(Li-Fang Liu) ； 張彩秀(Tsai-Hsiu Chang)

《護理暨健康照護研究》 6卷3期 (2010/09) Pp. 183-190

https://doi.org/10.6225/JNHR.6.3.183

摘要

背景　慢性C型肝炎病患接受干擾素及Ribavirin治療常產生生理、心理方面的困擾，進而對生活品質造成負面的影響。
目的　探討慢性C型肝炎病患接受長效型干擾素及Ribavirin合併治療之症狀困擾、憂鬱及生活品質的情形。
方法　以縱貫追蹤研究法，採立意取樣方式，針對中部某區域教學醫院之慢性C型肝炎病患40名，進行合併治療前、治療期間第一、三、六個月及治療結束後第一個月的測量。將所得資料以SPSS 14.0進行分析，在描述性統計方面：以平均值（標準差）對接受干擾素及Ribavirin合併治療前、後進行描述；推論性統計方面：以重複測量ANOVA、無母數多個相關樣本卡方檢定分析不同治療期間之差異。
結果　在治療期間第一、三、六個月之症狀困擾、憂鬱明顯高於治療前，治療後之症狀困擾與憂鬱則明顯下降。生活品質部分，治療期間第一、三、六個月之生活品質明顯較治療前變差，但治療結束後第一個月則明顯較治療期間第六個月佳。
結論　本研究結果可提供臨床醫護人員及慢性C型肝炎病患瞭解治療期間可能產生之不適情形，以作為其調適困擾、憂鬱情形，進而提升生活品質之參考。

關鍵字

慢性C型肝炎 ； 困擾 ； 憂鬱 ； 生活品質

並列摘要

Background: Patients with chronic hepatitis C receiving interferon and ribavirin combination therapy face greater risks of physiological and psychological distress, which often result in a negative impact on quality of life.
Purpose: The purpose of this study was to explore distress and depression levels and quality of life in patients with chronic hepatitis C who were currently receiving the interferon and ribavirin combination therapy.
Methods: This study employed a longitudinal follow-up design and purposive sampling. Forty patients with chronic hepatitis C were evaluated for this study at several points in time. These points included: prior to starting combination therapy; at the end of the first, third and sixth months after starting combination therapy; and at the end of the first month following therapy course completion. Data were analyzed using SPSS 14.0. Mean and standard deviation values were obtained using descriptive statistics to describe patient distress, depression severity and quality of life before and after treatment. Inferential statistics, repeated-measures ANOVA, nonparametric testing, and a K related samples chisquare test were used to analyze variations between treatment periods.
Results: Analysis showed degrees of distress and depression to be significantly more severe during the therapy period (i.e., end of the 1st, 3rd and 6th months) than prior to the start of combination therapy. Quality of life was worse also during the therapy period than prior to the start of combination therapy. Variables in the three realms, however, had improved significantly one month after completion of the therapy course as compared to the the sixth month of the therapy.
Conclusions/Implications for Practice: The author hopes this study will provide information and suggest effective strategies for medical and nursing staffs with regard to the interferon and ribavirin combination therapy course and possible adjustments to improve distress, depression and quality of life for hepatitis C patients in the future.

並列關鍵字

chronic hepatitis C ； distress ； depression ； quality of life