探討晚期癌症病人及家屬對疾病之不確定感
與希望狀態的預測因子

李劉瀅瀅

doi:10.6342/NTU.2009.01650

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探討晚期癌症病人及家屬對疾病之不確定感與希望狀態的預測因子

Predictive Factors of Uncertainty and Hope of the Patients with Advanced Cancer and Their Families

李劉瀅瀅 , Masters　　Advisor：胡文郁　　

繁體中文 DOI： 10.6342/NTU.2009.01650

晚期癌症；末期醫療決策；安寧共同照護；疾病不確定感；希望狀態； Advanced Cancer ； Medical Decision at the end of life ； Hospice shared Care ； Uncertainty in Illness ； Hope Status

Abstract │ Reference (132) │ Times Cited (8) │ Altmetrics

Abstract 〈TOP〉

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This research aims to discuss the predictive factors of uncertainty and hope of the patients with advanced cancer and their families. The cases were conducted in a medical center in northern Taiwan from September 9th 2008 to March 31st 2009 by purposive sampling and interviewing. 87 patients and 125 family members participated in the research. The research instruments include background data form, Mishel’s Uncertainty in Illness Scale Chinese Version and Herth Hope Index. As it turned out, 27.6% patients are fully aware of their disease, only 9.2% of them have signed the agreement of DNR, 4.6% have signed the agreement of hospice care, 70.4% family members are fully aware of the patients’ disease, 49.6% of them have signed the agreement of DNR and 23.2% have assisted signing the agreement of hospice care. This showed that the family members know more about the state of illness than the patients and are more likely to sign the agreement of DNR and hospice care. Most medical decisions at the end of life are still made by the families. 
The average total score of the families’ hope state is 30.61±4.50 (the total score is  10-40, a higher score means a higher level of hope.) and the hope state scores of the patient group labeled as workers and the family group labeled as Folk Religion or Taoism are all lower than their reference groups: the Unemployed and the Irreligious; the average total score of the families’ uncertainty about the disease is 62.92±11.38 (the total score is 23-115, a higher score means a higher level of uncertainty.) and the uncertainty scores of the family group labeled as Poorly Informed about the state of illness, the family group that didn’t sign the agreement of hospice care, the family group that remain single, divorced or widowed and the patient group that didn’t accept hospice shared Care are all higher than their reference ones: the fully informed, the families that signed the agreement of hospice care, the married families and the patient group that accepted hospice shared care.
For those patients and their families who have accepted the hospice shared care, it will be easier to make medical decision at the end of life and possibly reduce the family’s uncertainty. This research result is expected to serve as references for medical staff; assist the families to allow the patients to know about their own disease and have equal opportunities for medical decision according to their own wishes; reduce the families’ uncertainty and get better suitable medical care for the patients.

Reference ( 132 ) 〈TOP〉

毛家舲、張鈺（1996）．倫理困境與倫理決策過程．護理雜誌，43（1），40-45。
連結：
吳名珠、陳美玲、陳淑卿、劉會平 (2003) ．肺部手術病患術後疼痛、疲倦及希望之相關性探討．新台北護理期刊，5 (1)，25-36。
連結：
柯乃熒、蕭琪、許淑蓮 (1997) ．不確定之概念分析．護理雜誌，44（1），92-97。
連結：
胡文郁、邱泰源、呂碧鴻、陳慶餘、謝長堯、陳月枝（2001）．醫護人員對「安寧緩和醫療條例」之教育需求．醫學教育，5（1），21-29。
連結：
徐翠霞 (2001)．肺癌病患之疼痛程度與不確定感和希望狀態之相關性．未發表之碩士論文，台北醫學大學護理學研究所。
連結：

Times Cited (8) 〈TOP〉

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