新診斷肺癌病患治療期間的生活品質與相關因素探討

廖幼媫

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新診斷肺癌病患治療期間的生活品質與相關因素探討

廖幼媫 , Ph.D　　Advisor：賴裕和　　

繁體中文

肺癌；生活品質；症狀；自我效能；不確定感；憂鬱； lung cancer ； quality of life ； symptom ； self-efficacy ； uncertainty ； depression

Abstract │ Reference (162) │ Times Cited (3) │ Altmetrics

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Newly diagnosed lung cancer patients experience severe physical and psychological impacts during their first three-month treatment. Ineffective adaptation during this period will negatively affect their long-term quality of life (QOL). Little was known about the factors related to the change of QOL of patients with stage III - IV lung cancer in this critical period. Therefore, the purposes of this study were to examine the levels and change of QOL, symptoms, self-efficacy on cancer coping behavior and symptom management, uncertainty and depression in newly diagnosed lung cancer patients undergoing first three-month treatment, and to determine the related factors of the change of QOL in six dimensions (global QOL, physical function, role function, psychological function, cognitive function and social function). The prospective longitudinal study of 74 newly diagnosed lung cancer patients at a medical center in northern Taiwan assessed their symptoms, QOL, self-efficacy on cancer coping behavior, symptom management self-efficacy, uncertainty and depression at pretreatment and one-month and three-month after treatment initiated. Six Generalized Estimating Equations (GEE) models were applied to analyze the longitudinal data and to identify the significantly related factors of change of QOL in six dimensions. The results showed that the participants had a moderate level of global QOL which did not change statistically in the period of study. Relatively low scores in role function and social function were reported. Physical, cognitive and role functions significantly reduced over time while emotional and social functions had no significant change. In general, levels of symptoms were mild-to-moderate; cough and hemoptysis significantly diminished after treatment while the other symptoms increased or remained unchanged. Stable self-efficacy and reduced uncertainty were observed over time while depression increased with 31.3 % of the participants developing clinical depression after the three-month treatment. The GEE models identified that self-efficacy on coping behavior, fatigue, pain and treatment significantly contributed to the change of global QOL. Demographic and disease characteristics, symptoms, self-efficacy on coping behavior, uncertainty and depression significantly affected the change of different dimensions of QOL-related functioning. In conclusion, the QOL of newly diagnosed lung cancer patients was affected by multiple factors. A comprehensive multi-faceted intervention delivered by a multi-disciplinary team consisting of systematic assessment of QOL and the related factors, tailored symptom management and training of symptom management skills, self-efficacy enhancement, and uncertainty reduction is suggested to improve patients’ QOL. Further research to test the feasibility and effectiveness of the QOL enhancement intervention is recommended.

Reference ( 162 ) 〈TOP〉

簡淑芳、黃珊、韓彤珍、郭美玲、余芳娥 (2006)•乳癌患者之不確定感及其相關因素之探討•腫瘤護理雜誌，5 (2)，1-13。
連結：
蔡琇文、賴裕和、陳美伶、陳主智 (2000)•癌症疼痛生理感覺特質與疾病不確定感關係之探討•護理雜誌，8 (1)，59-70。
連結：
羅惠敏、徐南麗、邱慧汝、廖慧娥、劉欣怡 (2005)•癌症病患症狀困擾與不確定感關係之探討•慈濟護理雜誌，3 (1)，72-80。
連結：
Aaronson, N. K., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A., Duez, N. J., et al. (1993). The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. Journal of the Nantional Cancer Institute, 85(5), 365-376.
連結：
Agero, A. L. C., Dusza, S. W., Benvenuto-Andrade, C., Busam, K. J., Myskowski, P., & Halpern, A. C. (2006). Dermatologic side effects associated with the epidermal growth factor receptor inhibitors. Journal of the American Academy of Dermatology, 55(4), 657-670.
連結：

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