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  • 學位論文

癌末安寧療護病患症狀嚴重程度、身體活動功能、靈性安適感與生活品質之關係

Determinate the association of symptoms severity、performance status、spiritual well-being and quality of life among advanced cancer patients receiving palliative care

指導教授 : 鄭素月

摘要


隨著癌症病況進展,疾病無法控制時,進入癌症末期階段,此時病 人面臨身體功能衰退,同時也面對臨終前的心理及靈性困擾,導致生活 品質低落。因此提供癌末病人症狀控制、心理支持及靈性照護,提升生 活品質為目標的安寧療護逐漸受到重視。 本研究目的為調查癌末安寧療護病患症狀嚴重程度、身體活動功 能、靈性安適感與生活品質狀況,並分析癌末安寧療護病患在不同安寧 療護狀況的症狀嚴重程度、身體活動功能、靈性安適感與生活品質之差 異,並探討癌末安寧療護病患生活品質之相關因素及解釋因子。 本研究採橫斷式相關性研究設計,以SPSS19.0 統計軟體分析研究資 料,共50 位癌末安寧療護病患,包括30 位住院組及20 位居家組。收集 III 研究資料之工具為結構式問卷,包含:人口學資料、症狀嚴重程度量表、 活動功能評估量表、靈性安適感量表及McGill 台灣版生活品質問卷。 研究結果如下:一、研究對象呈現輕度的症狀嚴重程度、部分失能的 身體活動功能、中等程度的靈性安適感與中等程度生活品質。二、安寧 療護期間與症狀嚴重度呈現顯著負相關(r= -.468, p< .01),並與生活品質 正相關(r= .374, p< .01)。三、居家組比住院組呈現較輕微的症狀嚴重程 度、較好的身體活動功能及較佳的生活品質。四、症狀嚴重程度、休閒 娛樂、安寧療護場所與生活品質有顯著相關性。五、對生活品質具有解 釋力的因子,包含身體活動功能、安寧療護期間及靈性安適感,對癌末 安寧療護病患生活品質之總變異量具40.2%的解釋力。 研究結果發現:身體活動功能、安寧療護期間、靈性安適感功能對 癌末安寧療護病患的生活品質有顯著的解釋力,建議護理人員依據癌末 安寧療護病患的症狀嚴重程度給予較長時間的安寧療護,提升病患的生 活品質。安寧療護團隊依病患狀況,將其轉至居家組,可減輕症狀嚴重 程度,改善身體活動功能及生活品質。

並列摘要


Palliative care could provide symptoms control, mental support, and spiritual care become more and more attentive. The purpose of this study were to survey the symptoms severity, performance status, spirituality, and quality of life among the advanced cancer patients receiving palliative care and analyze those factors correlated to palliative time as well as examine the difference of those factors under different palliative place. This study also determined the correlation factors and explainable factors of quality of life among the study subjects. A cross-section study with SPSS 19.0 software was used. Total 50 of participants was obtained, including 30 ward-base and 20 home-base. The V instruments were including: demographic questionnaires, symptoms severity score, Karnofsky performance scale, the 12-item Spiritual Well-Being questionnaires, and Taiwan version McGill quality of life Questionnaire. The research results showed (1) The participants had mild symptoms severity, partially performance status, middle level of spirituality and quality of life, (2) Palliative time correlated with symptoms severity and quality of life, (3) The home-base participants had slighter symptoms severity, better performance status, and better quality of life than ward-base participants, (4) Leisure activities, symptoms severity and palliative place significantly correlated to the participants’ quality of life, and (5) Performance status, spirituality, and palliative time could explain 40.2% variance of quality of life among advanced cancer patients receiving palliative care. Clinical nurses should provide longer palliative time after assessing symptom severity among advanced cancer patients and to elevate their quality of life. Palliative team members could refer advanced cancer patients receiving home-base palliative care first to improve their quality of life.

參考文獻


剖析與建構癌末病人健康相關生活品質內涵之研究•安寧療護雜
Main Care Issues among Terminal Cancer Patients in Hospice Home
Concepts of Hospice Spiritual Care in Christian Anthropology. Taiwan
Consultation in Terminal Cancer Patients. Formosan Journal of medicine,
Cancer Patients from the Taiwanese Cultural Contexture. Formosan

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