大腸癌病人決定接受標靶治療之決策過程

Targeted Therapy in Colorectal Cancer Treatment: The Patient Decision-Making Process

姚遠賢(Yuan‐Hsien Yao) ； 黃玉苹(Yu‐Ping Huang) ； 楊政議(Cheng‐I Yang) ； 王守玉(Shou‐Yu Wang)

《護理暨健康照護研究》 9卷4期 (2013/12) Pp. 311-319

https://doi.org/10.6225/JNHR.09.4.311

摘要

背景：近年來大腸癌的病人數持續的上升，而標靶藥物在癌症治療過程中被認為能有效延長病人存活時間，目前對於標靶治療的研究多傾向探討其成效及副作用等，然對於大腸癌病人決定接受標靶治療之決策過程相關研究卻付之闕如。目的：探討大腸癌病人在決定接受標靶治療之決策過程。方法：採質性研究深入訪談方式，資料收集先以立意取樣，後採理論取樣（theoretical sampling）及紮根理論分析的技巧，深入訪談9位曾接受過標靶治療的大腸癌病人。結果：研究發現，大腸癌病人在決定接受標靶治療之重大決策過程共包含三個範疇：「治療的動機」、「資訊的收集」及「改善病後生活品質」；而核心範疇為「把握當下，希望未來」。結論／實務應用：本研究結果可供臨床護理人員進一步了解大腸癌病人於罹癌時行標靶治療決策的過程，藉此同理病人感受並適時提供病人所需的幫助。

關鍵字

大腸癌 ； 標靶治療 ； 決策過程 ； 質性研究 ； 紮根理論分析

並列摘要

Background: Numbers of colorectal cancer patients have continued to rise in recent years. Targeted therapy is an approach that has proven effective in prolonging the life of colorectal cancer patients. Research related to targeted therapy has focused primarily on therapy effectiveness and side effects. No research has yet investigated the decision‐making process used by colorectal cancer patients to accept targeted therapy.Purpose: This study explores the decision‐making process used by colorectal cancer patients to accept targeted therapy treatment.Methods: This study used a qualitative research method. Purposive sampling, theoretical sampling, and grounded theory data analysis were used in the data collection and analysis process. A total of 9 colorectal cancer patient recipients of targeted therapy participated in in‐depth interviews.Results: The decision‐making process used by participants to accept targeted therapy may be subdivided into the 3 main categories of motives of treatment, searching for information, and improving life quality. The core category is: ”seize the moment and look forward to the future”.Conclusions/Implications for Practice: Study results provide important new information to clinical nurses about the patient decision‐making process with regard to target therapy. Nurses may apply this information to focus on the feelings of patients and offer timely, appropriate patient‐centered assistance.

並列關鍵字

colorectal cancer ； targeted therapy ； decision‐making process ； qualitative research ； grounded theory analysis

參考文獻

姚遠賢、謝東呈、蘇淑芬、王守玉（2011）•現今大腸癌 之治療趨勢•弘光學報，65，72−92。[Yao, Y. H., Shieh, D. C., Su, S. F., & Wang, S. Y. (2011). Current trends in the treatment of colorectal cancer. Journal of Hung Kuang University, 65, 72−92.]

羅湘云（2008）•探討一位肺癌末期患者初次接受化學治 療之護理經驗•澄清醫護管理雜誌，4(3)，40−46。[Lo, H. Y. (2008). Nursing role in the psychological adjustment of a patient with terminal lung cancer. Cheng Ching Medical Journal, 4(3), 40−46.]

張玉如、陳素根、鄧慶華（2008）•一位肝癌末期個案之 護理經驗•腫瘤護理雜誌，8(1)，79−90。[Chang, Y. J., Chen, S. K., & Teng, C. H. (2008). Nursing experiences of a patient with hepatocellular carcinoma at terminal stage. The Journal of Oncology Nursing, 8(1), 79−90.]

張淑娟、陳淑雯、陳淑貞、陳筱瑀、楊勝舜（2007）•慢 性C型肝炎患者接受干擾素合併Ribavirin治療的決策過 程•長庚護理，18(1)，21−31。[Chang, S. C., Chen, S. W., Chen, S. J., Chen, H. Y., & Yang, S. S. (2007). The decision-making process of receiving interferon plus Ribavirin therapy for patients with chronic hepatitis C. Chang Gung Nursing, 18(1), 21−31.]

王守玉、Windsor, C., & Yates, P.（2012）•簡介紮根理論 研究法•護理雜誌，59(1)，90−94。doi:10.6224/JN.59.1.90 [Wang, S. Y., Windsor, C., & Yates, P. (2012). Introduction to grounded theory. The Journal of Nursing, 59(1), 90−94.]