本研究爲探討幷建構癌末病人健康相關生活品質之內涵以及概念架構,研究對象采立意取樣,於某醫學中心安寧緩和醫療病房及腫瘤病房之15位高異質性之癌症末期住院病患,使用低結構式面對面訪談方式收集資料,將所得文字資料或錄音轉寫成文字稿,逐字逐句重複閱讀並進行分析、編碼與歸類,研究結果所建構之概念架構圖,呈現出健康相關生活品質內涵爲「四個類目及八個主題」,每個主題均含正向及負向的叙述,分別爲類目(一)身體內外的和諧與安適,共含兩個主題,分別爲1)身體內在的生理功能與活力;2)身體外在的活動功能與外觀。類目(二)心理情感的和諧與安適:共含兩個主題,分別為l)主觀的情感表達:2)幸福的認知評價。類目(三)家庭社會的和諧與安適︰共含兩個主題,分別爲1)與家人和親友的人際關係2)與生活和醫療環境的共處。類目(四)靈性存在的和諧與安適,共含兩個主題,分別為l)與自身和他人的和諧;2)與至高者和他人的和諧。而癌末病人健康相關生活品質之四個類目與八個主題,均爲環環相扣且相互影響,其終極目標爲追尋「身心靈及社會」整體的動態和諧,即達「天人合一」之境界,每個主題均含有「正向與負向」的生活品質,如太極圖之「陰與陽」,彼此互滲與消長。本研究結果期能讓臨床醫護專業人員多些文化敏感度,以提供適切性的末期醫療照顧,以及發展本土化健康相關生活品質評量工具之參考。
The purpose of this study was to investigate the constructs and to establish the conceptual framework of health related quality of life (HRQOL) in terminal cancer patients. Low structured interviews were used for data collection in the palliative care unit and oncology ward. Fifteen subjects were selected by purposive sampling and by the high heterogeneous backgrounds. Interview transcripts provided the data for content analysis by categorizing and coding. The results show that the life quality is composed of four categories and eight themes in terminal cancer patients. Each theme included positive and negative aspects for life quality. The first category is ”Physical internal-external harmony and well-being” which include two themes: 1) Internal physiological functions and stamina. 2) Body appearance and external physical activities. The second category is ”Psychological-affective harmony and well-being which include two themes: 1) Subjective affection. 2) Cognitive evaluation of well-being. The third category is ”Family-social harmony and well-being” which include two themes: 1) Relationships of family and kinsfolk. 2) Integration of life and medical environment. The fourth category is ”Spiritual-existential harmony and well-being” which include two themes: 1) Harmonizing with self and others. 2) Harmonizing with higher being and nature. The ultimate HRQOL goal is the dynamic harmony of physical psychological、spiritual and social which equal with the ”unity of nature and human being. The four categories have mutual interaction and each theme included positive and negative life quality, which is similar to Yin and Yang of Tai-Chi symbol. The results would help the medical professionals provide cultural care and develop the native HRQOL assessment tool further.
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