臺灣博碩士論文加值系統

惡性腫瘤自民國71年到現在為止一直是我國十大死亡原因排名第一位的，有鑑於此，癌症的預防與治療一直以來也是國家的重要政策。從最前端的篩檢到接下來的診療，而到後續的個案追蹤、癌症登記都是癌症防治的重點，缺一不可。對於癌症患者來說除了臨床的治療外，個人的心理支持、社會功能的維護亦是重要的一環，因此病友團體便成為一個重要的媒介，它能帶給病友心理與社會功能上的後援，甚至會因此對疾病的治療有正面的幫助。如此全人的發展勢必會帶給癌症病患更好的結果，也會對國家的策政有所幫助。
本研究以220位加入病友團體的女性癌症患者為樣本，調查加入病友團體前、後自覺的感受性。以描述性統計分析樣本的結構，參加病友團體對病人本身的感受性、病友團體活動對於病友幫助性、罹病期間病友「最希望」與「實際」給予支持的人。再以成對樣本T檢定分析參加病友團體前、後在心理狀態與社會功能上之差異情形。最後以單因子變異分析去分析年齡、婚姻狀況、現居地區、職業、可支配的金額、教育程度之於加入病友團前、後之生理、心理、社會功能得分差異情形，再以Scheffe事後多重檢定判斷排序。
研究結果顯示，本研究乳癌患者佔63％、參加病友團體四年以上~五年以下(含五年)佔44％、年齡介於51~60歲的佔44％、已婚佔77％、居住於高高屏的佔97％、職業為家管佔52％、高中職學歷佔41％；參加病友團體對病人本身的感受性方面九成以上都表示覺得非常有改善；病友團體活動方面以「醫學講座」、「自強活動」讓病友感覺最有幫助；罹病期間病友最希望獲得支持的依序為子女配偶、手足，病友則居於第五順位，而實際上給予支持的前三名分別為子女、配偶、病友，由此可知病友在實際給予支持方面甚至超越父母與手足。各項人口統計變項絕大部份不會直接影響病人本身的感受性，而加入病友團前、後的對病人的心理狀態方面並沒有顯著差異，但卻對病人的社會功能有顯著的差異。
本研究結果發現，病友團體的功能性對病友來說是相當需要的，並且在部分假設的分析上的確呈現有顯著差異的結果，因此藉由本研究的結果，希望相關單位可以在醫療院所方面、公共衛生政策方面更實際的支持病友團體之發展，以達到癌症患者與癌症防治政策兩方雙贏的結果。

In Taiwan, the malignant neoplasm is always the top of ten leading causes of death since 1982. In the light of this, strategies for cancer prevention and treatment are crucial national policies. Cancer screening, treatment, case tracking, cancer registry are all important points in the strategies. In addition to clinical treatment, personal psychological support and social function maintain are also important for cancer patients. Therefore, the patients support group could play a key medium, which not only bring psychological and social support to the patients but also exert positive influences on the diseases. Such holistic care will help the patients to obtain better outcomes and aid the country to promote policy effectively.
In this study, 220 female cancer patients in the patients support group were enrolled. The self-consciousness of the participants were investigated before and after joining the patients support group. We analyzed the samples using descriptive statistic to investigate the influence of joining the patients support group on the self-consciousness, the benefit of the activities hold in the patients support group, the person whom the patient mostly expected to give her support, and the person who supported the patient actually. Then, we used the pairs-T test to analyze the differences of the patients’ psychological state and social function before and after participating in the patients support group. Finally, we applied the ANOVA to analyze the effects of age, marital status, living area, occupation, disposable income, education degree on the patients’ physical, psychological state and social function before and after joining the patients support group.
Most female cancer patients in this study were breast cancers(63％). The majority of patients in this study were enrollment period more than four years to five years (44％), age of 51-60 (44％), married (44％), living in Kaohsiung or Pingtung (97％), housewife (52％), senior high school or vocational high school (41％). Over 90％ patients thought that their self-consciousness significantly improved after joining the patients support group. Among the activities, patients thought that the " medical lectures" and " tourism activities " were the most helpful ones. During the illness, the first three order of people whom patients expected to support them were children, spouse, and siblings; the wardmates were at the fifth position. However, actually, the top three order of people who really gave a support to the patients were children, spouses, and wardmates. As a result, the support provided from the wardmates even exceeded that provided from the parents and siblings. Most demographic variables do not directly affect the self-consciousness. To compare whether joining the patients support group or not, there are no significant differences in psychological state, but there are significant differences in social function after joining the patients support group.
The results of this study showed that the patients support group was quite important for the patients. Therefore, we hoped that the government can practically stand by the development of the patients support group by raising related policies regarding medical institutions and public health and expected these would bring up the beneficial outcomes for cancer patients and cancer prevention and treatment strategies.

論文審定書 i
誌謝 ii
中文摘要 iv
Abstract vi
目 錄 viii
圖 次 x
表 次 xi
第一章 緒論 1
第一節 研究背景及動機 1
第二節 研究目的 5
第二章 文獻探討 6
第一節 癌症病人的生理 6
第二節 癌症病人的心理 8
第三節 癌症病人的社會功能 10
第四節 臨床治療外的輔助性治療 11
第五節 病友團體介紹與功能 15
第三章 研究方法 18
第一節 研究架構與假設 18
第二節 研究對象與資料收集 19
第三節 信度與效度分析 20
第四節 資料統計與分析方法 22
第四章 研究分析與結果 24
第一節 描述性統計 24
第二節 推論性統計 42
第五章 討論與建議 152
第一節 研究討論 152
第二節 研究限制 154
第三節 建議 155
參考文獻 158
附錄一：本研究之問卷 163
附錄二：專家簡介 168

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