臺灣博碩士論文加值系統

本研究目的為探討放鬆介入對頭頸癌患者術後於住院期間疼痛、疲憊與睡眠品質之成效，本研究為隨機控制實驗性設計，採隨機分配，分配的號碼放入密封信封並做縱貫性觀察，採單盲設計，從入院接受頭頸癌手術至出院的14天期間接受9天的觀察及紀錄。兩組在手術前接受前測，實驗組在加護病房轉出第三天開始韓瑞克森肌肉放鬆訓練，每天晚上睡前一次，每次共15分鐘，對照組則進行一般照護。分別於入院第一天手術前、術後加護病房轉出第三天到十天進行測量。研究工具包括中文版匹茲堡睡眠品質量表Chinese version of the Pittsburgh Sleep Quality Index (C-PSQI)、簡明疲憊量表 (The Brief Fatigue Inventory, BFI) 、簡明疼痛量表（Brief Pain Inventory, BPI）及每天記錄視覺類比量表(肌肉緊繃、疼痛、疲憊、焦慮、憂鬱、睡眠障礙)、生命徵象及睡眠日誌。資料分析以百分比、平均值之描述性統計、廣義分析方程式(GEE)等方式進行。
本研究結果共收案67位病人，實驗組34人、對照組33人，其中7人流失(4人病情加重、2人不願參加退出此實驗、1人傳染性疾病)，最後完成研究實驗組及對照組各為30人。(1)在睡眠品質、疼痛、疲憊部分，整體睡眠品質前後測為(5.97±3.19、10.83±3.34，p﹦0.00；)、疼痛前後測為(1.47±1.65、2.83±1.13，p﹦0.00)、疲憊前後測為(0.41±1.11、0.97±0.18，p﹦0.00)。而實驗組於整體睡眠品質前後測則為(6.40±3.74、9.20±2.95，p﹦0.00)、疼痛前後測為(1.42±1.95、2.11±1.07，p﹦0.09)，而疲憊前後測為(0.50±1.49、0.93±0.25，p﹦0.00)。兩組後測分數均顯著高於前測。利用GEE分析，在睡眠品質及疲憊部分，實驗組降低幅度優於對照組，睡眠品質(β﹦0.38， p﹦0.03)、疲憊(β﹦0.09，p﹦0.03)。(2)利用視覺類比量表測量，兩組症狀困擾的情形隨著天數而下降，其中肌肉緊繃程度於加護病房轉出第七天至十天，實驗組顯著低於對照組(46.77±25.10、59.67±18.47，p﹦0.03；38.67±21.13、50.67±21.80，p﹦0.04；30.33±19.21、45.67±17.94，p﹦0.00；23.33±18.63、35±18.15，p﹦0.02)，疼痛則於加護病房轉出第七天至第十天，實驗組明顯低於對照組 (43.33±26.31、56.67±22.02，p﹦0.04；39.33±18.37、52±19.19，p﹦0.01；31.67±17.83、45.67±19.06，p﹦0.01；24.33±13.31、38.33±20.53，p﹦0.00)，疲憊於加護病房轉出第八天至第十天，實驗組明顯低於對照組(50±22.59、62.33±21.28，p﹦0.03、41.67±23.65、57.67±21.61，p﹦0.01、36.67±20.23、50±4.91，p﹦0.03)；焦慮於加護病房轉出第四天實驗組明顯低於對照組(7.00±11.49、16.67±12.95，p﹦0.00)，憂鬱於加護病房轉出第四天及第五天，實驗組明顯低於對照組(1.33±4.34、8±11.57，p﹦0.01；0.33±1.83、4.33±10.06，p﹦0.04)，睡眠部分則於加護病房轉出第八天及第十天，實驗組明顯低於對照組(51.90±24.31、66±26.68，p﹦0.02；42.67±19.99、53.67±22.97，p﹦0.05)。(3)實驗組在每次介入後血壓、脈搏、呼吸皆顯著降低。
結論：本篇研究為第一篇利用隨機控制試驗進行放鬆介入於頭頸癌術後病患，病患在術後其疼痛、疲憊、睡眠品質皆變差，但放鬆介入能顯著提升睡眠品質及降低疲憊程度，值得提供臨床醫護人員照護之參考。

Abstract
This study examined the effectiveness of relaxation intervention on pain, fatigue, and sleep quality of patients with head and neck cancer during postsurgical hospitalization. Based on a randomized controlled trial design, random distribution was used: grouping numbers were placed inside sealed envelopes, and longitudinal observations were performed. Using single blind design, the patients were observed for 9 days during the 14 days’ hospitalization—from the day of admission for head and neck cancer surgery to the day of discharge; the observations were logged. The two groups of patients underwent pretesting before surgery. The experimental group underwent Hendrickson muscle relaxation training for 15 minutes every night before bed starting from the Day 3 of transfer from the intensive care unit (ICU); the control group received regular care. Measurements were taken on the day of admission before surgery and from Days 3–10 of transfer from the ICU postsurgery. Research instruments included the Chinese version of the Pittsburgh Sleep Quality Index (C-PSQI), Brief Fatigue Inventory (BFI), and Brief Pain Inventory (BPI); a daily visual analogue scale (VAS) record (muscle tension, pain, fatigue, anxiety, depression, and sleep disorder), vital signs, and sleep diary were also taken. Data analysis was performed using the percentage and mean value of descriptive statistics, and a generalized estimating equation (GEE).
This study recruited 67 patients, who were divided into two groups: 34 in the experimental group and 33 in the control group. Subsequently, 7 patients were removed from the study (4 patients developed serious conditions, 2 dropped out of study, and 1 contracted a sexually transmitted disease); ultimately, the study was completed with 30 patients in each group. The research results were as follows: (1) Regarding the pretest and posttest scores, they were: sleep quality (5.97 ± 3.19, 10.83 ± 3.34; p = 0.00), pain (1.47 ± 1.65, 2.83 ± 1.13; p = 0.00), and fatigue (0.41 ± 1.11, 0.97 ± 0.18; p = 0.00). The pretest and posttest scores for the experimental group were: overall sleep quality (6.40 ± 3.74, 9.20 ± 2.95; p = 0.00), pain (1.42 ± 1.95, 2.11 ± 1.07; p = 0.09), and fatigue (0.50 ± 1.49, 0.93 ± 0.25; p = 0.00). The posttest scores of the two groups were significantly higher than the pretest scores. GEE analysis revealed that the sleep quality and fatigue of the experimental group exhibited greater improvements than those of the control group; sleep quality (β ﹦0.38; p ﹦0.03), fatigue (β ﹦0.09; p ﹦0.03). (2) According to the VAS, the symptoms were alleviated in both groups as the days progressed. On Days 7–10 of transfer from the ICU, the muscle tension of the experimental group was significantly lower than that of the control group, (46.77 ± 25.10, 59.67 ± 18.47; p = 0.03), (38.67 ± 21.13, 50.67 ± 21.80; p = 0.04), (30.33 ± 19.21, 45.67 ± 17.94; p = 0.00), and (23.33 ± 18.63, 35 ± 18.15; p = 0.02); and the pain level of the experimental group was significantly lower than that of the control group, (43.33 ± 26.31, 56.67 ± 22.02; p = 0.04), (39.33 ± 18.37, 52 ± 19.19; p = 0.01), (31.67 ± 17.83, 45.67 ± 19.06; p = 0.01), and (24.33 ± 13.31, 38.33 ± 20.53; p = 0.00). The fatigue level of the experimental group was significantly lower than that of the control group on Days 8–10 of transfer from the ICU, (50 ± 22.59, 62.33 ± 21.28; p = 0.03), (41.67 ± 23.65, 57.67 ± 21.61; p = 0.01), and (36.67 ± 20.23, 50 ± 4.91; p = 0.03). The anxiety level of the experimental group was significantly lower than that of the control group on Day 4 of transfer from the ICU (7.00 ± 11.49, 16.67 ± 12.95; p = 0.00). The depression level of the experimental group was significantly lower than that of the control group on Days 4 and 5 of transfer from the ICU; (1.33 ± 4.34, 8 ± 11.57; p = 0.01) and (0.33 ± 1.83, 4.33 ± 10.06; p = 0.04). The sleep score of the experimental group was significantly lower than that of the control group on Days 8 and 10 of transfer from the ICU; (51.90 ± 24.31, 66 ± 26.68; p = 0.02) and (42.67 ± 19.99, 53.67 ± 22.97; p = 0.05). (3) The blood pressure, pulse, and breathing measurements of the experimental group were significantly lowered after every intervention.
Conclusions: This study was the first to use a randomized controlled trial to conduct relaxation intervention for post head and neck cancer surgery patients. Pain, fatigue, and sleep quality of patients worsened postsurgery, but relaxation intervention could significantly enhance sleep quality and reduce fatigue level. Hence, clinical care workers could use this study as a reference for patient care.

目錄
致謝 I
中文摘要 II
Abstract IV
目錄 VII
表目錄 IX
圖目錄 X
附錄 XI
第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的 5
第三節 研究假設 5
第四節 名詞界定 6
第貳章 文獻查證 8
第一節 頭頸癌發展及治療 8
第二節 術後疼痛 13
第三節 疲憊 17
第四節 睡眠品質 19
第五節 放鬆訓練的原理與相關研究 22
第六節 頭頸癌患者術後疼痛、疲憊、睡眠品質與基本屬性之關係 25
第三章 研究方法 28
第一節 研究架構 28
第二節 研究設計 29
第三節 研究對象及場所 31
第四節 研究工具 32
第五節 資料收集過程 38
第六節 研究對象權益與倫理考量 38
第七節 資料分析方法 39
第肆章 研究結果 40
第一節 研究對象之基本屬性與疾病分析 41
第二節 研究對象之睡眠品質分析 45
第三節 研究對象之疼痛分析 48
第四節 研究對象之疲憊分析 51
第五節 研究對象之症狀困擾程度分析 55
第六節 研究對象之生理反應 67
第五章 討論 71
第一節 護理介入措施對頭頸癌患者術後睡眠品質之分析 71
第二節 護理介入措施對頭頸癌患者術後疼痛之分析 75
第三節 護理介入措施對頭頸癌患者術後疲憊之分析 78
第四節 護理介入措施對頭頸癌患者術後症狀困擾之分析 80
第五節 護理介入措施對頭頸癌患者術後生理反應之分析 82
第六章 結論與建議 84
第一節 結論 84
第二節 研究結果在護理上的應用 86
第三節 研究限制與建議 88
參考文獻 90
中文參考文獻 90
英文參考文獻 96

表目錄
表一：研究工具信效度 37
表4-1、研究對象中途退出之時間點及原因 40
表 4-2、研究個案基本屬性 43
表4-2、研究個案基本屬性續 44
表4-3、兩組病患在手術前晚及術後第十天其中文版匹茲堡睡眠品質量表之變化與比較 47
表4-4、實驗組與對照組之主觀整體睡眠成效 47
表4-5、兩組病患在手術前晚及術後第十天其簡明疼痛量表之變化與比較 50
表4-6、實驗組與對照組之主觀疼痛成效 51
表4-7、前測與後測疲憊的產生人數次數分配表 53
表4-8、兩組病患在手術前晚及術後第十天其簡明疲憊量表之變化與比較 54
表4-9、實驗組與對照組之主觀整體疲憊成效 54
表4-10、兩組病患在手術前與加護病房轉出第三天到第十天其肌肉緊繃程度之變化 56
表4-11、兩組病患在手術前與加護病房轉出第三天到第十天其疼痛程度之變化 58
表4-12、兩組病患在手術前與加護病房轉出第三天到第十天其疲憊程度之變化 60
表4-13、兩組病患在手術前與加護病房轉出第三天到第十天其焦慮程度之變化 62
表4-14、兩組病患在手術前與加護病房轉出第三天到第十天其憂鬱程度之變化 64
表4-15、兩組病患在手術前與加護病房轉出第三天到第十天其睡眠障礙程度之變化 66

圖目錄
圖一：研究架構概念圖 28
圖二、收案流程圖 30
圖三：兩組病患在手術前與加護病房轉出第三天至第十天其肌肉緊繃程度變化 56
圖四：兩組病患在手術前與加護病房轉出第三天到第十天其疼痛程度之變化 58
圖五：兩組病患在手術前與加護病房轉出第三天到第十天其疲憊程度之變化 60
圖六：兩組病患在手術前與加護病房轉出第三天到第十天其焦慮程度之變化 62
圖七：兩組病患在手術前與加護病房轉出第三天到第十天其憂鬱程度之變化 64
圖八：兩組病患在手術前與加護病房轉出第三天到第十天其睡眠障礙程度之變化 66
圖九：實驗組病患在手術前與加護病房轉出第三天到第十天其收縮壓之變化 67
圖十：實驗組病患在手術前與加護病房轉出第三天到第十天其舒張壓之變化 68
圖十一：實驗組病患在手術前與加護病房轉出第三天到第十天其脈搏之變化 69
圖十二：實驗組病患在手術前與加護病房轉出第三天到第十天其呼吸之變化 70

附錄
附錄一、研究同意書 114
附錄二、研究問卷 119
附錄三、中文版匹茲堡睡眠品質量表121
附錄四、簡明疼痛量表 123
附錄五、簡明疲憊量表 125
附錄六、生理反應紀錄表 127
附錄七、視覺類比量表 128
附錄八、睡眠日誌 129
附錄九、專家效度名單 130
附錄十、致專家效度鑑定函 131
附錄十一、專家效度評分方向與標準 132

中文參考文獻
台灣癌症防治網(2009，9月25日)‧頭頸癌的標靶治療現況與展望‧2014年8
月21日取自
http://cisc.twbbs.org/lifetype/index.php?op=ViewArticle&articleId=179
0&blogId=1
衛生福利部統計處(2017，6月19日)‧105年死因統計結果分析‧2017年6月 22日取自http://www.mohw.gov.tw/cp-16-33598-1.html
李德芬(2009)‧實驗性研究設計‧於李選總校閱，護理研究與應用(三版，183-207
頁)‧台北市：華杏。
王文娟(2004)‧頭頸癌患者症狀嚴重度、情緒狀態與睡眠品質之探討。發表的碩士論文，台北：國立台北護理學院。
王宏銘、廖俊達、范網行、吳樹鏗、詹勝傑、閣紫宸 (2009)頭頸部鱗狀細胞癌
治療的新進展‧腫瘤護理雜誌，9(S)51-67。
王秀禾、葉美玲、鍾聿琳、楊千慧(2008)‧應用耳穴貼壓改善睡眠之成效‧實證
護理，4(3)，243-250。
王恩南‧(2014)‧失眠‧臺灣醫學，18(2)，221-225。
王謹賢(2013)‧腹式呼吸訓練於口腔癌手術患者焦慮與生活品質之成效。發表的
碩士論文，台中：中國醫藥大學。
江惠英（1995）．血液透析病人疲倦感與社會支持憂鬱傾向及血液生化檢驗值相關性探討．發表的碩士論文，高雄：高雄醫學大學。
江惠英、鍾信心(1997)‧血液透析病人疲倦感與社會支持，憂鬱傾向及血液生化檢驗植相關性探討‧護理研究，5(2)，115-126。
江姿瑩(2005) ‧口腔癌及癌前病變患者術後症狀困擾與照護需求之相關因素探討．發表的碩士論文，高雄：高雄醫學大學。
江裕陽、蔡盧浚、徐坤銘、黃伯瑜(2008)‧針刺治療失眠症的研究思路‧臺灣中醫臨床醫學雜誌，14(2)，128-140。
江淑華、林佳靜(2010)‧頭頸癌病人術後接受放射化學治療之症狀困擾與生活干擾程度探討‧新臺北護理期刊，12(2)，17-26。
呂美嬅(2002)‧放鬆反應於改善癌症末期病患之疼痛程度、情緒狀態及生理反應之成效。未發表的碩士論文，台北：台北醫學院。
何菊修、陳宗鷹(2005)‧急性術後疼痛‧慈濟醫學雜誌，17(6)，43-50。
李明濱、李宇宙（1996）‧精神官能症之行為治療‧台北：健康。
向肇英(2000)‧比較衛教與肌肉放鬆訓練處置乳癌婦女術後疼痛及焦慮改善之成效‧發表碩士論文，台北：台北醫學大學。
杜佳玲(2004)‧疼痛教育及放鬆訓練對改善癌痛之立即與中程效果比較。未發表的碩士論文，台北：台北醫學大學。
李宇宙(2005)‧失眠症的臨床評估與處置‧臺灣醫學，9(3)，346-353。
李佳倫(2006)‧結直腸癌病患手術前後生活品質變化及其相關因素調查‧未發
表的碩士論文，高雄：高雄醫學大學。
明金蓮、洪曉佩(2011)‧急性疼痛評估與症狀護理‧源遠護理，5(1)，11-16。
邱曉彥、邱艷芬(2010)‧睡眠品質之概念分析‧護理雜誌，57(4)，106-111。
何培申(2013)‧台灣地區乳癌患者焦慮、憂鬱、睡眠與生活品質之相關‧未發表碩士論文，台北：國立臺北教育大學。
林佳靜、陳淑如、謝麗鳳‧(1997)‧疼痛護理‧護理雜誌，44(1)，37-47。
林維君‧(2010)‧癌症患者失眠的認知行為治療：系統性的文獻回顧‧中華心理學刊，52(2)，173-188。
林瓊芳(2000)‧漸進式肌肉鬆弛處置對原發性高血壓患者之成效‧發表碩士論文，台北：國立台灣大學。
林瓊珠、姚吟蓮、廖素滿、莊淑娟、林金燕、林碧珠(2002)‧探討不同給藥方式對脊椎手術病患疼痛控制之成效‧榮總護理，19(1)，21-34。
林嘉玲、蘇東平、張媚（2003）．機構老人之睡眠品質及其相關因素．臺灣醫學，7（2），174－184。
林硯農，魏靚華，黃媺淳，張光華，邱俊傑 (2007)．頸部淋巴結切片手術後脊副神經損傷引起肩頸部疼痛及疑似硬塊：病例報告．臺灣復健醫學雜誌,，35(4)，224-228。
林廷宣、李芳輝、羅正興、梁錦榮、楊國強、陳家榮、章浩宏(2009)‧以手術修補頸部淋巴廓清手術後乳糜漏—病例報告‧臺灣口腔顎面外科學會雜誌， 20(1)，9-18。
林維君(2010)‧癌症患者失眠的認知行為治療：系統性的文獻回顧‧中華心理學刊，52(2)，173-188。
邱曉彥、邱艷芬(2010)‧睡眠品質之概念分析‧護理雜誌，57(4)，106-111。
周繡玲、廖珍娟、姚鍾太(2007) ‧癌症病人的失眠困擾‧腫瘤護理雜誌，7(2)，25-35。
胡麗霞(2003)‧放鬆訓練於改善肝癌病患接受肝動脈栓塞治療期間疲憊及焦慮之成效‧未發表碩士論文，台北：台北醫學大學。
郭淑柳(2002)‧疼痛衛教及放鬆訓練對改善癌症疼痛之效果探討‧未發表的碩士論文，臺北：台北醫學大學。
洪慧容(2002)‧音樂治療對改善癌症病患焦慮憂鬱及睡眠品質之成效‧未發表的碩士論文，高雄：高雄醫學大學。
張宏育、劉文山、蘇茂昌、辛宗翰、歐哲甫、廖倩茹(2003)‧強度調控放射線治療對鼻咽癌患者治療之評估‧中山醫學雜誌，14(1)，83-88。
徐偉凱、白馨、林廷宣、蘇偉嘉、李芳輝、羅正興(2010)‧口腔癌術後併發自
由皮瓣靜脈血栓與肺水腫─ 病例報告‧臺灣口腔顎面外科學會雜誌，
21(2)， 119-132。
許晏寧(2012)‧早期肺癌術後患者睡眠品質與相關因素探討‧未發表的博士論文，台北：臺灣大學。
陳修宜、徐茂銘（2002）•台灣地區頭頸部癌症綜論•當代醫學，29(4)，269-272。
陳麗華(2006)‧耳、鼻、喉疾病病人的護理‧於陳敏麗、燕翔、陳麗華、陳亭如、簡淑慧、曾明月等人編著，最新實用內外科護理學(下冊，18-111-18-121頁)‧台北：永大。
陳淑卿(2007)‧口腔癌病患手術後之生活經驗‧腫瘤護理雜誌，7(2)，13-23。
陳淑卿、林佳靜(2008)‧影響口腔癌病人手術後心理困擾之因素‧馬偕護理雜
誌，2(1)，16-26。
陳淑卿(2009)‧口腔癌病患手術重建及放射線治療期間照護需求改變及相關因素之探討—長期追蹤研究‧未發表的博士論文，台北：台北醫學大學。
陳昱芬(2007)‧腹式呼吸放鬆訓練用於改善焦慮狀態之成效探討‧未發表的碩士論文，台中：中國醫藥大學。
陳依鈴(2012)‧睡眠介入措施對改善外科加護病房病人睡眠品質程度之成效探討‧未發表的碩士論文，台中：弘光科技大學。
陳淑芬(2013)‧引導想像對乳癌化療病人身心不適症狀之影響‧未發表的碩士論文，台北‧國立臺北護理健康大學。
詹淑雅(2008)‧穴位指壓對接受化學治療的頭頸癌病人的睡眠品質、疲憊與能量之成效：Rogers護理理論之應用‧未發表的碩士論文，高雄：高雄醫學大學。
莊麗蘭(2011)‧放鬆訓練對早發性分娩孕婦之壓力緩解與早產防治之成效‧未發表碩士論文，台北：國立陽明大學。
曾令儀、李引玉(1999)‧放鬆治療在護理上的應用‧護理雜誌，46(5)，68-74。
曾光毅、曾嵩智(2011)‧現階段口腔癌的預防與治療‧家庭醫學與基層醫療，26(5)，215-224。
黃采薇(2000)‧比較背部按摩與放鬆訓練處置對化學治療期間疲憊程度改善之成效。未發表的碩士論文，台北：台北醫學大學。
黃采薇、賴裕和、鄭安理、史麗珠、張正雄、向肇英(2001)．背部按摩對化學治療期間疲憊及焦慮之成效．台灣醫學，5(4)，369-378。
隋善中(2003)‧手術後疼痛影響因素及疼痛管理之探討-以某醫學中心為例。未發表的碩士論文，台北‧台灣大學。
黃采薇、謝孟蓁、賴俊宏、賴秋絨(2006)‧乳癌病患接受化學治療期間疲憊及睡眠品質之研究‧弘光學報(49)，111-124。
黃秀月、謝素英‧(2016)‧癌症有關失眠困擾照護之新概況‧台灣健康照顧研究學刊，(17)，111-126。
傅雅雯(2007)‧匹茲堡睡眠品質量表於台灣癌症病人之信效度檢定‧未發表的碩士論文，台北：台北醫學大學。
趙美珍(2004)‧肝硬化病患疲倦與睡眠品質之相關因素探討‧未發表的碩士論文，台北：台北醫學大學。
廖海萍(2010)‧探討漸進式肌肉放鬆運動團體對住院慢性精神病人睡眠品質的成效‧發表的碩士論文，台北：國立台北護理學院。
雷啟文(2003)‧中年婦女身體活動與睡眠品質之相關研究‧未發表的碩士論文，台北：台北護理學院。
楊曜臨、張淑珍、陳宗鷹（2005）‧病人術後自控式疼痛控制‧慈濟醫學，17(6)，51-55。
楊翠雲(2007)‧肌肉放鬆及意像引導之運用‧安寧療護雜誌，12(1)， 66-73。
楊建銘(2009)‧臨床心理學在睡眠醫學的應用：過去、現在與未來‧應用心理研究，(41)，77-92。
賴裕和（2002）．手術期間的護理．賴裕和、林佳靜、廖媛美、鄭素月、林美良、鄭綺等合譯，拉克曼內外科護理學（109－153頁）．台北：華杏。
詹秀妹、吳麗玲(2003)‧病患急性疼痛定養性特徵與 Demerol 使用相關性探討‧新臺北護理期刊，5(1)，15-23。
詹日全、黃穰基、潘超群、王仲祺、王景平、劉時安(2007)‧口腔癌治療後影響局部復發之相關因素分析‧臺灣耳鼻喉頭頸外科雜誌，42(4)，115-127。
趙基安、許名雅、陳虹汶、蘇文浩、黃麗卿、鄒孟婷(2011)‧癌因性疲憊相關之病理生理機轉‧安寧療護雜誌，16(3)，348-360。
樊君儀、黃秀霖、陳嬿如、胡麗霞、蔡淑合、洪世欣‧(2015)‧應用耳穴按壓改善癌症病人之睡眠困擾‧護理暨健康照護研究，11(1)，3-12。
劉嘉蕙(1996)‧放鬆訓練對失眠的改善探討。發表碩士論文，高雄：高雄醫學院。
劉引玉、周桂如、謝佳容(2009)‧老人睡眠品質與相關測量問題之探討‧長期照護雜誌，13(2)，231-242。
蔡佳辰(2007)‧放鬆介入對化療癌症患者其焦慮緩解之效果。發表的碩士論文，台南：國立成功大學。
蔣婷婷(2003)‧口腔癌切除病患術後症狀嚴重度之探討‧發表的碩士論文，台北‧台北醫藥大學。
謝麗鳳、劉淑珍、林惠蘭、陳美碧(2008)‧探討音樂治療對首次化學治療病人焦慮及憂鬱之改善成效‧榮總護理，25(2)，137-145。
謝佩芸 (2010)．頭頸部癌症病人疼痛特質與其因應策略之探討．未發表碩士論文，台北:國立台灣大學。
蕭筑棋(2014)‧探討大腸直腸癌患者化學治療期間運用漸進式肌肉放鬆訓練對症狀困擾及焦慮改善之成效‧未發表的碩士論文，台北‧國立臺北護理健康大學。
羅英毓、王森德、李芸霏、蘇千田(2010)‧口腔癌危險因子與癌前病變‧家庭
醫學與基層醫療，25(8)，310-317。
蘇燦煑(2009)‧不孕婦女對 “自我放鬆訓練” 的學習狀況‧亞東學報，
(29)，199-206。
滕慧彥 (2015)‧頭頸癌患者疼痛困擾與生活功能探討‧未發表的碩士論文，台北‧臺灣大學。
顧淑芳(2006)‧探討鬆弛訓練對外科加護病房術後病患急性疼痛及焦慮緩解之
成效‧未發表的碩士論文，台北‧輔仁大學。
 
英文參考文獻
Ahlberg, A., Nikolaidis, P., Engström, T., Gunnarsson, K., Johansson, H., Sharp, L., & Laurell, G. (2012). Morbidity of supraomohyoidal and modified radical neck dissection combined with radiotherapy for head and neck cancer. A prospective longitudinal study. Head & neck, 34(1), 66-72.
Aigner, M., Graf, A., Freidl, M., Prause, W., Weiss, M., Kaup-Eder, B., ...
& Bach, M. (2003). Sleep disturbances in somatoform pain disorder.
Psychopathology, 36(6), 324-328.
Alroosan, M., & Alroosan, A. (2011). Pain Control in Head and Neck Cancer. Otorhinolaryngology ClinicsAn International Journal, 3(2), 84-87.
American Cancer Society. Cancer Facts and Figures 2011. Atlanta, GA: American Cancer Society; 2012. 2011. Retrieved October 3, 2011.
Ashbury, F. D., Findlay, H., Reynolds, B., & McKerracher, K. (1998). A Canadian survey of cancer patients’ experiences: are their needs being met?. Journal of pain and symptom management, 16(5), 298-306.
Asltoghiri, M., & Ghodsi, Z. (2012). The effects of Reflexology on sleep disorder in menopausal women. Procedia-Social and Behavioral Sciences, 31, 242-246.
Ancoli-israel, S., Moore, P. J., & Jones, V. (2001). The relationship between
fatigue and sleep in cancer patients: a review. European journal of cancer care,
10(4), 245-255.
Ancoli-Israel, S., Cole, R., Alessi, C., Chambers, M., Moorcroft, W., & Pollak, C. (2003). The role of actigraphy in the study of sleep and circadian rhythms. American Academy of Sleep Medicine Review Paper. Sleep, 26(3), 342-392.
Ando, M., Morita, T., Akechi, T., Ito, S., Tanaka, M., Ifuku, Y., & Nakayama, T.
(2009). The efficacy of mindfulness-based meditation therapy on anxiety,
depression, and spirituality in Japanese patients with cancer. Journal of palliative
medicine, 12(12), 1091-1094.
Barsevick, A. M. (2007, September). The elusive concept of the symptom cluster. In
Oncology nursing forum (Vol. 34, No. 5, pp. 971-980). Oncology Nursing
Society.
Bravi, F., Bosetti, C., Filomeno, M., Levi, F., Garavello, W., Galimberti, S., ... & La
Vecchia, C. (2013). Foods, nutrients and the risk of oral and pharyngeal cancer.
British journal of cancer, 109(11), 2904-2910.
Barnes, E. A., & Bruera, E. (2002). Fatigue in patients with advanced cancer: a review. International Journal of Gynecological Cancer, 12(5), 424-428.
Beecroft, J. M., Ward, M., Younes, M., Crombach, S., Smith, O., & Hanly, P. J. (2008). Sleep monitoring in the intensive care unit: comparison of nurse assessment, actigraphy and polysomnography. Intensive care medicine, 34(11), 2076-2083.
Bernier, J., Domenge, C., & Ozsahin, M. (2011). Head and neck cancer. Springer.
Benson, H., Beary, J. F., & Carol, M. P. (1974). The relaxation response. Psychiatry: Journal for the Study of Interpersonal Processes.
Benson, H. ( 2000 ). The relaxation response. NY : Avon Books.
Berry, P. E., & Ward, S. E. (1995). Barriers to pain management in hospice: a study of
family caregivers. Hospice Journal.
Berstein,D.,& Boekovec,T.(1973).Progressive relaxation training.Champaign,IL：Research Press.
Bianchini, C., Malag?, M., Crema, L., Aimoni, C., Matarazzo, T., Bortolazzi, S., ... & Pastore, A. (2016). Post-operative pain management in head and neck cancer patients: predictive factors and efficacy of therapy. Acta Otorhinolaryngologica Italica, 36(2), 91.
Blanchard, P., Baujat, B., Holostenco, V., Bourredjem, A., Baey, C., Bourhis, J., & Pignon, J. P. (2011). Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): a comprehensive analysis by tumour site. Radiotherapy and Oncology, 100(1), 33-40.
Broeckel, J. A., Jacobsen, P. B., Horton, J., Balducci, L., & Lyman, G. H. (1998).
Characteristics and correlates of fatigue after adjuvant chemotherapy for breast
cancer. Journal of Clinical Oncology, 16(5), 1689-1696.
Brown, A. K., Christo, P. J., & Wu, C. L. (2004). Strategies for postoperative pain management. Best Practice & Research Clinical Anaesthesiology, 18(4), 703-717.
Burns, D. S., Azzouz, F., Sledge, R., Rutledge, C., Hincher, K., Monahan, P. O., &
Cripe, L. D. (2008). Music imagery for adults with acute leukemia in protective
environments: a feasibility study. Supportive Care in Cancer, 16(5), 507-513.
Burish, T. G., & Lyles, J. N. (1981). Effectiveness of relaxation training in reducing
adverse reactions to cancer chemotherapy. Journal of behavioral medicine, 4(1),
65-78.
Cannici, J., Malcolm, R., & Peek, L. A. (1983). Treatment of insomnia in cancer patients using muscle relaxation training. Journal of behavior therapy and experimental psychiatry, 14(3), 251-256.
Carrico, D. J., Peters, K. M., & Diokno, A. C. (2008). Guided imagery for women with interstitial cystitis: results of a prospective, randomized controlled pilot study. The Journal of Alternative and Complementary Medicine, 14(1), 53-60
Cardoso, L. R., Rizzo, C. C., de Oliveira, C. Z., dos Santos, C. R., & Carvalho, A. L.
(2014). Myofascial pain syndrome after head and neck cancer treatment:
Prevalence, risk factors, and influence on quality of life. Head & neck.
Charalambous, A., Giannakopoulou, M., Bozas, E., Marcou, Y., Kitsios, P., &
Paikousis, L. (2016). Guided imagery and progressive muscle relaxation as a cluster of symptoms management intervention in patients receiving chemotherapy: a randomized control trial. PloS one, 11(6), e0156911.
Chiesa, F., Ostuni, A., Grigolato, R., Calabrese, L., & Ansarin, M. (2016). Head and
Neck Cancer Prevention. In Head and Neck Cancer (pp. 59-76). Springer
International Publishing.
Chin, D., Boyle, G. M., Porceddu, S., Theile, D. R., Parsons, P. G., & Coman, W.B.
(2006). Head and neck cancer: past, present and future.
Chua, K. S., Reddy, S. K., Lee, M. C., & Patt, R. B. (1999). Pain and loss of function in head and neck cancer survivors. Journal of pain and symptom management, 18(3), 193-202.
Cleeland, C. S. (1984). The impact of pain on the patient with cancer. Cancer, 54(S2),
2635-2641.
Crile, G. (1987). Excision of cancer of the head and neck: with special reference to
the plan of dissection based on one hundred and thirty-two operations. Jama,
258(22), 3286-3293.
Daut, R. L., & Cleeland, C. S. (1982). The prevalence and severity of pain in cancer.
Cancer, 50(9), 1913-1918.
Davidson, J. R., MacLean, A. W., Brundage, M. D., &Schulze, K. (2002). Sleep disturbance in cancer patients. Social Science & Medicine, 54(9),1309-1321.
Dean, G. E., Redeker, N. S., Wang, Y. J., Rogers, A. E., Dickerson, S. S., Steinbrenner, L. M., & Gooneratne, N. S. (2013, September). Sleep, mood, and quality of life in patients receiving treatment for lung cancer. In Oncology nursing forum (Vol. 40, No. 5, p. 441). NIH Public Access.
DeCherne, A. H., Bachmann, G., Isaacson, K., & Gall, S. (2002). Postoperative fatigue negatively impacts the daily lives of patients recovering from hysterectomy. Obstetrics & Gynecology, 99(1), 51-57.
de Melo, G. M., Ribeiro, K. D. C. B., Kowalski, L. P., & Deheinzelin, D. (2001). Risk factors for postoperative complications in oral cancer and their prognostic implications. Archives of Otolaryngology–Head & Neck Surgery, 127(7), 828-833.
Demiralp, M., Oflaz, F., & Komurcu, S. (2010). Effects of relaxation training on sleep quality and fatigue in patients with breast cancer undergoing adjuvant chemotherapy. Journal of clinical nursing, 19(7‐8), 1073-1083.
Donovan, M., Dillon, P., & McGuire, L. (1987). Incidence and characteristics of pain in a sample of medical-surgical inpatients. Pain, 30(1), 69-78.
Dündar, Y., Dodd, S., Strobl, J., Boland, A., Dickson, R., & Walley, T. (2004). Comparative efficacy of newer hypnotic drugs for the short‐term management of insomnia: a systematic review and meta‐analysis. Human Psychopharmacology: Clinical and Experimental, 19(5), 305-322.
Eilers, J. (2004, January). Nursing interventions and supportive care for the prevention and treatment of oral mucositis associated with cancer treatment. In Oncology Nursing Forum (Vol. 31, pp. 13-23). Oncology Nursing Society.
Elliott, R., McKinley, S., & Cistulli, P. (2011). The quality and duration of sleep in the intensive care setting: an integrative review. International journal of nursing studies, 48(3), 384-400.
Epstein, J. B., Hong, C., Logan, R. M., Barasch, A., Gordon, S. M., Oberlee-Edwards, L., ... & Brennan, M. T. (2010). A systematic review of orofacial pain in patients receiving cancer therapy. Supportive care in cancer, 18(8), 1023-1031.
Espitalier, F., Testelin, S., Blanchard, D., Binczak, M., Bollet, M., Calmels, P., ... & Albert, S. (2014). Management of somatic pain induced by treatment of head and neck cancer: Postoperative pain. Guidelines of the French Oto-Rhino-Laryngology–Head and Neck Surgery Society (SFORL). European annals of otorhinolaryngology, head and neck diseases, 131(4), 249-252.
Feldman, C. S., & Salzberg, H. C. (1990). The role of imagery in the hypnotic treatment of adverse reactions to cancer therapy. Journal of the South Carolina Medical Association (1975), 86(5), 303-306.
Fillingim, R. B. (2000). Sex, gender, and pain: women and men really are different. Current review of pain, 4(1), 24-30.
Fischer, D. J., Klasser, G. D., & Epstein, J. B. (2008). Cancer and orofacial pain. Oral and maxillofacial surgery clinics of North America, 20(2), 287-301.
Frisk, U., & Nordström, G. (2003). Patient’s sleep in an intensive care unit -patient's and nurse’s perception. Intensive and Critical Care Nursing 19(6), 342-349.
Gandhi, A. K., Roy, S., Thakar, A., Sharma, A., & Mohanti, B. K. (2014). Symptom burden and quality of life in advanced head and neck cancer patients: AIIMS study of 100 patients. Indian journal of palliative care, 20(3), 189.
G. C. H. L., Young, A., McFarlane, J., Watson, M., Coleman, R. L., Eifel, P. J., ... &
Richardson, M. (2014). Effects of music relaxation video on pain and anxiety for
women with gynaecological cancer receiving intracavitary brachytherapy: a
randomised controlled trial. Journal of Research in Nursing, 1744987114529298.
Gillison, M. L., Koch, W. M., Capone, R. B., Spafford, M., Westra, W. H., Wu, L., ...
& Sidransky, D. (2000). Evidence for a causal association between human
papillomavirus and a subset of head and neck cancers. Journal of the National
Cancer Institute, 92(9), 709-720.
Given, B. (2008). Cancer-related fatigue: A brief overview of current nursing perspectives and experiences. Clinical journal of oncology nursing, 12, 7-9.
Glaus, A., Crow, R., & Hammond, S. (1996). A qualitative study to explore the concept of fatigue/tiredness in cancer patients and in healthy individuals. Supportive Care in Cancer, 4(2), 82-96.
Good, M., Anderson, G. C., Ahn, S., Cong, X., & Stanton‐Hicks, M. (2005). Relaxation and music reduce pain following intestinal surgery. Research in nursing & health, 28(3), 240-251.
Gonzales, E. A., Ledesma, R. J., McAllister, D. J., Perry, S. M., Dyer, C. A., & Maye, J. P. (2010). Effects of guided imagery on postoperative outcomes in patients undergoing same-day surgical procedures: a randomized, single-blind study. UNIFORMED SERVICES UNIV OF THE HEALTH SCIENCES WRIGHT-PATTERSON AFB OH GRADUATE SCHOOL OF NURSING.
Graydon, J. E., Bubela, N., Irvine, D., & Vincent, L. (1995). Fatigue-reducing strategies used by patients receiving treatment for cancer. Cancer Nursing, 18(1), 23-28.
Gunn, G. B., Mendoza, T. R., Fuller, C. D., Gning, I., Frank, S. J., Beadle, B. M., ... & Rosenthal, D. I. (2013). High symptom burden prior to radiation therapy for head and neck cancer: A patient‐reported outcomes study. Head & neck, 35(10), 1490-1498.
Gupta, B., Johnson, N. W., & Kumar, N. (2016). Global epidemiology of head and neck cancers: a continuing challenge. Oncology, 91(1), 13-23.
Haddad, R. I., & Shin, D. M. (2008). Recent advances in head and neck cancer. New England Journal of Medicine, 359(11), 1143-1154.
Hanna, E. Y., Mendoza, T. R., Rosenthal, D. I., Gunn, G. B., Sehra, P., Yucel, E., & Cleeland, C. S. (2015). The symptom burden of treatment‐naive patients with head and neck cancer. Cancer, 121(5), 766-773.
Hirst, A., & Sloan, R. (2001). Benzodiazepines and related drugs for insomnia in palliative care. Cochrane Database of Systematic Reviews, 4.
Infante-Cossio, P., Torres-Carranza, E., Cayuela, A., Gutierrez-Perez, J. L., & Gili-Miner, M. (2009). Quality of life in patients with oral and oropharyngeal cancer. International journal of oral and maxillofacial surgery, 38(3), 250-255.
Inhestern, J., Schuerer, J., Illge, C., Thanos, I., Meissner, W., Volk, G., & Guntinas-Lichius, O. (2015). Pain on the first postoperative day after head and neck cancer surgery. European Archives of Oto-Rhino-Laryngology, 272(11).
Irvine, D. M., Vincent, L., Graydon, J. E., & Bubela, N. (1998). Fatigue in women with breast cancer receiving radiation therapy. Cancer nursing, 21(2), 127-135.
Irwin, M. R., Olmstead, R., & Motivala, S. J. (2008). Improving sleep quality in older adults with moderate sleep complaints: A randomized controlled trial of Tai Chi Chih. SLEEP-NEW YORK THEN WESTCHESTER-, 31(7), 1001.
Jacobsen, P. B., Hann, D. M., Azzarello, L. M., Horton, J., Balducci, L., & Lyman, G. H. (1999). Fatigue in women receiving adjuvant chemotherapy for breast cancer: characteristics, course, and correlates. Journal of pain and symptom management, 18(4), 233-242.
Jaiswal, S. J., Owens, R. L., & Malhotra, A. (2017). Raising awareness about sleep disorders. Lung India: official organ of Indian Chest Society, 34(3), 262.
Kashani, F., & Kashani, P. (2014). The effect of massage therapy on the quality of sleep in breast cancer patients. Iranian journal of nursing and midwifery
Katz, M. R., Irish, J. C., Devins, G. M., Rodin, G. M., & Gullane, P. J. (2003). Psychosocial adjustment in head and neck cancer: the impact of disfigurement, gender and social support. Head & neck, 25(2), 103-112.
Keogh, E., & Cochrane, M. (2002). Anxiety sensitivity, cognitive biases, and the experience of pain. The Journal of Pain, 3(4), 320-329.
Keogh, E., & Herdenfeldt, M. (2002). Gender, coping and the perception of pain. Pain, 97(3), 195-201.
Kim, Y. H., Kim, H. J., Do Ahn, S., Seo, Y. J., & Kim, S. H. (2013). Effects of meditation on anxiety, depression, fatigue, and quality of life of women undergoing radiation therapy for breast cancer. Complementary therapies in medicine, 21(4), 379-387.
Koch, M. E., Kain, A. Z., Ayoub, C., & Rosebaum, S. H. (1998). The sedative and analgesic sparing effects of music. Anesthesiology, 89(2), 300-306.
Kolcaba, K., & Fox, C. (1998, December). The effects of guided imagery on comfort of women with early stage breast cancer undergoing radiation therapy. In Oncology Nursing Forum (Vol. 26, No. 1, pp. 67-72).
Koopman, C., Nouriani, B., Erickson, V., Anupindi, R., Butler, L. D., Bachmann, M. H., et al. (2002). Sleep disturbances in women with metastatic breast cancer. The Breast Journal, 8(6), 362-370.
Ko, Y. C., Huang, Y. L., Lee, C. H., Chen, M. J., Lin, L. M., & Tsai, C. C. (1995).
Betel quid chewing, cigarette smoking and alcohol consumption related to oral
cancer in Taiwan. Journal of oral pathology & medicine, 24(10), 450-453.
Kushida, C. A., Chang, A., Gadkary, C., Guilleminault, C., Carrillo, O., & Dement, W.
C. (2001). Comparison of actigraphic, polysomnographic, and subjective
assessment of sleep parameters in sleep-disordered patients. Sleep medicine, 2(5), 389-396.
Kwekkeboom, K. L., Hau, H., Wanta, B., & Bumpus, M. (2008). Patients’ perceptions of the effectiveness of guided imagery and progressive muscle relaxation interventions used for cancer pain. Complementary therapies in clinical practice, 14(3), 185-194.
Lang, P. J. (1979). A bio‐informational theory of emotional imagery.Psychophysiology, 16(6), 495-512.
Langius, A., Björvell, H., & Lind, M. G. (1994). Functional status and coping in patients with oral and pharyngeal cancer before and after surgery. Head & neck, 16(6), 559-568.
Lautenbacher, S., Kundermann, B., & Krieg, J. C. (2006). Sleep deprivation and pain perception. Sleep medicine reviews, 10(5), 357-369.
Lee, H. L., Chung, M. H., Chao, S. C., & Ku, N. P.(2001). Fatigue and related factors in women with breast cancer receiving chemotherapy. Journal of Medical Sciences, 21(3), 123−133
Leak, A., Hu, J., & King, C. R. (2008). Symptom distress, spirituality, and quality of life in African American breast cancer survivors. Cancer nursing, 31(1), E15-E21.
Li, C. Y., Chen, S. C., Li, C. Y., Gau, M. L., & Huang, C. M. (2011). Randomised controlled trial of the effectiveness of using foot reflexology to improve quality of sleep amongst Taiwanese postpartum women. Midwifery, 27(2), 181-186.
Liao, C. T., Chang, J. T. C., Wang, H. M., Ng, S. H., Hsueh, C., Lee, L. Y., ... & Yen, T. C. (2008). Analysis of risk factors of predictive local tumor control in oral cavity cancer. Annals of surgical oncology,15(3), 915-922.
Lichstein, K. L., Stone, K. C., Donaldson, J., Nau, S. D., Soeffing, J. P., Murray, D., ... & Aguillard, R. N. (2006). Actigraphy validation with insomnia. SLEEP-NEW YORK THEN WESTCHESTER-, 29(2), 232.
Lin, C. C. (2001). Congruity of cancer pain perceptions between Taiwanese patients
and family caregivers: relationship to patients' concerns about reporting pain and
using analgesics. Journal of Pain and Symptom Management, 21(1), 18-26.
Lin, L. Y., & Wang, R. H. (2005). Abdominal surgery, pain and anxiety: preoperative
nursing intervention. Journal of advanced nursing, 51(3), 252-260.
Lin, S., Chen, Y., Yang, L., & Zhou, J. (2013). Pain, fatigue, disturbed sleep and distress comprised a symptom cluster that related to quality of life and functional status of lung cancer surgery patients. Journal of clinical nursing, 22(9-10), 1281-1290.
Longworth, J. C. (1982). Psychophysiological effects of slow stroke back massage in normotensive females. Advances in Nursing Science, 4(4), 44-61.
Lucy, M. S. (1999). An analysis of the concept of pain. Journal of Advanced Nursing, 29(4), 935－941.
Martín-Hernán, F., Sánchez-Hernández, J. G., Cano, J., Campo, J., & Del Romero, J.
(2012). Oral cancer, HPV infection and evidence of sexual transmission.
Medicina oral, patologia oral y cirugia bucal, 18(3),e439-44.
Marur, S., & Forastiere, A. A. (2008, April). Head and neck cancer: changing epidemiology, diagnosis, and treatment. In Mayo Clinic Proceedings (Vol. 83, No. 4, pp. 489-501). Elsevier.
Massie, M. J. (2004). Prevalence of depression in patients with cancer. JNCI Monographs, 2004(32), 57-71.
Matthews, E. E. (2011). Sleep disturbances and fatigue in critically ill patients. AACN
advanced critical care, 22(3), 204.
McGarvey, A. C., Osmotherly, P. G., Hoffman, G. R., & Chiarelli, P. E. (2013).
Scapular Muscle Exercises Following Neck Dissection Surgery for Head and Neck Cancer: A Comparative Electromyographic Study. Physical therapy, 93(6), 786-797.
McGregor, B. A., Antoni, M. H., Boyers, A., Alferi, S. M., Blomberg, B. B., & Carver,
C. S. (2004). Cognitive–behavioral stress management increases benefit finding
and immune function among women with early-stage breast cancer. Journal of
psychosomatic research, 56(1), 1-8.
McMillan, S. C., Tofthagen, C., & Morgan, M. A. (2008, July). Relationships among pain, sleep disturbances, and depressive symptoms in outpatients from a comprehensive cancer center. In Oncology nursing forum (Vol. 35, No. 4, pp. 603-611). Oncology Nursing Society.
Megwalu, U. C., & Ma, Y. (2017). Racial disparities in oropharyngeal cancer survival. Oral Oncology, 65, 33-37.
Mercier, J., Savard, J., & Bernard, P. (2016). Exercise interventions to improve sleep in cancer patients: A systematic review and meta-analysis. Sleep Medicine Reviews.
Meuser, T., Pietruck, C., Radbruch, L., Stute, P., Lehmann, K. A., & Grond, S. (2001). Symptoms during cancer pain treatment following WHO-guidelines: a longitudinal follow-up study of symptom prevalence, severity and etiology. Pain, 93(3), 247-257.
Moore, R. J., Chamberlain, R. M., & Khuri, F. R. (2004). Communicating suffering in
primary stage head and neck cancer*. European Journal of Cancer Care, 13(1),
53-64.
Moore, R. J., Chamberlain, R. M., & Khuri, F. R. (2004). A qualitative study of head and neck cancer. Supportive care in cancer, 12(5), 338-346.
Mom, T., Derbal, C., Dubray, C., Eschalier, A., Bost, P., Avan, P., ... & Gilain, L. (1995). [Postoperative pain evaluation in the surgery of head and neck cancers]. Revue de laryngologie-otologie-rhinologie, 117(2), 93-96.
Nishiura M, Tamura A, Nagai H, Matsushima E (2015) Assessment of sleep disturbance in lung cancer patients: relationship between sleep disturbance and pain, fatigue, quality of life, and psychological distress. Palliat Support Care 13:575–581
Ohayon, M. M., & Shapiro, C. M. (2002). Tenses of insomnia epidemiology. Journal of psychosomatic research, 53(1), 525-527.
Oliveira, K. G., von Zeidler, S. V., Podestá, J. R., Sena, A., Souza, E. D., Lenzi, J., ... & Gouvea, S. A. (2014). Influence of pain severity on the quality of life in patients with head and neck cancer before antineoplastic therapy. BMC cancer, 14(1), 39.
Orwelius, L., Nordlund, A., Nordlund, P., Edéll-Gustafsson, U., & Sjöberg, F. (2008).
Prevalence of sleep disturbances and long-term reduced health-related quality of life after critical care: a prospective multicenter cohort study. Critical Care, 12(4), R97.
Paivio, A. (2013). Imagery and verbal processes. Psychology Press.
Pfister, D. G., Cassileth, B. R., Deng, G. E., Yeung, K. S., Lee, J. S., Garrity, D., ... & Vickers, A. J. (2010). Acupuncture for pain and dysfunction after neck dissection: results of a randomized controlled trial. Journal of Clinical Oncology, 28(15), 2565-2570.
Pöpping, D. M., Zahn, P. K., Van Aken, H. K., Dasch, B., Boche, R., & Pogatzki-Zahn, E. M. (2008). Effectiveness and safety of postoperative pain management: a survey of 18 925 consecutive patients between 1998 and 2006 (2nd revision): a database analysis of prospectively raised data†. British journal of anaesthesia, 101(6), 832-840.
Pathak, P., Mahal, R., Kohli, A., & Nimbran, V. (2013). Progressive Muscle Relaxation: An adjuvant therapy for reducing pain and fatigue among hospitalized cancer patients’ receiving radiotherapy. International Journal of Advanced Nursing Studies, 2(2), 58-65.
RANKIN, M. A. (1982). Use of drugs for pain with cancer patients. Cancer nursing,
5(3), 181-190.
Raymond, I., Nielsen, T. A., Lavigne, G., Manzini, C., & Choinière, M. (2001). Quality of sleep and its daily relationship to pain intensity in hospitalized adult burn patients. Pain, 92(3), 381-388.
Redeker, N. S., Tamburri, L., & Howland, C. L. (1998). Prehospital correlates of
sleep in patients hospitalized with cardiac disease. Research in nursing & health,
21(1), 27-37.
Reich, M., Leemans, C. R., Vermorken, J. B., Bernier, J., Licitra, L., Parmar, S., ... & Lefebvre, J. L. (2014). Best practices in the management of the psycho-oncologic aspects of head and neck cancer patients: recommendations from the European Head and Neck Cancer Society Make Sense Campaign. Annals of oncology, 25(11), 2115-2124.
Roberge, C., Tran, M., Massoud, C., Poirée, B., Duval, N., Damecour, E., ... & Henry-Amar, M. (2000). Quality of life and home enteral tube feeding: a French prospective study in patients with head and neck or oesophageal cancer. British Journal of Cancer, 82(2), 263.
Rogers, L. Q., Courneya, K. S., Robbins, K. T., Rao, K., Malone, J., Seiz, A., ... & Burra, V. (2008). Factors associated with fatigue, sleep, and cognitive function among patients with head and neck cancer. Head & neck, 30(10), 1310-1317.
Roh, J. L., Yoon, Y. H., Kim, S. Y., & Park, C. I. (2007). Cervical sensory preservation during neck dissection. Oral oncology, 43(5), 491-498.
Roscoe, J. A., Kaufman, M. E., Matteson-Rusby, S. E., Palesh, O. G., Ryan, J. L., Kohli, S., ... & Morrow, G. R. (2007). Cancer-related fatigue and sleep disorders. The Oncologist, 12(Supplement 1), 35-42.
Roykulcharoen, V., & Good, M. (2004). Systematic relaxation to relieve postoperative pain. Journal of Advanced Nursing, 48(2), 140-148.
Sakuramoto, C., Kanai, I., Matoba, M., Asato, F., & Goto, F. (1996). Treatment of postoperative pain with thoracic epidural morphine in oral malignant tumor patients. The Clinical journal of pain, 12(2), 142-144.
Salmon, P., & Hall, G. M. (1997). A theory of postoperative fatigue: an interaction of biological, psychological, and social processes. Pharmacology Biochemistry and Behavior, 56(4), 623-628.
Savard, J., & Morin, C. M. (2001). Insomnia in the context of cancer: a review of a
neglected problem. Journal of Clinical Oncology, 19(3), 895-908.
Scarpa, M., Saadeh, L. M., Fasolo, A., Alfieri, R., Cagol, M., Cavallin, F., ... &
Castoro, C. (2013). Health-related quality of life in patients with oesophageal
cancer: analysis at different steps of the treatment pathway. Journal of
Gastrointestinal Surgery, 17(3), 421-433.
Scarpa, M., Pinto, E., Saadeh, L. M., Parotto, M., Da Roit, A., Pizzolato, E., ... &
Castoro, C. (2014). Sleep disturbances and quality of life in postoperative
management after esophagectomy for esophageal cancer. World Journal of
Surgical Oncology, 12(1), 156.
Scharpf, J., Karnell, L. H., Christensen, A. J., & Funk, G. F. (2009). The role of pain
in head and neck cancer recurrence and survivorship. Archives of Otolaryngology–Head & Neck Surgery, 135(8), 789-794.
Shah, S., Har‐El, G., & Rosenfeld, R. M. (2001). Short‐term and long‐term quality of life after neck dissection. Head & neck, 23(11), 954-961.
Shah, J. P., & Gil, Z. (2009). Current concepts in management of oral cancer - Surgery. Oral Oncology, 45(4−5), 394−401.
Shuman, A. G., Duffy, S. A., Ronis, D. L., Garetz, S. L., McLean, S. A., Fowler, K. E., & Terrell, J. E. (2010). Predictors of poor sleep quality among head and neck cancer patients. The Laryngoscope, 120(6), 1166-1172.
Shuman, A. G., Terrell, J. E., Light, E., Wolf, G. T., Bradford, C. R., Chepeha, D., ... & Duffy, S. A. (2012). Predictors of pain among patients with head and neck cancer. Archives of Otolaryngology–Head & Neck Surgery, 138(12), 1147-1154.
Siegel, R. L., Miller, K. D., & Jemal, A. (2015). Cancer statistics, 2015. CA: a cancer journal for clinicians, 65(1), 5-29.
Simpson, T., Lee, E. R., & Cameron, C. (1996). Patients' perceptions of
environmental factors that disturb sleep after cardiac surgery. American Journal
of Critical Care, 5(3), 173-181.
Smith, M. C., Kemp, J., Hemphill, L., & Vojir, C. P. (2002). Outcomes of therapeutic massage for hospitalized cancer patients. Journal of Nursing Scholarship, 34(3), 257-262.
Smith, C. A., Levett, K. M., Collins, C. T., & Crowther, C. A. (2011).
Relaxation techniques for pain management in labour. Cochrane Database Syst Rev,
Sloman, R. (2002). Relaxation and imagery for anxiety and depression control in community patients with advanced cancer. Cancer nursing, 25(6), 432-435.
Stone, P. C., & Minton, O. (2008). Cancer-related fatigue. European journal of cancer, 44(8), 1097-1104.
Su, T. P., Huang, S. R., & Chou, P. (2004). Prevalence and risk factors of insomnia in
community‐dwelling Chinese elderly: a Taiwanese urban area survey. Australian and New Zealand Journal of Psychiatry, 38(9), 706-713.
Syrjala, K. L., Donaldson, G. W., Davis, M. W., Kippes, M. E., & Carr, J. E. (1995). Relaxation and imagery and cognitive-behavioral training reduce pain during cancer treatment: a controlled clinical trial. Pain, 63(2), 189-198.
Snyder‐Halpern, R., & Verran, J. A. (1987). Instrumentation to describe subjective sleep characteristics in healthy subjects. Research in Nursing & Health, 10(3), 155-163.
Tarrasch, R., Carmel-Neiderman, N. N., Ben-Ami, S., Kaufman, B., Pfeffer, R., Ben-David, M., & Gamus, D. (2017). The Effect of Reflexology on the Pain-Insomnia-Fatigue Disturbance Cluster of Breast Cancer Patients During Adjuvant Radiation Therapy. The Journal of Alternative and Complementary Medicine.
Terrell, J. E., Welsh, D. E., Bradford, C. R., Chepeha, D. B., Esclamado, R. M., Hogikyan, N. D., & Wolf, G. T. (2000). Pain, quality of life, and spinal accessory nerve status after neck dissection. The Laryngoscope, 110(4), 620-626.
Terrell, J. E., Ronis, D. L., Fowler, K. E., Bradford, C. R., Chepeha, D. B., Prince, M. E., ... & Duffy, S. A. (2004). Clinical predictors of quality of life in patients with head and neck cancer. Archives of Otolaryngology–Head & Neck Surgery, 130(4), 401-408.
Theobald, D. E. (2004). Cancer pain, fatigue, distress, and insomnia in cancer patients. Clinical Cornerstone, 6(1), S15-S21.
Tiesinga, L. J., Dassen, T. W., & Halfens, R. J. (1996). Fatigue: a summary of the
definitions, dimensions, and indicators. International Journal of Nursing
Terminologies and Classifications, 7(2), 51-62.
Van den Beuken-van Everdingen, M. H. J., De Rijke, J. M., Kessels, A. G., Schouten, H. C., Van Kleef, M., & Patijn, J. (2007). Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Annals of oncology, 18(9), 1437-1449.
Van Fleet, S. (2000, April). Relaxation and imagery for symptom management: improving patient assessment and individualizing treatment. In Oncology Nursing Forum (Vol. 27, No. 3, pp. 501-510).
Van Wilgen, C. P., Dijkstra, P. U., van der Laan, B. F., Plukker, J. T., & Roodenburg, J. L. (2004). Morbidity of the neck after head and neck cancer therapy. Head & neck, 26(9), 785-791.
Van Wilgen, C. P., Dijkstra, P. U., Van der Laan, B. F. A. M., Plukker, J. T., & Roodenburg, J. L. N. (2004). Shoulder and neck morbidity in quality of life after surgery for head and neck cancer. Head & neck, 26(10), 839-844.
Viljanen, M., Malmivaara, A., Uitti, J., Rinne, M., Palmroos, P., & Laippala, P. (2003). Effectiveness of dynamic muscle training, relaxation training, or ordinary activity for chronic neck pain: randomised controlled trial. Bmj, 327(7413), 475.
Wang, X. S., Mendoza, T. R., Gao, S. Z., & Cleeland, C. S. (1996). The Chinese version of the Brief Pain Inventory (BPI-C): its development and use in a study of cancer pain. Pain, 67(2), 407-416.
Wang, M. Y., Hung, H. L., & Tsai, P. S. (2011). The sleep log and actigraphy: congruency of measurement results for heart failure patients. Journal of Nursing Research, 19(3), 173-180.
Walker, L. G., Walker, M. B., Ogston, K., Heys, S. D., Ah-See, A. K., Miller, I. D., ... & Eremin, O. (1999). Psychological, clinical and pathological effects of relaxation training and guided imagery during primary chemotherapy. British Journal of Cancer, 80(1-2), 262.
Walder, B., Schafer, M., Henzi, I., & Tramer, M. R. (2001). Efficacy and safety of patient‐controlled opioid analgesia for acute postoperative pain. Acta Anaesthesiologica Scandinavica, 45(7), 795-804.
Whale, Z., Lyne, P. A., & Papanikolaou, P. (2001). Pain experience following radical treatment for head and neck cancer. European Journal of Oncology Nursing, 5(2), 112-120.
Winningham, M. L., Nail, L. M., Burke, M. B., Brophy, L., Cimprich, B., Jones, L. S., ... & Beck, S. (1994). Fatigue and the cancer experience: the state of the knowledge. In Oncology nursing forum (Vol. 21, No. 1, p. 23). Oncology Nursing Society.
Williamson, A., & Hoggart, B. (2005). Pain: a review of three commonly used pain rating scales. Journal of clinical nursing, 14(7), 798-804.
Wolfe, G. (2000). Fatigue: the most important consideration for the patient with cancer. Caring: National Association for Home Care magazine, 19(4), 46-47.
Wu, C. L., & Raja, S. N. (2011). Treatment of acute postoperative pain. The Lancet, 377(9784), 2215-2225.
Wyatt, G., Sikorskii, A., Siddiqi, A., & Given, C. W. (2007, January). Feasibility of a reflexology and guided imagery intervention during chemotherapy: Results of a quasi-experimental study. In Oncology nursing forum (Vol. 34, No. 3, pp. 635-642). Oncology Nursing Society.
Xie, X., O’Neill, W., & Pan, Q. (2017). Immunotherapy for head and neck cancer: the future of treatment?. Expert Opinion on Biological Therapy, 17(6), 701-708.
Yang, X. O. (1996). Diagnosis and nursing care of postoperative fatigue. Jounal of Nursing, 31(2) , 116-117.
Zimmermann, M. (2004). Basic physiology of pain perception. In Pathophysiology of pain perception (pp. 1-24). Springer US.