臺灣博碩士論文加值系統

研究目的：本研究旨在系統性摘錄術前復健介入對上消化道癌症病人手術後生活品質成效之文獻並統合分析綜合效果。
研究設計：隨機對照試驗之系統性文獻回顧與統合分析。
研究方法：以系統性文獻回顧方式，蒐集採術前復健為介入措施，生活品質為成行文獻索引。採用The Cochrane Collaboration’s Tool for Assessing Risk of Bias進行文獻品質評讀。統計方法採用Review Manager 5.0軟體進行統合分析，並運用隨機或固定模式與Z值進行其效果量；Cochrane Q test及I2檢測異質性，並以漏斗圖（Funnel plot）判定有無出版偏差。
研究結果：文獻搜尋後共有16,025篇文章，經過刪除重複文獻、檢視文章標題、摘要及全文後，符合納入條件的文章共有6篇，故最後納入6篇研究資料進行文獻回顧及統合分析。生活品質生理健康狀態總效果量為0.02(-0.30-0.34)，異質性檢定結果呈現Q=2.08, p=0.15, I2=52%，及生活品質心理狀態總效果量為0.08(-0.78-0.93)，異質性檢定結果呈現Q=5.12, p=0.02, I2=80%，結果顯示術前復健對於改善癌症病人手術後生活品質，統計呈現未達統計差異。文章中存有中度到高度的異質性，且因個研究資料使用相同量表篇數量少所導致。
研究結論：本研究結果發現術前復健對生理健康狀態生活品質次量表(SF-36 physical health subscale) 及心理健康狀態生活品質次量表(SF-36 mental health subscale)其整體效果量未達統計顯著成效，故術前復健對於改善癌症病人手術後生活品質，不具統計顯著差異。

Purpose: This study aims to systematically extract the literature on the effects of preoperative rehabilitation on quality of life of cancer patients after surgery and analyze the comprehensive effects.
Design: Systematic review and meta-analysis of randomized controlled trials.
Method: This study systematically identified relevant studies through searching 3 databases, including PubMed, EMBASE, and Cochrane Library. Studies that (1) used a randomized controlled trials design (2) were published in English (3) investigated "preoperative rehabilitation", and (4) used "quality of life" as the main outcome were included. Two reviewers independently extracted data according to the Collaboration's Tool for Assessing Risk if Bias. Z with a random or fixed effects model was used to evaluate the effects of quality of life. Cochrane Q test and I2 were used to determine the heterogeneity. Publication bias were assessed by constructing funnel plot. Statistical analyses were performed using Review Manager software version 5.0.
Results: The initial search yielded 16,025 studies. After deleting duplicate articles, reviewing the article titles, abstracts and full texts, there were 6 articles that met the inclusion criteria, the final research data for systematic review and meta-analysis included 6 articles. This was associated with improved preoperative SF-36 physical health score, the overall effect size was 0.02 (95% Confidence Interval, -0.30~0.34). Cochrane Q test (2.08, p=0.15), and I2 (52%) indicate moderate heterogeneity among the analyzed studies, and SF-36 mental health score, the overall effect size was 0.08 (95% Confidence Interval, -0.78-0.93). Cochrane Q test (5.12, p=0.02), and I2 (80%) indicate high heterogeneity among the analyzed studies. The results showed that preoperative rehabilitation can’t improve the quality of life of cancer patients after surgery, and there is no statistically significant difference.
Conclusion: The results of this study found that the effects of preoperative rehabilitation on physical health quality of life subscale (SF-36 physical health) and mental health quality of life subscale (SF-36 mental health) were not statistically significantly. Therefore, preoperative rehabilitation can’t improve quality of life of cancer patients after surgery, and there is no statistically significant differences.

致謝 I
中文摘要 II
英文摘要 III
論文目錄 IV
表目錄 VI
圖目錄 I
附錄 I
第一章 緒論 1
第一節 研究背景與重要性 1
第一節 研究目的 2
第二節 研究問題 3
第三節 名詞定義與解釋 4
第二章 文獻查證 5
第一節 上消化道癌症現況與治療 5
第二節 術前復健 8
第三節 生活品質 9
第四節 系統性文獻回顧及統合分析 12
第三章 研究方法 14
第一節 研究設計 14
第二節 文獻之納入及排出條件 15
第三節 文獻檢索 17
第四節 文獻選擇與資料搜集 20
第五節 文獻品質評值 21
第六節 資料分析 23
第四章 研究結果 25
第一節 資料索引 25
第二節 基本特性 27
第三節 文章品質評析 32
第四節 術前運動用於上消化道癌症病人手術後生活品質之成效 34
第五章 討論 38
第一節 研究樣本特性 39
第二節 術前運動用於上消化道癌症病人手術後生活品質之成效 41
第六章 限制與建議 43
第一節 結論 43
第二節 臨床照護實務上的應用 44
第三節 研究上的應用 45
第四節 教育的應用 46
第五節 研究限制 47
中文部份 48
英文部份 49
附錄一 搜尋策略 53

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