臺灣博碩士論文加值系統

本研究目的在探討消化系統癌症惡病質患者之營養、焦慮與感知能量之相關性，採用橫斷式、描述相關性研究設計，整個研究過程採用立意取樣，選取南部某醫學中心胃腸內科、肝膽內科及血液腫瘤內科病房之消化系統癌症惡病質患者共40人。研究過程使用結構式問卷，進行一對一的訪談方式來收集資料。研究工具包括：個人基本屬性量表（如社會人口學特性與疾病特性）、貝克焦慮量表及舒適圖量表，而患者的營養評估則由研究者親自使用Tanita BF-701體脂計來測量及填寫等四部份。
研究結果顯示：（1）患者之平均身體質量指數為21.35㎏/㎡（± 3.37㎏/㎡），有70.0%患者營養狀況屬於正常範圍；患者之平均體脂肪率為23.48%（± 8.50%）。（2）患者之平均焦慮分數為11.88分（± 5.77分），屬於輕度焦慮。（3）患者之平均感知能量分數為54.30分（± 10.77分），屬於中、高度能量。（4）身體質量指數、體脂肪率分別與焦慮呈現顯著負相關。（5）營養、焦慮與感知能量呈現無顯著之相關性。（6）職業狀況、年齡層（足歲）及每月收入對身體質量指數有顯著之差異。（7）性別、職業狀況及婚姻狀況對體脂肪率有顯著差異。（8）每月收入、症狀困擾程度對焦慮有顯著差異。（9）家人支持度對感知能量有統計上顯著差異。
本研究結果除了可提供資訊增加患者及家屬對營養、焦慮及感知能量的瞭解，更可作為醫療人員在照護消化系統癌症惡病質患者之參考依據。未來可提供有效的營養措施介入，延緩惡病質情形，降低患者焦慮，進而提升其感知能量。

Abstract
The purpose of this study was to explore the correlations among nutrition, anxiety, and perceived energy in gastrointestinal tract (GI) cancer patients with cachexia syndrome. A cross-sectional, descriptive correlational study design was applied. Purposive sampling and structured questionnaires were used to collect data during the study. 40 GI cancer patients with cachexia syndrome recruited from Gastroenterology, Hepatobiliary, and Hematolgy Oncology units of a medical center in Southern Taiwan. Research instruments, the Demographic Inventory of patient, Beck Anxiety Inventory, and The Well-Being Picture Scale, were used to collect data. Then patients’ nutritional status was measured by the researcher by employing Tanita body fat monitor BF-701.
Results of the study were showed: (1) The mean (±SD) body mass index (BMI) of the patients was 21.35kg/m2 (±3.37kg/m2), and seventy per-cent of the patients was within normal range; the mean body fat percentage (BF%) of the patients was 23.48% (±8.50%). (2) The mean of the Beck Anxiety Inventory was 11.88 score (±5.77 score) , which was a mild level of anxiety. (3) The mean of The Well-Being Picture Scale was 54.30 score (±10.77 score) , which was from middle to high level perceived energy of the patients.(4) Body mass index and body fat percentage, respectively, were negatively correlated with anxiety. (5) Perceived energy was not significantly associated with nutrition and anxiety. (6) In body mass index, there were significant differences in occupation, age, and income. (7) Gender, occupation, and marriage had statistically significance in body fat percentage. (8) In anxiety, there were significant differences in income and symptom distress. (9) Family support had statistically significance in perceived energy.
Besides providing the information of nutrition, anxiety, and perceived energy to the patients and family, the result of this study can be as authority for medical members to care the patients of GI cancer with cachexia syndrome. It will supply the nutritional intervention efficiently, postponing cachexia syndrome, reducing the patients'' anxiety, and advancing perceived energy.

目 錄 頁次
中文摘要………………………………………………………… I
英文摘要………………………………………………………… III
致謝……………………………………………………………… V
全文目錄………………………………………………………… VII
圖表目錄………………………………………………………… XI
第一章 緒論
第一節 研究背景及重要性…………………………………… 1
第二節 研究目的……………………………………………… 5
第三節 研究問題……………………………………………… 6
第二章 文獻查證
第一節 消化系統癌症……………………………………… 7
第二節 癌症惡病質………………………………………… 8
第三節 焦慮之概念………………………………………… 12
第四節 癌症患者焦慮之相關研究………………………… 13
第五節 能量之概念………………………………………… 15
第六節 癌症患者感知能量之相關研究…………………… 17
第七節 營養、慮及感知能量關係及其相關因素之研究… 20


第三章 研究架構、名詞定義
第一節 概念架構…………………………………………… 26
第二節 名詞定義…………………………………………… 27
第四章 研究方法
第一節 研究對象…………………………………………… 30
第二節 研究地點…………………………………………… 31
第三節 研究工具…………………………………………… 32
第四節 研究工具的信度與效度檢定……………………… 37
第五節 資料收集過………………………………………… 39
第六節 研究倫理之考量…………………………………… 40
第七節 資料分析…………………………………………… 42
第五章 研究結果
第一節 消化系統癌症惡病質患者個人基本屬性之描述…… 45
第二節 癌症惡病質患者營養、焦慮及感知能量之描述…… 49
第三節 癌症惡病質患者個人基本屬性、營養、焦慮及感知
能量之關係………………………………………… 60
第四節 癌症惡病質患者個人基本屬性對營養、焦慮及感知
能量之差異………………………………………… 67


第六章 討論
第一節 消化系統癌症惡病質患者營養及其相關因素……… 82
第二節 消化系統癌症惡病質患者焦慮及其相關因素……… 84
第三節 消化系統癌症惡病質患者感知能量及其相關因素… 90
第四節 消化系統癌症惡病質患者之營養、焦慮及感知能量
之關係………………………………………………… 96

第七章 結論與建議
第一節 結論…………………………………………………… 99
第二節 應用與建議…………………………………………… 100
第三節 研究限制……………………………………………… 104
參考文獻
一、中文部份………………………………………………… 105
二、英文部份………………………………………………… 109











附 錄
附錄一 個案同意書…………………………………………… 122
附錄二 高雄醫學大學公文…………………………………… 123
附錄三 人體試驗委員會同意書……………………………… 124
附錄四 研究問卷同意書……………………………………… 125
附錄五 專家效度名單………………………………………… 127
附錄六 基本屬性資料………………………………………… 128
附錄七 貝克焦慮量表………………………………………… 129
附錄八 舒適圖量表…………………………………………… 130




















圖 表 目 錄
圖一 概念架構圖……………………………………………… 26
表 4-1 BMI及BF%判定標準………………………………… 36
表5-1社會人口學特性之基本資料...………………………… 46
表5-2 疾病特性之基本資料………………………………… 48
表5-3 慢性病種類及數量之分佈表………………………… 49
表5-4 營養狀況之分佈表…………………………………… 50
表5-5 患者焦慮程度之分級………………………………… 51
表5-6 貝克焦慮量表各題次之平均得分及排序分配表…… 53
表5-7 患者選擇各題次之分布情形………………………… 55
表5-8 舒適圖量表（WPS）平均得分及排序表…………… 57
表5-9患者選擇WPS各題次之分布情形.………………… 59
表5-10 患者基本屬性與營養、焦慮及感知能量之關係… 61
表5-11 營養、焦慮及感知能量之相關性………………… 62
表5-12 基本屬性與焦慮程度之關聯……………………… 64
表5-13 疾病特性與焦慮程度之關係……………………… 66
表5-14 社會人口學特性對身體質量指數之差異性分析… 68
表5-15 疾病特性對身體質量指數之差異性分析………… 70
表5-16 社會人口學特性對體脂肪率之差異性分析……… 72
表5-17 疾病特性對體脂肪率之差異性分析……………… 74
表5-18 社會人口學特性對焦慮之差異性分析…………… 76
表5-19 疾病特性對焦慮之差異性分析…………………… 78
表5-20 社會人口學特性對感知能量之差異性分析……… 80
表5-21 疾病特性對感知能量之差異性分析……………… 81

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