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研究生:賴慧倫
研究生(外文):Hui-Lun Lai
論文名稱:肝癌患者的疲憊、不確定感與生活品質之相關性探討
論文名稱(外文):Exploration of the Relationship among Fatigue, Uncertainty and Quality of Life in Patients with Hepatocellular Carcinoma
指導教授:林淑媛林淑媛引用關係
指導教授(外文):Shu-Yuan Lin
學位類別:碩士
校院名稱:高雄醫學大學
系所名稱:護理學研究所碩士班
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2007
畢業學年度:95
語文別:中文
論文頁數:123
中文關鍵詞:肝癌疲憊不確定感生活品質
外文關鍵詞:Hepatocellular Carcinoma (HCC)FatigueUncertaintyQuality of Life(QOL)
相關次數:
  • 被引用被引用:7
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  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:16
本研究目的在探討肝癌患者之人口學特性、疾病特性、疲憊程度、不確定感與生活品質間之相關性,以及生活品質之預測因素。採橫斷式的描述相關性研究法,在高雄某醫學中心及某區域教學醫院,以立意取樣方式選擇近六個月內曾接受治療之門診肝癌患者110位為研究對象,平均年齡為62.07歲。研究工具使用結構式問卷,包括個人基本屬性問卷、台灣版簡明疲憊量表、中文版Mishel疾病不確定感量表、中文版生活品質量表(FACT-Hep)等來進行資料收集,並以SPSS 10.0中文版電腦套裝軟體作資料分析。
研究結果發現:肝癌患者的整體生活品質(FACT-Hep)之平均值為
125.36(±15.73),標準化得分為69.64,屬於中等程度。肝癌患者疲憊嚴重度之平均值為3.84(±2.24),過去24小時內最嚴重疲憊程度之平均值為4.75(±2.73),疲憊干擾日常活動程度之平均值為2.83(±2.01),故目前疲憊嚴重度為輕度,過去24小時內最嚴重疲憊程度為中度,而疲憊干擾程度為輕度。肝癌患者不確定感之平均值(±標準差)為61.69(±7.33),標準化得分為53.64,屬於中等程度。男性患者、大於65歲以上者、罹患肝癌三年以上者、Child’A級者及無相關合併症者,則整體生活品質較好。白蛋白檢驗值趨於正常範圍內者,整體生活品質愈好(r=.23, p<.05)﹔疼痛強度愈低者,整體生活品質愈好(r=-.33, p<.01)﹔疲憊嚴重度(r=-.56, p<.01)與疲憊干擾程度愈低者,整體生活品質愈好(r=-.64, p<.01))﹔不確定感愈少者,整體生活品質愈好(r=-.51, p<.01)。生活品質之顯著預測因子為疲憊干擾程度、不確定感、Child- Pugh分級,可解釋整體生活品質總變異量的59.0%。本研究結果可作為臨床癌症照護及癌症護理教育課程計之參考,建議臨床醫護人員應加強與病患的溝通討論,且未來研究可藉由介入措施來探討改善肝癌患者疲憊、不確定感及生活品質之成效。
中文摘要........................Ⅰ
英文摘要........................Ⅱ
正文目錄........................Ⅳ
附錄目錄........................Ⅵ
圖表目錄........................Ⅶ

正文目錄
第壹章 緒論
第一節 研究動機與重要性............... 1
第二節 研究目的..................  4
第貳章 文獻查證
第一節 肝癌..................... 5
第二節 疲憊..................... 12
第三節 不確定感................... 16
第四節 生活品質................... 21
第五節 癌症患者生活品質的相關因素.......... 27
第參章 研究架構與研究假設
第一節 名詞界定................... 32
第二節 研究架構..................  34
第三節 研究問題................... 35
第四節 研究假設..................  35
第肆章 研究工具與方法
第一節 研究設計、場所與研究對象........... 36 
第二節 研究工具................... 37
第三節 研究工具之信效度............... 42
第四節 資料收集過程................. 45 
第五節 研究對象權利之維護.............. 46
第六節 資料分析方法................. 47
第伍章 研究結果
第一節 肝癌患者之個人基本屬性之分析......... 49
第二節 肝癌患者之疲憊程度.............  54
第三節 肝癌患者之不確定感程度...........  56
第四節 肝癌患者之生活品質.............. 58
第五節 生活品質與各研究變項之關係.......... 60
第六節 生活品質之預測因子.............. 69
第陸章 討論
第一節 肝癌患者之基本資料.............. 73
第二節 肝癌患者之疲憊程度.............. 74
第三節 肝癌患者之不確定感.............. 76
第四節 肝癌患者之生活品質.............. 78
第五節 肝癌患者生活品質之相關因素.......... 80
第六節 肝癌患者生活品質之預測因子.......... 85
第柒章 結論、限制與建議
第一節 結論....................  86
第二節 研究限制.................. 87
第三節 建議..................... 88
參考資料
中文部分......................  92
英文部分....................... 94
附錄目錄
附錄一 個人基本屬性問卷............... 103
附錄二 疼痛視覺類比量表............... 105附錄三 台灣版簡明疲憊量表.............. 106
附錄四 疾病不確定感量表................107
附錄五 中文版FACT-Hep第四版..............109
附錄六 受試者同意書................. 112
附錄七 研究工具使用同意書...............113
圖表目錄
圖一 研究架構圖....................34
表一 研究工具信度...................44
表二 收案醫院之分佈..................46
表三 肝癌患者的人口學特性...............50
表四 肝癌患者之疾病特性................52
表四 肝癌患者之疾病特性(續)..............53
表四 肝癌患者之疾病特性(續)..............53
表五 肝癌患者的疲憊嚴重度及疲憊干擾日常活動程度之得分.55
表六 肝癌患者疲憊強度及疲憊干擾日常活動程度之分佈...55
表七 肝癌患者之不確定感得分..............56
表八 不確定感單題得分之分佈與排序...........57
表九 肝癌患者之生活品質得分............ . 59表十 肝癌關注事項分量表單題得分之分佈.........59
表十一 人口學特性在生活品質之差異性分析........ 62
表十二 疾病特性在生活品質之差異性分析......... 65
表十三 疼痛強度、血液生化檢驗值與生活品質之相關性... 66
表十四 疲憊程度與生活品質之相關性........... 67
表十五 不確定感與生活品質之相關性........... 68
表十六 生活品質複迴歸分析之共線性診斷......... 72表十七 整體生活品質之逐步複迴歸分析.......... 72
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