臺灣博碩士論文加值系統

癌症存活者經正規治療完成，轉換到無病存活的階段，可能有持續的症狀困擾，但其出現症狀困擾的情形與處置很少被研究。本研究以Andersen健康服務使用行為模式探討治癒性治療後大腸癌與乳癌存活者的症狀困擾、症狀對生活的干擾、焦慮、憂鬱情形與輔助替代療法使用的相關性，並比較癌症存活者與一般民眾的輔助替代療法使用。
本研究採個案對照研究法（case-control study），研究對象來源以某醫院癌症登記資料庫，訪談2009到2011年完成治癒性治療的大腸癌與乳癌存活者共146位，包括乳癌77位、大腸癌69位，並以無癌症診斷的一般民眾161位做為對照組，研究工具包括自擬問卷、台灣版安德森症狀量表（M.D. Anderson Symptom Inventory-Taiwan form, MDASI-Taiwan form）及醫院焦慮憂鬱量表（Hospital Anxiety and Depression Scale, HADS）。
研究結果治癒性治療後癌症存活者的輔助替代療法使用率為54.1％高於一般民眾36.6％，癌症存活者常用的種類依序為天然產品（32.9％）、傳統中醫（21.9％）、身心醫學、推拿及身體療法（6.2％）；一般民眾則依序為天然產品（65.4％）、推拿及身體療法（8.7％）、身心醫學（5.0％）。治癒性治療後癌症存活者與一般民眾的症狀困擾及症狀對生活的干擾程度是沒有顯著差異，但治癒性治療後癌症存活者的焦慮（M=3.87 vs M=5.24, p=0.001）、憂鬱的總分（M=3.51 vs M=5.53, p=0.001）低於一般民眾。利用二元邏輯式迴歸分析檢驗治癒性癌症存活者使用輔助替代療法的因素，發現以前曾使用過輔助替代療法、生活干擾程度越高、越焦慮者，輔助替代療法使用率越高。而性生活與生活樂趣兩方面的生活干擾程度較高者會增加輔助替代療法的使用。
完成治癒性治療後癌症存活者的症狀困擾未高於一般民眾，甚至焦慮與憂鬱情形比一般民眾少，但在輔助替代療法的使用卻明顯較高，尤其是在傳統中醫的使用，比率上高出一般民眾許多。由於以前的輔助替代療法使用經驗對完成治癒性治療後癌症存活者在輔助替代療法使用有明顯的影響，平常若能與其討論過去的使用經驗，了解他們對輔助替代療法的想法及需要，更能引導合適的使用。同時，生活干擾程度及焦慮亦是完成治癒性治療後癌症存活者使用輔助替代療法的因素，醫護人員在癌症存活者的追蹤過程中，不應只是關心疾病的復發與否，對於他們的生活品質問題也應多加留意。

After completion of the conventional anti-cancer treatment, cancer survivors who are in the disease-free stage might still have symptom distress. However, studies that focused on the situation and treatment for those patients who had symptom distress are very limited. This study examined the correlation among symptom distress, symptom interference, anxiety, depression, and use of complementary and alternative medicine in post-curative treatment cancer survivors who had been diagnosed as colorectal or breast cancer by using Andersen’s model of health service utilization; and compared their use of complementary and alternative medicine and symptoms to a comparison group.
A case-control study was conducted on 146 patients, 77 breast and 69 colorectal cancer survivors, who had completed the conventional curative treatment from a hospital’s cancer registry database during 2009 to 2011. The comparison group was composed of 161 non-cancer individuals. Face-to-face interview with M.D. Andersen Symptom Inventory-Taiwan Form (MDASI-Taiwan Form), Hospital Anxiety and Depression Scale (HADS), and self-developed structured questionnaire were used to collect the data.
Findings indicated that use of complementary and alternative medicine was higher in those who were post-curative treatment cancer survivors (54.1%) than in the comparison group (36.6%). The complementary and alternative medicine used by cases includes: natural products (32.9%), traditional Chinese medicine (21.9%), mind-body medicine (6.2%), manipulative and body-based practices (6.2%); those used by comparison group were natural products (65.4%), manipulative and body-based practices (8.7%), and mind-body medicine (6.2%). There was no significant difference in symptom distress and interference between the case and control groups. However, post-curative treatment cancer survivors had a significantly lower score in anxiety (M=3.87 vs M=5.24, p=0.001) and depression (M=3.51 vs M=5.53, p=0.001) compared to the comparison group. Binary logistic regression showed that prior experience of using the complementary and alternative medicine, more symptoms interference with life activities, and higher anxiety level were related to more use of complementary and alternative medicine among post-curative treatment cancer survivors. Those cancer survivors who reported higher level of symptom interference to the sexual life and enjoyment of life aspects were more likely to use complementary and alternative medicine.
Post-curative treatment cancer survivors did not have higher symptom distress and symptom interference, but did have less anxiety and depression, than the comparison group. Use of complementary and alternative medicine was significantly higher among post-curative treatment cancer survivors than the comparison group, especially in the traditional Chinese medicine. Prior use experience significantly influence current use among post-curative treatment cancer survivors. Medical staff could discuss with patients their needs and use of complementary and alternative medicine in order to guide for more appropriate use. Moreover, the factors that lead to the search of complementary and alternative medicine were symptom interference with life activities among post-curative treatment cancer survivors. It is suggested that medical staff should not only focus on monitor of cancer relapse, but also pay more attention on their quality of life during the follow-up stage.

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致謝 i
中文摘要 iii
英文摘要 v
目錄 vii
圖目次 ix
表目次 x
附錄目次 xii
第一章 緒論
第一節 研究背景 1
第二節 研究動機及重要性 4
第二章 文獻查證
第一節 Andersen健康服務使用行為模式 6
第二節 癌症存活者的症狀困擾情況 11
第三節 輔助替代療法之介紹 19
第四節 輔助替代療法使用之狀況 22
第五節 影響癌症存活者使用輔助替代療法的相關因子 25
第三章 研究方法
第一節 研究目的 31
第二節 研究架構 32
第三節 名詞解釋 33
第四節 研究設計 35
第五節 研究對象 36
第六節 研究工具 38
第七節 資料處理與統計分析 44
第四章 研究結果
第一節 治癒性治療後癌症存活者與一般民眾基本屬性之比較分析 47
第二節 治癒性治療後癌症存活者與一般民眾輔助替代療法使用的比較 51
第三節 治癒性治療後癌症存活者與一般民眾的症狀困擾及焦慮、憂鬱的情形 55
第四節 Andersen健康服務使用行為模式預測治癒性治療後癌症存活者使用輔助替代療法的相關因素 60
第五章 討論
第一節 治癒性治療後癌症存活者與一般民眾輔助替代療法使用的比較 78
第二節 治癒性治療後癌症存活者與一般民眾的症狀困擾及焦慮、憂鬱的情形 81
第三節 Andersen健康服務使用行為模式預測治癒性治療後癌症存活者使用輔助替代療法的相關因素 82
第六章 結論與建議
第一節 研究限制 86
第二節 研究結論 88
第三節 研究建議 90
參考文獻 91

圖目次
圖一 Andersen健康服務使用行為模式 7
圖二 治癒性治療後癌症存活者的症狀困擾與輔助替代療法使用之研究架構 30
表目次
表一 推論性統計與資料分析方式 45
表二 二元邏輯式迴歸分析（Binary logistic regression）方法 46
表三 癌症存活者與一般民眾的人口社會學特徵差異 49
表四 癌症存活者的癌症相關病史 50
表五 癌症存活者與一般民眾輔助替代療法使用的比較 51
表六 癌症存活者與一般民眾常使用的輔助替代療法類型 52
表七 癌症存活者未使用輔助替代療法之原因分析 53
表八 癌症存活者未告訴醫護人員自己使用輔助替代療法之原因分析 54
表九 癌症存活者與一般民眾的症狀困擾嚴重程度得分之比較 56
表十 癌症存活者與一般民眾的症狀對生活干擾程度得分之比較 57
表十一 癌症存活者與一般民眾的焦慮與憂鬱總分之比較 59
表十二 癌症存活者與一般民眾的焦慮與憂鬱得分程度之比較 59
表十三 癌症存活者使用輔助替代療法中人口社會學特徵之比較 61
表十四 癌症存活者使用輔助替代療法中癌症病史之比較 63
表十五 癌症存活者使用輔助替代療法中健康信念之比較 64
表十六 癌症存活者使用輔助替代療法之動機分析 65
表十七 癌症存活者有無使用輔助替代療法之使能因素（enabling factors）比較 66
表十八 癌症存活者有無使用輔助替代療法與症狀困擾、焦慮與憂鬱之比較 67
表十九 癌症存活者有無使用輔助替代療法的症狀困擾嚴重程度得分之比較 69
表二十 癌症存活者有無使用輔助替代療法的症狀對生活干擾程度得分之比較 70
表二十一 癌症存活者有無使用輔助替代療法的焦慮與憂鬱總分之比較 71
表二十二 癌症存活者有無使用輔助替代療法的焦慮與憂鬱得分程度之比較 71
表二十三 癌症存活者有無使用輔助替代療法中健康狀態之比較 72
表二十四 症狀困擾的嚴重程度總分、症狀對生活干擾程度總分、焦慮總分與憂鬱總分之相關系數 75
表二十五 預測治癒性治療後癌症存活者使用輔助替代療法的相關因素（一） 75
表二十六 預測治癒性治療後癌症存活者使用輔助替代療法的相關因素（二） 76
表二十七 預測治癒性治療後癌症存活者使用輔助替代療法之最後模式（一） 76
表二十八 預測治癒性治療後癌症存活者使用輔助替代療法之最後模式（二） 76
表二十九 治癒性治療後癌症存活者使用輔助替代療法的預測模式統計檢定 77
附錄目次
附錄一 人體試驗審查委員會同意臨床研究證明書 103
附錄二 問卷 104
附錄三 台灣版安德森症狀量表使用同意書 112
附錄四 醫院焦慮憂鬱量表使用同意書 113
附錄五 專家效度名單 114

Aday, L. A., &; Andersen, R. (1974). A framework for the study of access to medical care. Health services research, 9(3), 208-220.
Afifi, F. U., Wazaify, M., Jabr, M., &; Treish, E. (2010). The use of herbal preparations as complementary and alternative medicine (CAM) in a sample of patients with cancer in Jordan. Complementary Therapies in Clinical Practice, 16(4), 208-212. doi: 10.1016/j.ctcp.2010.05.001
Andersen, R. M. (1995). Revisiting the behavioral model and access to medical care: does it matter? Journal of health and social behavior, 36(1), 1-10.
Andersen, R. M. (2008). National health surveys and the behavioral model of health services use. Med Care, 46(7), 647-653. doi: 10.1097/MLR.0b013e31817a835d
Armstrong, T. S. (2003). Symptoms experience: a concept analysis. Oncology nursing forum, 30(4), 601-606. doi: 10.1188/03.onf.601-606
Baker, F., Denniston, M., Smith, T., &; West, M. M. (2005). Adult cancer survivors: how are they faring? Cancer, 104(11 Suppl), 2565-2576. doi: 10.1002/cncr.21488
Bardia, A., Barton, D. L., Prokop, L. J., Bauer, B. A., &; Moynihan, T. J. (2006). Efficacy of complementary and alternative medicine therapies in relieving cancer pain: a systematic review. Journal of clinical oncology, 24(34), 5457-5464. doi: 10.1200/jco.2006.08.3725
Bauer-Wu, S., &; Decker, G. M. (2012). Integrative Oncology Imperative for Nurses. Seminars in Oncology Nursing, 28(1), 2-9. doi: http://dx.doi.org/10.1016/j.soncn.2011.11.002
Beatty, L. J., Adams, J., Sibbritt, D., &; Wade, T. D. (2012). Evaluating the impact of cancer on complementary and alternative medicine use, distress and health related QoL among Australian women: A prospective longitudinal investigation. Complementary Therapies in Medicine, 20(1–2), 61-69. doi: 10.1016/j.ctim.2011.09.008
Bennett, J. A., Cameron, L. D., Brown, P. M., Whitehead, L. C., Porter, D., Ottaway-Parkes, T., &; Robinson, E. (2010). Time since diagnosis as a predictor of symptoms, depression, cognition, social concerns, perceived benefits, and overall health in cancer survivors. Oncology Nursing Forum, 37(3), 331-338. doi: http://dx.doi.org/10.1188/10.ONF.331-338
Blaes, A. H., Kreitzer, M. J., Torkelson, C., &; Haddad, T. (2011). Nonpharmacologic complementary therapies in symptom management for breast cancer survivors. Seminars in oncology, 38(3), 394-402. doi: 10.1053/j.seminoncol.2011.03.009
Brant, J. M., Beck, S., Dudley, W. N., Cobb, P., Pepper, G., &; Miaskowski, C. (2011). Symptom trajectories in posttreatment cancer survivors. Cancer Nursing, 34(1), 67-77. doi: 10.1097/NCC.0b013e3181f04ae9
Carpenter, C. L., Ganz, P. A., &; Bernstein, L. (2009). Complementary and alternative therapies among very long-term breast cancer survivors. Breast cancer research and treatment, 116(2), 387-396. doi: 10.1007/s10549-008-0158-3
Chao, M. T., Wade, C., &; Kronenberg, F. (2008). Disclosure of complementary and alternative medicine to conventional medical providers: variation by race/ethnicity and type of CAM. Journal of the National Medical Association, 100(11), 1341-1349.
Chen, Z., Gu, K., Zheng, Y., Zheng, W., Lu, W., &; Shu, X. O. (2008). The use of complementary and alternative medicine among Chinese women with breast cancer. Journal of Alternative &; Complementary Medicine, 14(8), 1049-1055. doi: 10.1089/acm.2008.0039
Cleeland, C. S., Mendoza, T. R., Wang, X. S., Chou, C., Harle, M. T., Morrissey, M., &; Engstrom, M. C. (2000). Assessing symptom distress in cancer patients: the M.D. Anderson Symptom Inventory. Cancer, 89(7), 1634-1646.
Corner, J., Yardley, J., Maher, E. J., Roffe, L., Young, T., Maslin-Prothero, S., . . . Lewith, G. (2009). Patterns of complementary and alternative medicine use among patients undergoing cancer treatment. European Journal of Cancer Care, 18(3), 271-279. doi: 10.1111/j.1365-2354.2007.00911.x
Correa-Velez, I., Clavarino, A., &; Eastwood, H. (2005). Surviving, relieving, repairing, and boosting up: reasons for using complementary/alternative medicine among patients with advanced cancer: a thematic analysis. Journal of palliative medicine, 8(5), 953-961. doi: 10.1089/jpm.2005.8.953
Culos-Reed, S. N., Carlson, L. E., Daroux, L. M., &; Hately-Aldous, S. (2006). A pilot study of yoga for breast cancer survivors: physical and psychological benefits. [Article]. Psycho-Oncology, 15(10), 891-897. doi: 10.1002/pon.1021
Curt, G. A., Breitbart, W., Cella, D., Groopman, J. E., Horning, S. J., Itri, L. M., . . . Vogelzang, N. J. (2000). Impact of cancer-related fatigue on the lives of patients: new findings from the Fatigue Coalition. Oncologist, 5(5), 353-360.
D'Silva, S., Poscablo, C., Habousha, R., Kogan, M., &; Kligler, B. (2012). Mind-Body Medicine Therapies for a Range of Depression Severity: A Systematic Review. Psychosomatics, 53(5), 407-423. doi: 10.1016/j.psym.2012.04.006
Daly, M., Tai, C. J., Deng, C. Y., &; Chien, L. Y. (2009). Factors associated with utilization of traditional Chinese medicine by white collar foreign workers living in Taiwan. BMC health services research , 9, 10. doi: 10.1186/1472-6963-9-10
Davidson, R., Geoghegan, L., McLaughlin, L., &; Woodward, R. (2005). Psychological characteristics of cancer patients who use complementary therapies. Psychooncology, 14(3), 187-195. doi: 10.1002/pon.834
Deimling, G. T., Kahana, B., Bowman, K. F., &; Schaefer, M. L. (2002). Cancer survivorship and psychological distress in later life. [Article]. Psycho-Oncology, 11(6), 479-494. doi: 10.1002/pon.614
Deimling, G. T., Sterns, S., Bowman, K. F., &; Kahana, B. (2005). The health of older-adult, long-term cancer survivors. Cancer Nursing, 28(6), 415-424.
Deng, G., &; Cassileth, B. R. (2005). Integrative oncology: complementary therapies for pain, anxiety, and mood disturbance. CA: a cancer journal for clinicians, 55(2), 109-116.
Denise F. Polit, &; Cheryl Tatano Beck. (2007). Nursing research: generating and assessing evidence for nursing practice (8 ed.): Wolters Kluwer Health/Lippincott Williams &; Wilkins.
Donald, G. K., Tobin, I., &; Stringer, J. (2011). Evaluation of acupuncture in the management of chemotherapy-induced peripheral neuropathy. Acupuncture in Medicine, 29(3), 230-233. doi: 10.1136/acupmed.2011.010025
Feng, Y., Wang, X. Y., Li, S. D., Zhang, Y., Wang, H. M., Li, M., . . . Zhang, Z. (2011). Clinical research of acupuncture on malignant tumor patients for improving depression and sleep quality. Journal of traditional Chinese medicine, 31(3), 199-202.
Field, K. M., Jenkins, M. A., Friedlander, M. L., McKinley, J. M., Price, M. A., Weideman, P., . . . Phillips, K. A. (2009). Predictors of the use of complementary and alternative medicine (CAM) by women at high risk for breast cancer. European Journal of Cancer, 45(4), 551-560. doi: 10.1016/j.ejca.2008.09.023
Foster, C., Wright, D., Hill, H., Hopkinson, J., &; Roffe, L. (2009). Psychosocial implications of living 5 years or more following a cancer diagnosis: a systematic review of the research evidence. European Journal of Cancer Care, 18(3), 223-247. doi: http://dx.doi.org/10.1111/j.1365-2354.2008.01001.x
Fouladbakhsh, J. M., &; Stommel, M. (2008). Comparative Analysis of CAM Use in the U.S. Cancer and Noncancer Populations. Journal of Complementary and Integrative Medicine, 5(1), 9-10. doi: 10.2202/1553-3840.1140
Fouladbakhsh, J. M., &; Stommel, M. (2010). Gender, symptom experience, and use of complementary and alternative medicine practices among cancer survivors in the U.S. cancer population. Oncology Nursing Forum, 37(1), E7-E15. doi: 10.1188/10.onf.e7-e15
Fouladbakhsh, J. M., Stommel, M., Given, B. A., &; Given, C. W. (2005). Predictors of use of complementary and alternative therapies among patients with cancer. Oncology Nursing Forum, 32(6), 1115-1122. doi: 10.1188/05.onf.1115-1122
Frei, E., 3rd. (1985). Curative cancer chemotherapy. Cancer research, 45(12 Pt 1), 6523-6537.
Gansler, T., Kaw, C., Crammer, C., &; Smith, T. (2008). A population-based study of prevalence of complementary methods use by cancer survivors: a report from the American Cancer Society's studies of cancer survivors. Cancer, 113(5), 1048-1057. doi: 10.1002/cncr.23659
Ganz, P. A., Desmond, K. A., Leedham, B., Rowland, J. H., Meyerowitz, B. E., &; Belin, T. R. (2002). Quality of life in long-term, disease-free survivors of breast cancer: a follow-up study. Journal of the National Cancer Institute, 94(1), 39-49.
Ganz, P. A., Kwan, L., Stanton, A. L., Bower, J. E., &; Belin, T. R. (2011). Physical and psychosocial recovery in the year after primary treatment of breast cancer. Journal of clinical oncology, 29(9), 1101-1109. doi: 10.1200/jco.2010.28.8043
Golubicic, I., Borojevic, N., &; Pavlovic, T. (2008). Risk factors for breast cancer: is ionizing radiation among them? Journal of B.U.ON., 13(4), 487-494.
Guirimand, F., Buyck, J. F., Lauwers-Allot, E., Revnik, J., Kerguen, T., Aegerter, P., . . . Cleeland, C. S. (2010). Cancer-related symptom assessment in France: validation of the French M. D. Anderson Symptom Inventory. Journal of pain and symptom management, 39(4), 721-733. doi: 10.1016/j.jpainsymman.2009.08.014
Gulluoglu, B. M., Cingi, A., Cakir, T., &; Barlas, A. (2008). Patients in Northwestern Turkey Prefer Herbs as Complementary Medicine after Breast Cancer Diagnosis. Breast Care, 3(4), 269-273. doi: 10.1159/000144045
Hann, D., Allen, S., Ciambrone, D., &; Shah, A. (2006). Use of complementary therapies during chemotherapy: influence of patients' satisfaction with treatment decision making and the treating oncologist. Integrative cancer therapies, 5(3), 224-231. doi: 10.1177/1534735406291494
Hann, D., Baker, F., Denniston, M., &; Entrekin, N. (2005). Long-term breast cancer survivors' use of complementary therapies: perceived impact on recovery and prevention of recurrence. Integrative cancer therapies, 4(1), 14-20. doi: 10.1177/1534735404273723
Harrington, C. B., Hansen, J. A., Moskowitz, M., Todd, B. L., &; Feuerstein, M. (2010). It's not over when it's over: long-term symptoms in cancer survivors--a systematic review. International journal of psychiatry in medicine, 40(2), 163-181.
Helyer, L. K., Chin, S., Chui, B. K., Fitzgerald, B., Verma, S., Rakovitch, E., . . . Clemons, M. (2006). The use of complementary and alternative medicines among patients with locally advanced breast cancer--a descriptive study. BMC Cancer, 6, 39. doi: 10.1186/1471-2407-6-39
Hibdon, S. S. (2005). Biofield considerations in cancer treatment. Semin Oncol Nurs, 21(3), 196-200. doi: 10.1016/j.soncn.2005.04.009
Hoerske, C., Weber, K., Goehl, J., Hohenberger, W., &; Merkel, S. (2010). Long-term outcomes and quality of life after rectal carcinoma surgery. The British journal of surgery, 97(8), 1295-1303. doi: 10.1002/bjs.7105
Hoffman, C. J., Ersser, S. J., Hopkinson, J. B., Nicholls, P. G., Harrington, J. E., &; Thomas, P. W. (2012). Effectiveness of mindfulness-based stress reduction in mood, breast- and endocrine-related quality of life, and well-being in stage 0 to III breast cancer: a randomized, controlled trial. Journal of clinical oncology, 30(12), 1335-1342. doi: 10.1200/jco.2010.34.0331
Holland, J. C., &; Reznik, I. (2005). Pathways for psychosocial care of cancer survivors. Cancer, 104(11 Suppl), 2624-2637. doi: 10.1002/cncr.21252
Howlader, N., Noone AM, Krapcho M, Neyman N, Aminou R, Altekruse SF, . . . KA, C. (2012). SEER Cancer Statistics Review, 1975-2009 (Vintage 2009 Populations) Retrieved 09.01, 2012, from http://seer.cancer.gov/csr/1975_2009_pops09/
Hyodo, I., Amano, N., Eguchi, K., Narabayashi, M., Imanishi, J., Hirai, M., . . . Takashima, S. (2005). Nationwide survey on complementary and alternative medicine in cancer patients in Japan. Journal of clinical oncology, 23(12), 2645-2654. doi: 10.1200/jco.2005.04.126
Janz, N. K., Mujahid, M., Chung, L. K., Lantz, P. M., Hawley, S. T., Morrow, M., . . . Katz, S. J. (2007). Symptom experience and quality of life of women following breast cancer treatment. Journal of women's health, 16(9), 1348-1361. doi: 10.1089/jwh.2006.0255
Kaiser, N. C., Hartoonian, N., &; Owen, J. E. (2010). Toward a cancer-specific model of psychological distress: population data from the 2003-2005 National Health Interview Surveys. Journal of cancer survivorship, 4(4), 291-302. doi: 10.1007/s11764-010-0120-3
Kim, S. H., Son, B. H., Hwang, S. Y., Han, W., Yang, J.-H., Lee, S., &; Yun, Y. H. (2008). Fatigue and Depression in Disease-Free Breast Cancer Survivors: Prevalence, Correlates, and Association with Quality of Life. Journal of Pain and Symptom Management, 35(6), 644-655. doi: 10.1016/j.jpainsymman.2007.08.012
Knobf, M. T. (2007). Psychosocial Responses in Breast Cancer Survivors. Seminars in Oncology Nursing, 23(1), 71-83. doi: 10.1016/j.soncn.2006.11.009
Knobf, M. T. (2011). Clinical update: psychosocial responses in breast cancer survivors. Seminars in Oncology Nursing, 27(3), e1-e14. doi: 10.1016/j.soncn.2011.05.001
Knobf, M. T. (2011). Clinical Update: Psychosocial Responses in Breast Cancer Survivors. Seminars in Oncology Nursing, 27(3), e1-e14. doi: 10.1016/j.soncn.2011.05.001
Kremser, T., Evans, A., Moore, A., Luxford, K., Begbie, S., Bensoussan, A., . . . Zorbas, H. (2008). Use of complementary therapies by Australian women with breast cancer. The Breast, 17(4), 387-394. doi: 10.1016/j.breast.2007.12.006
Ku, C. F., &; Koo, M. (2012). Association of distress symptoms and use of complementary medicine among patients with cancer. Journal of Clinical Nursing, 21(5/6), 736-744. doi: 10.1111/j.1365-2702.2011.03884.x
Ku, C. F., &; Koo, M. (2012). Association of distress symptoms and use of complementary medicine among patients with cancer. Journal of Clinical Nursing, 21(5-6), 736-744. doi: 10.1111/j.1365-2702.2011.03884.x
Kua, J. (2005). The prevalence of psychological and psychiatric sequelae of cancer in the elderly -- how much do we know. Annals Academy of Medicine, 34, 250-256.
Kumar, N. B., Hopkins, K., Allen, K., Riccardi, D., Besterman-Dahan, K., &; Moyers, S. (2002). Use of complementary/integrative nutritional therapies during cancer treatment: implications in clinical practice. Cancer Control, 9(3), 236-243.
Lai, Y. H., Chang, J. T., Keefe, F. J., Chiou, C. F., Chen, S. C., Feng, S. C., . . . Liao, M. N. (2003). Symptom distress, catastrophic thinking, and hope in nasopharyngeal carcinoma patients. Cancer Nursing, 26(6), 485-493.
Lawsin, C., DuHamel, K., Itzkowitz, S. H., Brown, K., Lim, H., Thelemaque, L., &; Jandorf, L. (2007). Demographic, medical, and psychosocial correlates to CAM use among survivors of colorectal cancer. Support Care Cancer, 15(5), 557-564. doi: 10.1007/s00520-006-0198-3
Lee, R. T., Hlubocky, F. J., Hu, J. J., Stafford, R. S., &; Daugherty, C. K. (2008). An international pilot study of oncology physicians' opinions and practices on Complementary and Alternative Medicine (CAM). Integrative cancer therapies, 7(2), 70-75. doi: 10.1177/1534735408319059
Lengacher, C. A., Bennett, M. P., Kip, K. E., Gonzalez, L., Jacobsen, P., &; Cox, C. E. (2006). Relief of symptoms, side effects, and psychological distress through use of complementary and alternative medicine in women with breast cancer. Oncology nursing forum, 33(1), 97-104. doi: 10.1188/06.onf.97-104
Lengacher, C. A., Bennett, M. P., Kip, K. E., Keller, R., LaVance, M. S., Smith, L. S., &; Cox, C. E. (2002). Frequency of use of complementary and alternative medicine in women with breast cancer. Oncology nursing forum, 29(10), 1445-1452. doi: 10.1188/02.onf.1445-1452
Levine, M. N., &; Whelan, T. (2006). Adjuvant chemotherapy for breast cancer--30 years ater. The New England journal of medicine, 355(18), 1920-1922. doi: 10.1056/NEJMe068204
Lynch, B. M., Steginga, S. K., Hawkes, A. L., Pakenham, K. I., &; Dunn, J. (2008). Describing and predicting psychological distress after colorectal cancer. Cancer, 112(6), 1363-1370. doi: 10.1002/cncr.23300
Mao, J. J., Armstrong, K., Bowman, M. A., Xie, S. X., Kadakia, R., &; Farrar, J. T. (2007). Symptom burden among cancer survivors: impact of age and comorbidity. Journal of the American Board of Family Medicine, 20(5), 434-443. doi: 10.3122/jabfm.2007.05.060225
Mao, J. J., Farrar, J. T., Xie, S. X., Bowman, M. A., &; Armstrong, K. (2007). Use of complementary and alternative medicine and prayer among a national sample of cancer survivors compared to other populations without cancer. Complementary Therapies in Medicine, 15(1), 21-29. doi: 10.1016/j.ctim.2006.07.006
Mao, J. J., Palmer, S. C., Straton, J. B., Cronholm, P. F., Keddem, S., Knott, K., . . . Barg, F. K. (2008). Cancer survivors with unmet needs were more likely to use complementary and alternative medicine. Journal of cancer survivorship, 2(2), 116-124. doi: 10.1007/s11764-008-0052-3
Mast, M. E. (1998). Survivors of breast cancer: illness uncertainty, positive reappraisal, and emotional distress. Oncology Nursing Forum, 25(3), 555-562.
Matthews, A. K., Sellergren, S. A., Huo, D., List, M., &; Fleming, G. (2007). Complementary and alternative medicine use among breast cancer survivors. Journal of Alternative &; Complementary Medicine, 13(5), 555-562. doi: 10.1089/acm.2007.03-9040
Miller, L. E. (2012). Sources of uncertainty in cancer survivorship. Journal of cancer survivorship. doi: 10.1007/s11764-012-0229-7
Molassiotis, A., Fernadez-Ortega, P., Pud, D., Ozden, G., Scott, J. A., Panteli, V., . . . Patiraki, E. (2005). Use of complementary and alternative medicine in cancer patients: a European survey. Annals of oncology, 16(4), 655-663. doi: 10.1093/annonc/mdi110
Montazeri, A., Sajadian, A., Ebrahimi, M., &; Akbari, M. E. (2005). Depression and the use of complementary medicine among breast cancer patients. Support Care Cancer, 13(5), 339-342. doi: 10.1007/s00520-004-0709-z
Montazeri, A., Sajadian, A., Ebrahimi, M., Haghighat, S., &; Harirchi, I. (2007). Factors predicting the use of complementary and alternative therapies among cancer patients in Iran. European Journal of Cancer Care, 16(2), 144-149.
Monti, D. A., Sufian, M., &; Peterson, C. (2008). Potential role of mind-body therapies in cancer survivorship. Cancer, 112(11 Suppl), 2607-2616. doi: 10.1002/cncr.23443
Monti, D. A., &; Yang, J. (2005). Complementary medicine in chronic cancer care. Seminars in Oncology Nursing, 32(2), 225-231.
Moran, M. S., Ma, S., Jagsi, R., Yang, T. I., Higgins, S. A., Weidhaas, J. B., . . . Rockwell, S. (2012). A Prospective, Multicenter Study of Complementary/Alternative Medicine (CAM) Utilization During Definitive Radiation for Breast Cancer. International journal of radiation oncology, biology, physics. doi: 10.1016/j.ijrobp.2012.03.025
Nahin, R. L., Barnes, P. M., Stussman, B. J., &; Bloom, B. (2009). Costs of complementary and alternative medicine (CAM) and frequency of visits to CAM practitioners: United States, 2007. National health statistics reports (18), 1-14.
NCCAM. (2011). What Is Complementary and Alternative Medicine? Retrieved March,1, 2012, from http://nccam.nih.gov/health/whatiscam
NCCS. (2011). Defining Terms, from http://www.canceradvocacy.org/resources/take-charge/defining-terms.html
Oh, B., Butow, P., Mullan, B., Beale, P., Pavlakis, N., Rosenthal, D., &; Clarke, S. (2010). The use and perceived benefits resulting from the use of complementary and alternative medicine by cancer patients in Australia. Asia-Pacific journal of clinical oncology, 6(4), 342-349. doi: 10.1111/j.1743-7563.2010.01329.x
Owens, B., Jackson, M., &; Berndt, A. (2009). Complementary therapy used by Hispanic women during treatment for breast cancer. Journal of holistic nursing, 27(3), 167-176. doi: 10.1177/0898010108330801
Phipps, E., Braitman, L. E., Stites, S., &; Leighton, J. C. (2008). Quality of life and symptom attribution in long-term colon cancer survivors. Journal of evaluation in clinical practice, 14(2), 254-258. doi: 10.1111/j.1365-2753.2007.00842.x
Quartey, N. K., Ma, P. H., Chung, V. C., &; Griffiths, S. M. (2012). Complementary and alternative medicine education for medical profession: systematic review. Evid Based Complement Alternat Medicine, 2012, 656812. doi: 10.1155/2012/656812
Rakovitch, E., Pignol, J. P., Chartier, C., Ezer, M., Verma, S., Dranitsaris, G., &; Clemons, M. (2005). Complementary and alternative medicine use is associated with an increased perception of breast cancer risk and death. Breast cancer research and treatment, 90(2), 139-148. doi: 10.1007/s10549-004-3779-1
Roscoe, J. A., Morrow, G. R., Hickok, J. T., Bushunow, P., Pierce, H. I., Flynn, P. J., . . . Atkins, J. N. (2003). The efficacy of acupressure and acustimulation wrist bands for the relief of chemotherapy-induced nausea and vomiting. A University of Rochester Cancer Center Community Clinical Oncology Program multicenter study. Journal of pain and symptom management, 26(2), 731-742.
Rowland, J. H. (2008). Cancer Survivorship: Rethinking the Cancer Control Continuum. Seminars in Oncology Nursing, 24(3), 145-152. doi: 10.1016/j.soncn.2008.05.002
Rowland, J. H., &; Baker, F. (2005). Introduction: resilience of cancer survivors across the lifespan. Cancer, 104(11 Suppl), 2543-2548. doi: 10.1002/cncr.21487
Scott, J. A., Kearney, N., Hummerston, S., &; Molassiotis, A. (2005). Use of complementary and alternative medicine in patients with cancer: a UK survey. European journal of oncology nursing, 9(2), 131-137. doi: 10.1016/j.ejon.2005.03.012
Sewitch, M. J., &; Rajput, Y. (2010). A literature review of complementary and alternative medicine use by colorectal cancer patients. Complementary Therapies in Clinical Practice, 16(1), 52-56. doi: 10.1016/j.ctcp.2009.10.001
Shi, Q., Smith, T. G., Michonski, J. D., Stein, K. D., Kaw, C., &; Cleeland, C. S. (2011). Symptom burden in cancer survivors 1 year after diagnosis: a report from the American Cancer Society's Studies of Cancer Survivors. Cancer, 117(12), 2779-2790. doi: 10.1002/cncr.26146
Shumay, D. M., Maskarinec, G., Gotay, C. C., Heiby, E. M., &; Kakai, H. (2002). Determinants of the degree of complementary and alternative medicine use among patients with cancer. Journal of Alternative &; Complementary Medicine, 8(5), 661-671. doi: 10.1089/107555302320825183
Sloman, R. (2002). Relaxation and imagery for anxiety and depression control in community patients with advanced cancer. Cancer Nursing, 25(6), 432-435.
Stanton, A. L., Ganz, P. A., Rowland, J. H., Meyerowitz, B. E., Krupnick, J. L., &; Sears, S. R. (2005). Promoting adjustment after treatment for cancer. Cancer, 104(11 Suppl), 2608-2613. doi: 10.1002/cncr.21246
Stark, L., Tofthagen, C., Visovsky, C., &; McMillan, S. C. (2012). The Symptom Experience of Patients with Cancer. Journal of hospice and palliative nursing, 14(1), 61-70. doi: 10.1097/NJH.0b013e318236de5c
Steginga, S. K., Lynch, B. M., Hawkes, A., Dunn, J., &; Aitken, J. (2009). Antecedents of domain-specific quality of life after colorectal cancer. Psychooncology, 18(2), 216-220. doi: 10.1002/pon.1388
Stein, K. D., Kaw, C., Crammer, C., &; Gansler, T. (2009). The role of psychological functioning in the use of complementary and alternative methods among disease-free colorectal cancer survivors: a report from the American Cancer Society's studies of cancer survivors. Cancer, 115(18 Suppl), 4397-4408. doi: 10.1002/cncr.24591
Stein, K. D., Syrjala, K. L., &; Andrykowski, M. A. (2008). Physical and psychological long-term and late effects of cancer. Cancer, 112(11 Suppl), 2577-2592. doi: 10.1002/cncr.23448
Targ, E. F., &; Levine, E. G. (2002). The efficacy of a mind-body-spirit group for women with breast cancer: a randomized controlled trial. General Hospital Psychiatry, 24(4), 238-248. doi: 10.1016/s0163-8343(02)00191-3
Trinkaus, M., Burman, D., Barmala, N., Rodin, G., Jones, J., Lo, C., &; Zimmermann, C. (2011). Spirituality and use of complementary therapies for cure in advanced cancer. [Article]. Psycho-Oncology, 20(7), 746-754. doi: 10.1002/pon.1773
Vachon, M. (2006). Psychosocial distress and coping after cancer treatment. Cancer Nurs, 29(2 Suppl), 26-31.
Verhoef, M. J., Balneaves, L. G., Boon, H. S., &; Vroegindewey, A. (2005). Reasons for and characteristics associated with complementary and alternative medicine use among adult cancer patients: a systematic review. Integrative cancer therapies, 4(4), 274-286. doi: 10.1177/1534735405282361
Wanchai, A., Armer, J. M., &; Stewart, B. R. (2010a). Complementary and alternative medicine use among women with breast cancer: a systematic review. Clinical Journal of Oncology Nursing, 14(4), E45-55. doi: 10.1188/10.cjon.e45-e55
Wanchai, A., Armer, J. M., &; Stewart, B. R. (2010b). Self-care agency using Complementary and Alternative Medicine (CAM) among breast cancer survivors. Self-Care, Dependent-Care &; Nursing, 18(1), 8-18.
Wolfson, W. (2010). Building cancer survivorship care. The American journal of nursing, 110(4), 17-18. doi: 10.1097/01.NAJ.0000370149.49363.fa
Wong, L. C., Chan, E., Tay, S., Lee, K. M., &; Back, M. (2010). Complementary and alternative medicine practices among Asian radiotherapy patients. Asia-Pacific journal of clinical oncology, 6(4), 357-363. doi: 0.1111/j.1743-7563.2010.01296.x
Wong, R., &; Sagar, S. (2006). Acupuncture treatment for chemotherapy-induced peripheral neuropathy -- a case series. Acupuncture in Medicine, 24(2), 87-91.
Wu, S. I., Chou, P., Chen, M. L., Chen, J. H., Yeh, M. L., &; Lin, K. C. (2012). Multiple interacting factors corresponding to repetitive use of complementary and alternative medicine. Complementary therapies in medicine, 20(4), 190-198. doi: 10.1016/j.ctim.2012.01.003
Yang, C., Chien, L. Y., &; Tai, C. J. (2008). Use of complementary and alternative medicine among patients with cancer receiving outpatient chemotherapy in Taiwan. The journal of alternative and complementary medicine, 14(4), 413-416. doi: 10.1089/acm.2007.7181
Zick, S. M., Alrawi, S., Merel, G., Burris, B., Sen, A., Litzinger, A., &; Harris, R. E. (2011). Relaxation acupressure reduces persistent cancer-related fatigue. Evid Based Complement Alternat Medicine, 2011. doi: 10.1155/2011/142913
Zucca, A. C., Boyes, A. W., Linden, W., &; Girgis, A. (2012). All’s Well That Ends Well? Quality of Life and Physical Symptom Clusters in Long-Term Cancer Survivors Across Cancer Types. Journal of Pain and Symptom Management, 43(4), 720-731. doi: http://dx.doi.org/10.1016/j.jpainsymman.2011.04.023
丁漢祥, 黃仲諄, 邱憲良, 吳敬堂, 周佳正, &; 侯毓昌. (2007). 乳癌病人使用輔助及另類醫療狀況之研究－以某區域醫院外科門診患者為例. [Utilizations of Complementary and Alternative Medicine in Breast Cancer Patients-Survey of a Regional Hospital Surgery OutPatient Department].中西整合醫學雜誌, 9(2), 7-13.
王濟川, &; 郭志剛. (2004). Logistic迴規模型方法及應用 (Vol. 2). [Logistic Regression Models：Methods and Application].台北市.
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. [Effects of Symptom Distress and Symptom Interference of Daily Life in CCRT Patients with Head and Neck Cancer]. 新臺北護理期刊, 12(2), 17-26.
李丞華，周穎政，陳龍生，張鴻仁. (2004). 全民健保中醫門診利用率及其影響因素. [Utilization of Ambulatory Chinese Medical Services under the National Health Insurance in Taiwan].台灣衛誌, 23(2), 100-107.
林斈府, 莊岳泉, 吳逸（馬堇）, 黃文彥, &; 趙祖怡. (2009). 乳癌治療的新趨勢. [New Trands in the Treatment of Breast Cancer]. 腫瘤護理雜誌, 9(S), 19-35.
林純美. (2009). 頭頸癌病人肩功能於不同量表之比較. [Comparison of Three Shoulder Dysfunction Measures in Primary Head and Neck Cancer Patients Receiving Neck Dissection]碩士, 國立臺灣大學, 台北市.
林寬佳, 陳美麗, 葉美玲, 許中華, 陳逸倫, &; 周碧瑟. (2009). 輔助與替代療法之使用及其相關因素之全國性調查. [Prevalence, Pattern, and Predictors of Use of Complementary and Alternative Medicine in Taiwan]. 臺灣公共衛生雜誌, 28(1), 53-68.
侯毓昌, 丁漢祥, 曾韻潔, 謝一紅, &; 黃仲諄. (2006). 一般外科癌症患者對另類療法使用情況之研究－以某區域醫院外科門診患者爲例. [Study of Application of Alternative Medicine in Cancer Patients-Survey of a Regional Hospital Surgery Outpatient Department]. 中醫藥雜誌, 17(1&;2), 25-33.
張智雅. (2006). 另類療法醫病關係之初探：從傳統跌打損傷館患者就診行為之田野觀察談起. [The Preliminary Research about Doctor-Patient Relationships of Alternative Medicine: The Field Observation of Medical Examination Behaviors in "The Traditional Treatment Hall of Fracture and Injury"]. 嘉南學報（人文類）(32), 334-349.
張愛萍. (2003). 發展台灣版簡明疲憊量表(BFI-Taiwan Form)與台灣版安德森症狀量表(MDASI-Taiwan Form)及信效度檢測. [Development and Validation of the Brief Fatigue Inventory-Taiwan Form and M. D. Anderson Symptom Inventory-Taiwan Form]碩士, 臺北醫學大學, 台北市.
陳玉萍, 曾振淦, 曾雁明, &; 洪志宏. (2008). 放射腫瘤癌患接受西醫、中醫與另類療法的相關性調查分析. [An Investigational Analysis for Correlation of Cancer Patients in Radiation Oncology Department Receiving Western, Chinese and Alternative Medical Treatments]. 放射治療與腫瘤學, 15(4), 289-300.
陳佩英, 郭素青, 張惠甄, 徐一瑱, 林麗玉, &; 楊桂美. (2004). 口腔癌術後病患之身心症狀與調適. [Physio-Psychological Symptoms and Adaptation in Post-Surgical Oral Cancer Patients]. 安寧療護雜誌, 9(2), 153-164.
陳鴻銘. (2005). Characteristics of Patients Using Complementary Alternative Medicine Combined with Conventional Medicine in Primary Care. [併用輔助與替代療法之基層醫療病患特質]. 北市醫學雜誌, 2(3), 278-285.
辜智芬. (2007). 研究癌症病人使用輔助及另類醫療現況. [Use of complementary and alternative medicine by patients with cancer]碩士, 南華大學, 台中.
廖繼鼎. (2010). 臨床腫瘤學. [Clinical oncology]. 台北市: 合記書局.
榮泰生. (2009). SPSS與研究方法 (Vol. 2). [Statistical products and services solution] 台北市.
鄭惠鑫, 陳雅惠, 王琦, &; 廖梅珍. (2008). 婦癌病患於化學治療期間症狀困擾及護理指導需求之探討. [Distress Symptoms and Health Education Demands during among Gynecologic Oncology Patients Undergoing Chemotherapy]. 腫瘤護理雜誌, 8(2), 45-57.
賴榮年, 吳建東, &; 王榮德. (2013). 台灣乳癌婦女1998-2008年間的中藥使用率及模式分析. [Prevalence, Pattern, and Costs of Chinese Medicine Use among Breast Cancer Women in Taiwan during 1998-2008]. 中醫藥雜誌, 24(1), 13-23.
謝德熾, &; 陳立奇. (2010). 乳癌治療之演進. [The Evolution of Breast Cancer Treatment]. 北市醫學雜誌, 7(3), 313-322.
行政院衛生署(2012.10.18)。國民醫療帳100。台北市：行政院。民101年10月21日，取自http://www.doh.gov.tw/CHT2006/DM/DM2_2_p02.aspx?class_no=440
&;now_fod_list_no=12486&;level_no=2&;doc_no=86415
行政院衛生署(2010，4月21日) ．99-102年中程施政計畫．民102年6月25日，取自http://www.doh.gov.tw/CHT2006/DM/DM2_p01.aspx?class_no=450&;now
_fod_list_no=10530&;level_no=1&;doc_no=75502