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研究生:鍾清惠
研究生(外文):Ching-Hui Chung
論文名稱:癌症病人與家屬對醫師病情告知方式偏好之研究
論文名稱(外文):The preferences of cancer patients and their families prefer that when physicians delivery bad news
指導教授:李玉嬋 博士
指導教授(外文):Yu-Chan Li Ph.D.
口試委員:方俊凱唐婉如
口試委員(外文):Chun-Kai FangWoung-Ru Tang
口試日期:2014-01-28
學位類別:碩士
校院名稱:國立臺北護理健康大學
系所名稱:生死教育與輔導研究所
學門:社會及行為科學學門
學類:心理學類
論文種類:學術論文
論文出版年:2014
畢業學年度:102
語文別:中文
論文頁數:65
中文關鍵詞:病情告知偏好
外文關鍵詞:delivery bad newspreference
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本研究目的了解癌症病人及家屬對醫師病情告知方式的偏好、癌症病人及家屬對醫師病情告知方式偏好的差異、以及不同背景變項的癌症病人、家屬與醫師病情告知方式偏好的關係。使用研究工具為日本病情告知問卷(the measure for patients' preferences-Japan)。
本研究取樣100位癌症病人與家屬,癌症病人65位,家屬35位。在整體量表Cronbach’s α為0.93-0.96,各次量表Cronbach’s α則是0.76-0.98。研究結果顯示:癌症病人在問卷的整體分數略與各次量表分數均未達統計上的顯著差異(p>.05),因此癌症病人與家屬對醫師病情告知方式偏好並無差異,想法上相當近似。不同背景變項的病人與家屬,對醫師病情告知方式的偏好上沒有顯著的不同,只有年齡在整體量表、各次量表均呈現顯著差異(p<0.05),以及婚姻狀況在「提供情緒支持」次量表呈現顯著差異。從複迴歸分析結果得知:對整體量表有顯著預測的人口學變項為年齡(p<.01),可解釋12.6%的變異量;對「準備」次量表有顯著預測的變項是年齡(p<.001)以及教育程度(p<.01),可解釋34.4%的變異量;對「提供附加訊息」次量表有顯著預測的變項為年齡(p<.01),可解釋11.3%的變異量。所以,年齡越大的病人與家屬在「準備」、「提供附加訊息」與「提供情緒支持」次量表的偏好上,高於年輕的病人與家屬;在「準備」次量表的偏好,教育程度低的病人與家屬明顯高於教育程度高的病人及家屬。依此研究結果,對醫師進行病情告知方式提出建議。
This study describes the preferences of cancer patients and their families when the physicians delivery the bad news, examines the factor structure of the measure for patients' preferences-Japan(MPP-J) in a Taiwanese population, and explores variables that may be associated with their preferences. The MPP-J demonstrated factors structure: setting, how to delivery the bad news, additional information and emotional support. Sixty-five cancer in-patients and thirty-five families completed the Japanese version of the MPP(MPP-J). One Way ANOVA indicated that patients' and families' preferences when the physicians delivery the bad news didn't differ by gender, religion, stage of disease and diagnosis. Regression analyses indicated that the age(p<.01)was positively associated with the total scales, the Setting subscales and the Additional subscales. Regression analyses also indicated that age(p<.001)and education(p<.01)was positively associated with the Setting subscales. In conclusion, medical information and clear explanations significantly higher ratings from lower levels of education cancer patients and families than from higher levels of education cancer patients and families. Physicians didn’t delivery the bad news at the first meeting. Medical information, clear explanations, a warm and decisive tone of voice received significantly higher ratings from older cancer patients and families than from younger cancer patients and families.
致謝……………………………………………………………………………I
摘要……………………………………………………………………………II
英文摘要………………………………………………………………………III
目次……………………………………………………………………………IV
表次……………………………………………………………………………V
圖次……………………………………………………………………………VI
第一章 諸論…………………………………………………………1
第一節 研究背景……………………………………………………………1
第二節 研究目的與問題……………………………………………………3
第三節 名詞界定……………………………………………………………3
第二章 文獻探討………………………………………………………4
第一節 病情告知相關法令…………………………………………………4
第二節 病情告知相關研究…………………………………………………6
第三章 研究方法………………………………………………………13
第一節 研究設計與架構……………………………………………………13
第二節 研究對象……………………………………………………………14
第三節 資料蒐集方式與步驟………………………………………………14
第四節 研究工具……………………………………………………………15
第五節 資料處理與統計分析………………………………………………16
第六節 研究倫理……………………………………………………………17
第四章 結果與討論……………………………………………………18
第一節 研究對象之背景特性分析…………………………………………18
第二節 研究對象之病情告知偏好分析……………………………………23
第三節 研究對象人口學背景之病情告知偏好分析………………………30
第五章 結論與建議……………………………………………………37
第一節 研究結論……………………………………………………………37
第二節 研究限制與建議……………………………………………………38
參考文獻………………………………………………………………40
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