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研究生:滕慧彥
研究生(外文):Hui-Yen Teng
論文名稱:頭頸癌患者疼痛困擾與生活功能探討
論文名稱(外文):Pain in Head and Neck Cancer Patients and Its Interference on Daily Function
指導教授:賴裕和賴裕和引用關係
口試委員:王成平陳淑卿
口試日期:2015-06-22
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:護理學研究所
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:2015
畢業學年度:103
語文別:中文
論文頁數:63
中文關鍵詞:頭頸癌疼痛生活功能
外文關鍵詞:head and neck cancerpaindaily function
相關次數:
  • 被引用被引用:1
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  • 收藏至我的研究室書目清單書目收藏:1
治療引起的疼痛經常困擾頭頸癌患者於存活期,疼痛會影響其生活功能。本研究目的為:(1)探討頭頸癌患者疼痛嚴重度及特質與生活功能,(2)疼痛與生活功能相關性,(3)探討生活功能的預測因子。
本研究以橫斷性研究設計,於臺灣北部某醫學中心耳鼻喉科門診收案,時間自民國103年8月至民國104年5月,以結構式問卷訪談,問卷包括:病患基本資料、簡易疼痛量表、簡易McGill疼痛問卷與世界衛生組織生活功能評估2.0,資料以SPSS統計軟體進行分析,包括描述性統計(次數分配、平均值、標準差及百分比)、皮爾森積差相關 (Pearson’s correlation)、單因子變異數分析 (one-way ANOVA),及羅吉斯迴歸 (logistic regression)。
本研究共收集119位頭頸癌患者,研究結果發現:(1)半數 (50.5%) 患者在治療結束後仍然受疼痛困擾,且多數為治療所導致,73%患者接受手術治療,手術範圍越大,其疼痛情形越嚴重。(2)治療後疼痛部位多集中於肩頸部,其次為口腔,性質多為「一觸就痛的痛」、「刺痛」及「抽痛」。(3)疼痛強度多介於輕度至中度疼痛,接受治療完成6個月後疼痛干擾明顯下降,但仍有超過半數疼痛患者的疼痛持續時間大於半年。(4)疼痛影響生活功能,尤其以「社會參與」、「活動性」、「與他人相處」以及「認知與溝通」出現最多問題。
臨床照護應關注頭頸癌患者完成治療後疼痛,主動評估疼痛及疼痛引起的生活功能障礙,以減少頭頸癌患者治療後之生活功能障礙。

Head and neck cancer (HNC) patients suffered from treatment-induced pain during survival period. The purpose of this study was to (1) examine the severity and characteristics of pain, and daily function, (2) examine the correlation of pain and daily function, and (3) examine the predictors of daily function in HNC patients.
A cross-sectional study was conducted. Participants were recruited from the otolaryngology outpatient department of a medical center in northern Taiwan between August 2014 and May 2015. A set of questionnaires was used to interview, questionnaires including background information from, McGill Pain Questionnaire short-form (MGPQ), Brief Pain Inventory (BPI), and WHO Disability Assessment Schedule 2.0. (WHODAS 2.0). All calculations were made using SPSS for Window. The data analysis was conducted with descriptive statistics (frequency, mean, standard deviation, and percentage), Pearson’s product moment correlation, one-way ANOVA, and logistic regression.
A total of 119 HNC patients were recruited in this study. The results showed that (1) half of participants experienced pain at post-treatment, most of the patients was treatment-induced pain. 73% of the patients received surgery, and the larger area of surgery was significantly associated with severe pain, (2) the location of pain focused on shoulder and oral cavity, respectively; the characteristics of pain were tender, sharp, and throbbing, (3) Patients had mild-to-moderate levels of pain, especially significantly interfere with daily function within 6 months, and more than half of patients reported pain lasting more than 6 months, and (4) Patients’ pain impact on daily function, and the top four dimensions according to descending were participation in society, getting around, getting alone with people, and understanding and communication, respectively.
Healthcare providers should pay attention for HNC patients’ pain after completing treatment, actively assess the severity and characteristics of pain and interfere with daily function, and reduce the impairment of daily function in HNC patients during post-treatment.
The result of this research can provide into clinical HNC survivors’ care, in order to assess disability by pain, and become reference to the study in the future.

口試委員審定書........................................... II
致謝.................................................... III
中文摘要................................................. IV
英文摘要.................................................. V
第一章 緒論............................................... 1
第一節 研究問題及重要性 .................................. 1
第二節 研究目的 .......................................... 2
第二章 文獻查證........................................... 3
第一節 頭頸癌之現況 ...................................... 3
第二節 頭頸癌患者之疼痛................................... 6
第三節 頭頸癌之疼痛相關因素 ............................. 13
第四節 研究架構圖 ....................................... 16
第三章 研究方法.......................................... 17
第一節 研究設計 ......................................... 17
第二節 收案對象 ......................................... 17
第三節 研究假設 ......................................... 18
第四節 名詞解釋及操作型定義 ............................. 19
第五節 研究工具 ......................................... 20
第六節 資料收集過程與分析 ............................... 23
第七節 研究倫理考量 ..................................... 24
第四章 研究結果.......................................... 25
第一節 頭頸癌患者之疾病特性 ............................. 25
第二節 頭頸癌患者的疼痛經驗 ............................. 27
第三節 頭頸癌患者人口學、治療與疼痛強度之差異 ........... 28
第四節 頭頸癌患者疼痛與生活功能 ......................... 29
第五章 討論.............................................. 32
第一節 頭頸癌病人之疼痛狀態 ............................. 32
第二節 頭頸癌患者生活功能之影響 ......................... 34
第三節 頭頸癌患者疼痛對生活功能之影響 ................... 36
第六章 結論與建議........................................ 39
第一節 結論 ............................................. 39
第二節 研究限制與建議 ................................... 40
第三節 護理的應用 ....................................... 41
參考文獻................................................. 42

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