跳到主要內容

臺灣博碩士論文加值系統

(44.201.99.222) 您好!臺灣時間:2022/12/04 01:14
字體大小: 字級放大   字級縮小   預設字形  
回查詢結果 :::

詳目顯示

: 
twitterline
研究生:鄭伃倢
研究生(外文):CHENG, YU-CHIEH
論文名稱:非小細胞肺癌晚期病人生活品質及其影響因素探討
論文名稱(外文):An exploration of the quality of life and related factors for patients with non-small cell lung cancer in the terminal stage
指導教授:王桂芸
指導教授(外文):WANG, KWUA-YUN
口試委員:王桂芸蔡俊明林寬佳
口試委員(外文):WANG, KWUA-YUNTSAI, CHUN-MINGLIN, KUAN-CHIA
口試日期:2017-05-18
學位類別:碩士
校院名稱:國防醫學院
系所名稱:護理研究所
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:2017
畢業學年度:105
語文別:中文
論文頁數:112
中文關鍵詞:非小細胞肺癌晚期生活品質
外文關鍵詞:non-small cell lung cancerterminal stagequality of life
相關次數:
  • 被引用被引用:1
  • 點閱點閱:338
  • 評分評分:
  • 下載下載:1
  • 收藏至我的研究室書目清單書目收藏:1
背景:惡性腫瘤是國人十大死因之首,肺癌為最常診斷的癌症類別及死亡率之首位,其中非小細胞肺癌約佔八成以上比例。由於肺癌並沒有所謂的典型症狀,僅有警訊,因此,高達七成以上非小細胞肺癌病人診斷時已是晚期。非小細胞肺癌晚期病人以化學、放射線及標靶治療為主,雖可提升病人存活時間,但其疾病及治療相關症狀往往會影響病人及家庭之生活品質,也增加龐大醫療費用支出。雖然醫療科技不斷進步,然近年來肺癌晚期病人重視的不僅「存活期」(活得久),更重視其「生活品質」(活得好),此亦是醫療人員應重視的照護品質指標之一。
目的:探討非小細胞肺癌晚期病人之生活品質及其影響因素。
方法:採橫斷式研究設計,於北部地區某醫學中心胸腔內科門診以方便取樣方法進行,自2016年8月至2017年3月,共收集118位個案以基本資料表、SF-12生活品質量表、台灣版安德森症狀量表、身體活動功能量表及社會支持行為量表收集非小細胞肺癌晚期病人資料,使用SPSS 22.0軟體進行描述性、獨立樣本t檢定、皮爾森相關因素及迴歸分析,以p<.05作為判斷統計意義之標準。
結果:非小細胞肺癌晚期病人在其中有工作狀態、無慢性病史、接觸個案管理師者之病人其生活品質較好。非小細胞肺癌晚期病人在整體生活品質方面預測因子為症狀嚴重度、症狀干擾程度與社會支持。在生活品質生理範疇症狀干擾程度為重要預測因子、症狀嚴重度、症狀干擾程度為心理範疇重要預測因子。期望透過此研究結果,協助臨床照護人員進一步了解非小細胞肺癌晚期病人之生活品質及其影響因素,並提供未來相關研究之實證資料的參考,及非小細胞肺癌晚期病人最佳照護策略之依據,以期提升其整體生活品質。

Background: Cancer remained the first rank of 10 major death caused reasons in the last decade. Lung cancer is the most commonly diagnosed cancer category and the first rank of mortality. There is no typical symptoms in patient with except for lung cancer the warnings to seen. Most non-small cell lung cancer patients have been diagnosed in the late stage of cancer. In 2012, over 70% newly diagnosed lung cancer patients were terminal stage. Patients with non-small cell lung cancer terminal stage could improve survival rate by chemotherapy, radiation therapy and targeted therapy, but the treatment-related symptoms also affecting the QOL of the patients’ family and increasing the medical expenses. With the advanced medical and technological developments, the terminal stage patients of NSCLC not only pay attention to the "Longer life", but also pay more attention to "Good life". Especially quality of life.
Purpose: The purpose of this study were investigate the current status of quality of life and the influential factors for the patients with the terminal stage of non-small cell lung cancer.
Methods: This study were be a cross-sectional research design. One hundred eighteen patients with terminal stage of non-small cell lung cancer were be recruited from a medical center in North Taipei using convenience sampling. This study started from Auguest 2016 to March 2017. Collected using structural questionnaires including 12-Item Short Form Health Survey (SF-12), the M.D. Anderson Symptom Inventory –Taiwan Form (Taiwan-MDSAI), Karnofsky Performance status (KPS), and Inventory of Socially Supportive Behaviors (ISSB). EXCEL 2010 and SPSS 22.0 software package for statistical analysis will be used, and p < .05 as a criterion of statistical significance.
Results: Non-small cell lung cancer in patients with advanced state of work, no history of chronic disease, contact the case manager of the patient's life quality is better. Non-small cell lung cancer in patients with advanced quality of life in the predictive factors for the severity of symptoms, symptoms of interference and social support. In the quality of life, the degree of disturbance of symptoms is an important predictor of important predictors, symptom severity and symptom disturbance. It is expected that the results of this study will help clinicians to better understand the quality of life of patients with advanced non-small cell lung cancer and its influencing factors and provide reference for empirical data on future studies and the basis of best care strategies for patients with advanced non-small cell lung cancer , In order to enhance its overall quality of life.

正文目錄
第一章緒論1
第一節研究動機與重要性1
第二節研究目的4
第三節研究問題5
第四節研究假設6
第二章文獻查證7
第一節非小細胞肺癌晚期之相關概念7
第二節生活品質之相關概念12
第三節非小細胞肺癌晚期病人生活品質及其相關因素之相關研究22
第三章概念架構27
第一節、研究架構27
第二節名詞解釋28
第四章研究方法與過程30
第一節、研究設計30
壹、研究場所及對象30
第二節、研究工具32
第三節、資料收集過程36
第四節、統計分析 37
第五節、研究倫理之考量38
第五章研究結果39
第一節、非小細胞肺癌晚期病人人口學資料、疾病特性及治療方式之分布39
第二節、非小細胞肺癌晚期病人生活品質之分佈50
第三節、非小細胞肺癌晚期病人生活品質及其相關因素之分析52
第四節、非小細胞肺癌晚期病人生活品質之預測因子63
第六章討論67
第一節、非小細胞肺癌晚期病人生活品質67
第二節、非小細胞肺癌晚期病人人口學資料與生活品質之關係67
第三節、非小細胞肺癌晚期病人疾病特性及治療方式與生活品質之關係69
第四節、非小細胞肺癌晚期病人身體活動功能狀態及生活品質之關係70
第五節、非小細胞肺癌晚期病人症狀嚴重度及症狀干擾嚴重程度與生活品質之關係70
第六節、非小細胞肺癌晚期病人社會支持與生活品質之關係71
第七節、影響非小細胞肺癌晚期病人生活品質的重要預測因子71
第七章研究結論與建議73
第一節結論73
第二節建議74
第八章參考資料77 
中文文獻
林冠馨(2006).肺癌病患生活品質之縱貫面研究—歐洲癌症治療與研究組織生活品質核心問卷、肺癌生活品質問卷之反應性與預測死亡的能.未出版碩博士論文。中國醫藥大學,臺中市。
高綺吟(2007).安寧共同照護模式對提升癌末照護品質之成效.未出版碩博士論文。臺灣大學,台北市。
陳偉武、洪敏瑛、陳幼貴(2010).肺癌治療回顧及發展.腫瘤護理雜誌,10(2),39-54。
曾俊華(2008).歐洲癌症治療與研究組織生活品質核心問卷, 肺癌生活品質問卷之信效度研究.未出版碩博士論文。中國醫藥大學,臺中市。
曾慧雯(1999).門診憂鬱症患之社會支持與希望狀態之探討。未發表之碩士論文.未出版碩博士論文。高雄醫學大學,高雄市。
黃靖婷(2008).個案管理師介入對癌症治療成效和醫療費用之效益-以乳癌, 肺癌為例.未出版碩博士論文。嘉南藥理科技大學,臺南市。
楊志新(2014).肺癌治療新進展.台灣醫學,18(6),641-643。
臺灣癌症登記小組(2016).2012年癌症登記統計分析.取自https://cris.hpa.gov.tw/pagepub/Home.aspx?itemNo=cr.p.20
趙可式(2015).安寧療護是普世價值且為護理的本質.護理雜誌,62(2),5-12。doi:10.6224/JN.62.2.5
蔡政聰(2008).不同種類癌症病患於不同治療狀態之健康相關生活品質.未出版碩博士論文。台灣大學,臺北市。
衛生福利部國民健康署(2016a).民國103年全國死因結果統計分析.取自http://www.mohw.gov.tw/cht/DOS/Statistic.aspx?f_list_no=312&fod_list_no=2747
衛生福利部國民健康署(2016b).民國102年癌症登記年報.取自http://www.hpa.gov.tw/BHPNet/Web/Stat/StatisticsShow.aspx?No=201604210001
簡采汝、林哲斌(2010).非小細胞肺癌的維持性治療.台灣癌症醫學雜誌,26(2),45-54。doi:10.6323/JoCRP
羅淑芬、胡文郁(2008).癌症病人健康相關生活品質之概念與測量工具之評析.安寧療護雜誌,13(1),42-57。doi:10.6537/TJHPC.2008.13(1).4


英文文獻
Akin, S., Can, G., Aydiner, A., Ozdilli, K., & Durna, Z. (2010). Quality of life, symptom experience and distress of lung cancer patients undergoing chemotherapy. European Journal of Oncology Nursing, 14(5), 400-409. doi: 10.1016/j.ejon.2010.01.003
Alberg, A. J., & Samet, J. M. (2003). Epidemiology of lung cancer. Chest Journal, 123(1_suppl), 21S-49S.
Arrieta, O., Angulo, L. P., Nunez-Valencia, C., Dorantes-Gallareta, Y., Macedo, E. O., Martinez-Lopez, D., . . . Onate-Ocana, L. F. (2013). Association of depression and anxiety on quality of life, treatment adherence, and prognosis in patients with advanced non-small cell lung cancer. Annals of surgical oncology, 20(6), 1941-1948. doi: 10.1245/s10434-012-2793-5
Aubin, M., Giguere, A., Martin, M., Verreault, R., Fitch, M. I., Kazanjian, A., & Carmichael, P. H. (2012). Interventions to improve continuity of care in the follow-up of patients with cancer. Cochrane Database Syst Rev(7), CD007672. doi: 10.1002/14651858.CD007672.pub2
Caissie, A., Culleton, S., Nguyen, J., Zhang, L., Zeng, L., Holden, L., . . . Chow, E. (2012). EORTC QLQ-C15-PAL quality of life scores in patients with advanced cancer referred for palliative radiotherapy. Support Care Cancer, 20(4), 841-848. doi: 10.1007/s00520-011-1160-6
Chen, Y. M., Perng, R. P., Shih, J. F., Tsai, C. M., & Whang-Peng, J. (2005). Chemotherapy for non-small cell lung cancer in elderly patients. Chest, 128(1), 132-139. doi: 10.1378/chest.128.1.132
Chou, H. L., Chao, T. Y., Chen, T. C., Chu, C. M., Hsieh, C. H., Yao, C. T., & Janckila, A. J. (2016). The Relationship Between Inflammatory Biomarkers and Symptom Distress in Lung Cancer Patients Undergoing Chemotherapy. Cancer Nursing.
Cwikel, J. G., & Behar, L. C. (1999). Organizing social work services with adult cancer patients: integrating empirical research. Soc Work Health Care, 28(3), 55-76. doi: 10.1300/J010v28n03_04
Dai, Y. L., Yang, C. T., Chen, K. H., & Tang, S. T. (2017). Changes in and Determinants of Quality of Life in Patients With Advanced Non-Small-Cell Lung Cancer Undergoing Initial Chemotherapy. Journal of Nursing Research 25(3), 203-215. doi: 10.1097/JNR.0000000000000148
Edge, S. B., & Compton, C. C. (2010). The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Annals of surgical oncology, 17(6), 1471-1474.. doi: 10.1245/s10434-010-0985-4
Fossella, F., Pereira, J. R., von Pawel, J., Pluzanska, A., Gorbounova, V., Kaukel, E., ...& Millward, M. (2003). Randomized, multinational, phase III study of docetaxel plus platinum combinations versus vinorelbine plus cisplatin for advanced non–small-cell lung cancer: The TAX 326 study group. Journal of Clinical Oncology, 21(16), 3016-3024. doi: 10.1200/JCO
Franceschini, J., Santos, A. A. D., El Mouallem, I., Jamnik, S., Uehara, C., Fernandes, A. L. G., & Santoro, I. L. (2008). Assessment of the quality of life of patients with lung cancer using the Medical Outcomes Study 36-item Short-Form Health Survey. Jornal Brasileiro de Pneumologia, 34(6), 387-393.
Goldberg, S. W., Mulshine, J. L., Hagstrom, D., & Pyenson, B. S. (2010). An actuarial approach to comparing early stage and late stage lung cancer mortality and survival. Population Health Management, 13(1), 33-46. doi: 10.1089/pop.2009.0010
Halvorsrud, L., & Kalfoss, M. (2007). The conceptualization and measurement of quality of life in older adults: a review of empirical studies published during 1994–2006. European Journal of Ageing, 4(4), 229-246.
Henoch, I., Bergman, B., Gustafsson, M., Gaston-Johansson, F., & Danielson, E. (2007). The impact of symptoms, coping capacity, and social support on quality of life experience over time in patients with lung cancer. Journal of pain and symptom management, 34(4), 370-379. doi: 10.1016/j.jpainsymman.2006.12.005
Iyer, S., Roughley, A., Rider, A., & Taylor-Stokes, G. (2014). The symptom burden of non-small cell lung cancer in the USA: a real-world cross-sectional study. Support Care Cancer, 22(1), 181-187. doi: 10.1007/s00520-013-1959-4
Iyer, S., Taylor-Stokes, G., & Roughley, A. (2013). Symptom burden and quality of life in advanced non-small cell lung cancer patients in France and Germany. Lung Cancer, 81(2), 288-293. doi: 10.1016/j.lungcan.2013.03.008
Kaptein, A. A., Yamaoka, K., Snoei, L., Kobayashi, K., Uchida, Y., van der Kloot, W. A., . . . Rabe, K. (2011). Illness perceptions and quality of life in Japanese and Dutch patients with non-small-cell lung cancer. Lung Cancer, 72(3), 384-390. doi: 10.1016/j.lungcan.2010.09.010
Lee, L. J. H., Chung, C. W., Chang, Y. Y., Lee, Y. C., Yang, C. H., Liou, S. H., ... & Wang, J. D. (2011). Comparison of the quality of life between patients with non-small-cell lung cancer and healthy controls. Quality of Life Research,20(3), 415-423.
Liao, Y. C., Shun, S. C., Liao, W. Y., Yu, C. J., Yang, P. C., & Lai, Y. H. (2014, March). Quality of life and related factors in patients with newly diagnosed advanced lung cancer: a longitudinal study. In Oncology nursing forum (Vol. 41, No. 2).
Mohan, A., Singh, P., Kumar, S., Mohan, C., Pathak, A. K., Pandey, R. M., & Guleria, R. (2008). Effect of change in symptoms, respiratory status, nutritional profile and quality of life on response to treatment for advanced non-small cell lung cancer. Asian Pac J Cancer Prev, 9(4), 557-562.
Mor, V., Laliberte, L., Morris, J. N., & Wiemann, M. (1984). The Karnofsky Performance Status Scale. An examination of its reliability and validity in a research setting. Cancer, 53(9), 2002-2007.
Novotny, P. J., Smith, D. J., Guse, L., Rummans, T. A., Hartmann, L., Alberts, S., ...& Sloan, J. A. (2010). A pilot study assessing social support among cancer patients enrolled on clinical trials: a comparison of younger versus older adults. Cancer management and research, 2, 133.
Ott, C. (1997). The New World of survivorship and rehabilitation.Nebraska nurse, 30(3), 24-26.
Pan, H. H., Lin, K. C., Ho, S. T., Liang, C. Y., Lee, S. C., & Wang, K. Y. (2012). Factors related to daily life interference in lung cancer patients: a cross-sectional regression tree study. European Journal of Oncology Nursing, 16(4), 345-352. doi: 10.1016/j.ejon.2011.07.011
Park, K., Tan, E. H., O'Byrne, K., Zhang, L., Boyer, M., Mok, T., ...& Shi, Y. (2016). Afatinib versus gefitinib as first-line treatment of patients with EGFR mutation-positive non-small-cell lung cancer (LUX-Lung 7): a phase 2B, open-label, randomised controlled trial. The Lancet Oncology, 17(5), 577-589.
Pirker, R., Pereira, J. R., Szczesna, A., Von Pawel, J., Krzakowski, M., Ramlau, R., ...& Roh, J. K. (2009). Cetuximab plus chemotherapy in patients with advanced non-small-cell lung cancer (FLEX): an open-label randomised phase III trial. The Lancet, 373(9674), 1525-1531.
Poghosyan, H., Sheldon, L. K., Leveille, S. G., & Cooley, M. E. (2013). Health-related quality of life after surgical treatment in patients with non-small cell lung cancer: a systematic review. Lung Cancer, 81(1), 11-26.
Sandler, A., Gray, R., Perry, M. C., Brahmer, J., Schiller, J. H., Dowlati, A., ...& Johnson, D. H. (2006). Paclitaxel–carboplatin alone or with bevacizumab for non–small-cell lung cancer. New England Journal of Medicine, 355(24), 2542-2550.DOI: 10.1056/NEJMoa061884
Shepherd, F. A., Rodrigues Pereira, J., Ciuleanu, T., Tan, E. H., Hirsh, V., Thongprasert, S., ...& van Kooten, M. (2005). Erlotinib in previously treated non–small-cell lung cancer. New England Journal of Medicine, 353(2), 123-132.DOI: 10.1056/NEJMoa050753
Siegel, R. L., Miller, K. D., & Jemal, A. (2015). Cancer statistics, 2015. Cancer Journal for Clinicians, 65(1), 5-29. doi: 10.3322/caac.21254
Sloan, J. A., Zhao, X., Novotny, P. J., Wampfler, J., Garces, Y., Clark, M. M., & Yang, P. (2012). Relationship between deficits in overall quality of life and non–small-cell lung cancer survival. Journal of Clinical Oncology, 30(13), 1498-1504.doi: 10.1200/JCO.2010.33.4631
Stapleton, S. J., Holden, J., Epstein, J., & Wilkie, D. J. (2015). A Systematic Review of the Symptom Distress Scale in Advanced Cancer Studies. Cancer Nursing. doi: 10.1097/NCC.0000000000000292
Temel, J. S., Greer, J. A., Muzikansky, A., Gallagher, E. R., Admane, S., Jackson, V. A., . . . Lynch, T. J. (2011). Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med, 363(8), 733-742. doi: 10.1056/NEJMoa1000678
Toh, H. C. (2011). Providing hope in terminal cancer: when is it appropriate and when is it not? Ann Acad Med Singapore, 40(1), 50-55.
Ware Jr, J. E., Kosinski, M., & Keller, S. D. (1996). A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Medical care, 34(3), 220-233.
Wood, D. E. (2015). National Comprehensive Cancer Network (NCCN) clinical practice guidelines for lung cancer screening. Thoracic surgery clinics, 25(2), 185-197.
World Health Organization (2016). Cancer. Retrieved April ,25, 2016 from http://www.who.int/cancer/en/
Zheng, C., Yu, G., Wang, H., Tang, A., Geng, P., Zhang, H., . . . Xie, X. (2015). Meta-analysis of chemotherapy and dendritic cells with cytokine-induced killer cells in the treatment of non-small-cell lung cancer. International journal of clinical and experimental medicine, 8 (8), 14527-14537.

QRCODE
 
 
 
 
 
                                                                                                                                                                                                                                                                                                                                                                                                               
第一頁 上一頁 下一頁 最後一頁 top