臺灣博碩士論文加值系統

結腸直腸癌在十大癌症死因排在第三順位，且發生率持續攀升中，手術切除腫瘤是最主要的治療方式。研究顯示肥胖和生活型態如抽菸、喝酒、飲食習慣及運動習慣和結腸直腸癌發生與死亡風險有關。但少有研究探討肥胖和生活型態對結腸直腸癌病人術後恢復及生活品質的影響，因此本研究在探討人口學、疾病特性、共病嚴重度、營養狀況和健康生活型態(抽菸、喝酒、身體活動量和蔬果攝取量)對術後住院天數和術後一個月健康相關生活品質的影響。採描述相關性研究設計，以便利取樣，於北部某醫學中心一般外科、大腸直腸外科病房招募符合收案條件之結腸直腸癌並將接受結腸切除手術之病人共106位參與研究，以自填式問卷進行資料收集，內容包括人口學資料、查爾森共病症指標、抽菸習慣、飲酒失常識別試驗量表、台灣活動量調查短版量表和飲食習慣問卷，並由研究人員測量身體質量指數(BMI)及由病歷中收集疾病與治療相關資料，包括診斷、癌症分期、術式、血紅素(Hemoglobin)、白蛋白(Albumin)、術後合併症、腸功能恢復情形與住院天數。並於病人出院一個月回診時以結腸直腸癌病人癌症治療功能性評估量表收集健康相關生活品質。以SPSS 20.0軟體進行研究資料之統計分析，以次數、百分比、平均值與標準差描述研究對象之人口學、疾病特性及其他研究變項。以t檢定、單因子變異數分析、卡方檢定、皮爾森積差相關係數分析各研究變項的相關性，另以線性複回歸分別分析術後恢復及術後一個月健康相關生活品質的重要預測因子。研究對象平均術後住院天數為10.48 (SD = 3.66)，最低為6天，最高為25天，以線性複回歸分析結果顯示術後合併症、手術方式、白蛋白及年齡為術後住院天數之重要預測因子，四個變項共可解釋結腸直腸癌病人術後住院天數45.4%的變異量(F = 6.97, p = 0.010 )，其中有接受剖腹手術、術後合併症發生、白蛋白越低及年紀越大的結腸直腸癌病人的術後住院天數較長。
另外研究對象之整體健康相關生活品質平均得分為107.43 (SD = 13.95)，線性複回歸分析結果顯示年齡、術後住院天數、教育程度為術後一個月健康相關生活品質之重要預測因子，三個變項共可解釋結腸直腸癌病人術後健康相關生活品質24.1%的變異量(F = 4.04, p = 0.047)，其中年紀越大、術後住院天數越長及教育程度為大專以下的結腸直腸癌病人的健康相關生活品質較差。研究結果除了對影響術後恢復及健康相關生活品質的重要因子有進一步的了解外，並作為發展相關照護計畫以減少術後合併症和增進生活品質的參考。

Colorectal cancer is the third leading cause of cancer death and its incidence rate is continuously increasing. Tumor resection is primary treatment for colorectal cancer. Studies had shown that obesity and lifestyle, such as smoking, drinking, exercise and diet habits were related to the risk of death with colorectal cancer. However, only few studies have exploratored the impact of obesity and lifestyle on postoperative recovery and health related life quality of colorectal cancer patients. Therefore, the purpose of the study is to explore influences of demographics, disease characteristics, comorbidity, nutrition (BMI、Hemoglobin and Albumin), healthly lifestyle (smoking, drinking, exercise, and diet habits) and postoperative complications on postoperative length of hospital stay and health related life quality of patients with colorectal cancer. The study is a descriptive correlational design. A convenient sample of 106 colorectal cancer patients scheduled for cancer resection surgeries will be recruited from general surgery or rectal surgery clinics of a medical center in Taipei, Taiwan. Data will be collected by using the self-reported study questionnaires, including demographic questions, Charlson comorbidity index, the Alcohol Use Disorders Identification Test, Taiwan version of International Physical Activity Questionnaire, and the Eating at America’s Table Study-Quick Food Scan. Data on BMI, diagnosis, cancer stage, operative method, hemoglobin, albumin, postoperative complications and days of hospitalization will be also collected from the patients’ chart. Data on health-related quality of life were also collected at one month post-operation by using Functional Assessment of Cancer Therapy- Colorectal instruments version 4. Data were analyzed by using the SPSS software. The frequency, percentage, mean, and standard divisionwere used to descriptive the central tendency and dispersion of distributions of the study variables. T-tests, one-way ANOVA, Chi-square tests, and Pearson’s correlation coefficient analysis were used to analyze the influences of the study variables on postoperative length of hospital stay and health-related quality of life. Multivariate linear regression analyses were used to analyze the important predictive factors of patients’ postoperative length of hospital stay and health-related quality of life at one month. The average postoperative length of stay is 10.48 (SD = 3.66) days, ranged from 6 to 25 days. Results of linear regression showed that postoperative complications, types of surgery, albumin and age were the significant predictive factors for postoperative length of hospital stay in colorectal cancer patients. The four variables together explained 45.4% of the variation (F = 6.97, p = 0.010 ) in the length of hospital stay. Patients who had laparotomy, postoperative complications, a lower level of albumin, and older age had longer postoperative length of stay in hospital. In addition, the participants’ average score on health-related quality of life was 107.43 (SD = 13.95). Results of linear regression showed that age, postoperative length of hospital stay, and education level were the significant predictive factors of health-related quality of life. The three variables together explained 24.1% of the variation (F = 4.04, p = 0.047) in health-related quality of life. Patients who were older, had a longer postoperative length of hospital stay, and had below college level of education reported lower health-related quality of life. Results of the study inform us the important influencing factor of the patients’ recovery and life quality as well as provide a foundation for developing interventions to decrease post-operative complications and promote health related quality of life.

中文摘要 …………………………………………………………………… i - ii
英文摘要 ……………………………………………………………………… iii- iv
目次 …………………………………………………………………………… v - viii
表次 …………………………………………………………………………… ix
圖次 …………………………………………………………………………… x
第一章 緒論
第一節 背景與動機 ……………………………………………………… 1
第二節 研究目的 ………………………………………………………… 2
第三節 研究假設 ………………………………………………………… 3- 4
第二章 文獻探討
第一節 結腸直腸癌流行病學……………………………………………… 5
第二節 結腸直腸癌病理分期及治療……………………………………… 6- 7
第三節 結腸直腸癌病人術後恢復及健康相關生活品質………………… 7- 9
第四節 人口學、疾病、治療特性與結腸直腸癌切除術後恢復及健康相
關生活品質的相關性………………………………………………9 -10
第五節 共病嚴重度與結腸直腸癌切除術後恢復及健康相關生活品質的
相關性……………………………………………………………… 10
第六節 營養狀況(包括身體質量指數、血紅素、白蛋白)與結腸直腸癌
切除術後恢復情形及健康相關生活品質的相關性…………… 10 -11
第七節 健康生活型態(包括抽菸、喝酒、運動習慣、飲食習慣)與結腸
直腸癌術後恢復情形及健康相關生活品質的相關性………… 11- 13
第八節 研究理論架構………………………………………………… 13 -14
第九節 名詞定義………………………………………………………… 15 -18
第三章 研究方法
第一節 研究設計 ………………………………………………………… 19
第二節 研究對象與場所………………………………………………… 19- 20
第三節 研究工具………………………………………………………… 20- 27
第四節 資料收集過程…………………………………………………… 27
第五節 資料處理分析方法……………………………………………… 28
第六節 研究倫理考量 ……………………………………………………28- 29
第四章 研究結果
第一節 研究對象之人口學、疾病及治療特性………………………… 30- 31
第二節 研究對象之營養狀況(身體質量指數、血色素、白蛋白)與健康
生活型態………………………………………………………… 35- 36
第三節 研究對象之術後住院天數與術後一個月的健康相關生活品質 38
第四節 不同人口學、疾病與治療特性、抽菸喝酒習慣、肥胖程度、
營養狀況(血色素、白蛋白)的研究對象在術後住院天數及術
後健康相關生活品質的差異情形……………………………… 39- 41
第五節 年齡、共病嚴重度、抽菸量、喝酒量、運動量、蔬果攝取量
與術後住院天數及術後健康相關生活品質之關係…………… 46
第六節 術後住院天數之重要預測因子………………………………… 49
第七節 術後一個月的健康相關生活品質重要預測因子(無住院天數) 51
第八節 術後一個月的健康相關生活品質重要預測因子(有住院天數) 53
第五章 討論
第一節 人口學特性、疾病及治療特性………………………………… 55
第二節 共病情形、營養狀況與健康生活型態………………………… 56- 58
第三節 術後住院天數與術後一個月的健康相關生活品質…………… 58- 59
第四節 人口學特性、疾病與治療特性與術後住院天數及術後一個月
健康相關生活品質之關係……………………………………… 59- 60
第五節 營養狀態與術後住院天數及術後一個月健康相關生活品質之
關係……………………………………………………………… 60- 62
第六節 年齡、共病嚴重度、健康生活型態與術後住院天數及術後一
個月的健康相關生活品質之關係…………………………… 62- 64
第七節 術後住院天數之重要預測因子………………………………… 64
第八節 術後一個月的健康相關生活品質之重要預測因子(無住院天數)64- 65
第九節 術後一個月的健康相關生活品質之重要預測因子(含住院天數) 65
第九節 研究限制………………………………………………………… 65- 66
第六章 結論與建議
第一節 結論……………………………………………………………… 67- 68
第二節 建議……………………………………………………………… 68- 70
參考資料
中文部分 ……………………………………………………………… 71- 72
英文部分 ……………………………………………………………… 73- 82
附錄 研究問卷
附錄一 人口學特性……………………………………………………… 83
附錄二 疾病資料與治療………………………………………………… 84
附錄三 查爾森共病症指標量表………………………………………… 85
附錄四 台灣活動量調查短版量表……………………………………… 86- 87
附錄五 飲食習慣問卷…………………………………………………… 88- 90
附錄六 飲酒失常識別試驗……………………………………………… 91- 92
附錄七 術後恢復資料收集表…………………………………………… 93
附錄八 結腸直腸癌病人癌症治療功能性評估量表第四版…………… 94- 95
附錄九 量表使用同意書(一)IPAQ台灣活動量調查短版量表………… 96
量表使用同意書(二)結腸直腸癌病人癌症治療功能性評估量表
第四版…………………………………………………………… 97- 99
量表使用同意書(三)飲酒失常識別試驗……………………… 100
附錄十 專家效度鑑定函(一)專家效度邀請函………………………… 101
專家效度鑑定函(二)翻譯及回翻譯過程………………………121- 124
附錄十一 專家效度評核表…………………………………………… 125- 145

于博芮、蔡新中、蔡新民、張美娟、黃靜君、林秋玉…胡名霞(2013)･ 最新傷口護理學。台北市：華杏。
台灣癌症基金會(2016)･結直腸癌簡介･2016年04月05日，取自http:// www.canceraway.org.tw/cancerpageshow.asp?IDno=431
行政院衛福部(2015a)･中華民國一百零三年死因統計結果摘要･ 2016年03月 23日，取自http://mohw.gov.tw/CHT/DOS/Statistic.aspx? f_list_no=312&fod_list_no=5488
行政院衛福部(2016b)･大腸癌防治･ 2016年05月15日，取自http://www. http://www.hpa.gov.tw/BHPNet/Web/HealthTopic/TopicArticle.aspx?No=200907210002&parentid=200802140005
行政院衛福部(2014)･中華民國一百零三年嚴正期別與治療方式統計･2017年08月19日，取自http:// tcr.cph.ntu.edu.tw/uploadimages/CA16LF103.pdf
朱育增、吳肖琪(2010)･回顧與探討次級資料適用之共病測量方法･台灣衛誌，29(1)，8-21。
李孟璋(2004)･台灣地區老人之飲食的多樣性與其營養健康狀況關係之探討(碩士 論文)･國防大學國防醫學院，台北市。
李佳倫(2006)･結直腸癌病患手術前後生活品質變化及其相關因素調查(碩士 論文)･高雄醫學大學，高雄市。
吳淑芬、井慶芸、李燕、董弘一、阮建維、趙東波（2015）･不同時期結直腸癌病人症狀困擾、憂鬱與生活品質關係之探討．護理雜誌，62(6)，68-80
吳新新、馬杰、任鹏飛、郭曉萱、郭永軍 (2016)･结直腸癌KRAS、NRAS和BRAF基因突變與病理特徵、吸菸和飲酒之間的相關性･鄭州大學學報，51(1) ，39-42。
林哲群(2012)･體育課學習態度與滿意度對身體活動之研究(碩士論文)･中國文化 大學，台北市。
林明瑩、魏秀美、王復德(2012)･住院診斷關聯群(DRGs)與感染控制･感染控制雜誌，16(4)，1-9。
林春香、劉雪娥、王正儀(1996)･大腸直腸癌症病患生活品質及其相關因素之探討･護理研究，4(1)，13-25。
冼鴻曦(2011)･護理之家住民發生轉住院的整體分析(碩士論文)･國立中山大學，高雄市。
姚開屏(2002)･健康相關生活品質概念與測量原理之簡介･台灣醫學會，6(2)， 183-192。
凃美瑜(2007)･大腸直腸癌住院病患之營養狀況評估與飲食型態之研究(碩士論文)･台南科技大學，台南市。
梁金桐、林楨國、陳進勛、江支銘、楊再勝、李政昌…陳鴻華等(2010)･大腸癌 的篩檢與監測･ 於陳明仁、唐瑞平校閱，大腸癌臨床診療指引(一版，6-10頁)。台北市：財團法人國家衛生研究。
梁金桐(2011)･大腸直腸癌的腹腔鏡微創手術．癌症新探，46．2017年08月25日，取自http://cisc.twbbs.org/lifetype/index.php?op= ViewArticle&articled
廖繼鼎(2003)･臨床腫瘤學，6，514-518。台北市：合記
劉影梅 (2004)･國際身體活動量表台灣中文版之發展與信效度驗證･國立臺灣大學，台北市。
許清曉(1996)･常用臨床檢驗手冊(第二版)，1，4。台北市：藝軒
衛福部國民健康署(2016)･肥胖防治網：成人健康體位標準･ 2016年04月02日，取自http://obesity.hpa.gov.tw/PDA/weight.aspx
謝孟樵、靳志堅、黃文詩、葉重宏、郭益宏、陳進勛…王正儀(2012)･手術前低 血漿白蛋白的結腸癌患者之相關危險因子與併發症分析･中華民國大腸直 腸外科醫學會雜誌，23(1)，6-10。
韓豫玉(2015)･大腸癌篩檢陽性追蹤個案之行為決策相關因素探討-以高雄市大寮區為例(碩士論文)･國立臺北護理健康大學護理系，台北市。
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。
American Cancer Society (2016a). Key Statistics for Colorectal Cancer. Retrieved From http://www.cancer.org/cancer/colonandrectumcancer/detailedguide
/colorectal-cancer-key-statistics
American Cancer Society (2016b). Treatment of colorectal cancer, by stage. Retrieved From http://www.cancer.org/cancer/colonandrectumcancer/ detailed guide/colorectal-cancer-treating-by-stage-colon
American Cancer Society (2016c).Types of cancer in the colon and rectum. Retrieved From http://www.cancer.org/cancer cancer/colon and rectum cancer /detailedguide/colorectal-cancer-what-is-colorectal-cancer
American Cancer Society (2016d). Colorectal cancer stages. Retrieved From http://www.cancer.org/cancer/colonandrectumcancer/detailedguide/colorectal-cancer-staged
American Cancer Society (2016e). Risk Factors for Colorectal Cancer. Retrieved from http://www.cancer.org/cancer/colonandrectumcancer/detailedguide /colorectal-cancer-risk-factors
Amri, R., Bordeianou, L. G., Sylla, P., & Berger, D. L. (2014). Obesity, Outcomes and Quality of Care: BMI Increases the Risk of Wound-Related Complications in Colon Cancer Surgery. American Journal of Surgery, 207(1), 17-23. doi: 10.1016/j.amjsurg.2013.05.016
Artinyan, A., Nunoo-Mensah, J. W., Balasubramaniam, S., Gauderman, J., Essani, R., Gonzalez-Ruiz, C…Beart R. J. (2008). Prolonged postoperative ileus-definition, risk factors, and predictors after surgery. World Journal of Surgery, 32(7), 1495- 1500. doi:10.1007/s00268-008-9491-2
Bokey, L., Chapuis, P. H., & Dent, O. F. (2014). Impact of obesity on complications after resection for rectal cancer. Colorectal Disease, 16(11), 896 -906
Bokey, E. L, Chapuis, P. H., Fung, C., Hughes, W. J., Koorey, S. G., Brewer, D. & Newland, R.C. (1995). Postoperative morbidity and mortality following resection of the colon and rectum for cancer. Diseases of the Colon & Rectum, 38(5), 480-486
Bourke, L., Thompson, G., Gibson, D. J., Daley, A., Crank, H., Ian Adam…Saxton, J. (2011). Pragmatic Lifestyle Intervention in Patients Recovering From Colon Cancer: A Randomized Controlled Pilot Study. Archives of Physical Medicine and Rehabilitation, 92(5), 749-755. doi:10.1016/j.apmr.2010.12.020
Berstad, P. Haugum, B., Helgeland, M., Bukholm, I., & Almendingen, K. (2013). Preoperative body size and composition, habitual diet, and post-operative complications in elective colorectal cancer patients in Norway. Journal of Human Nutrition and Dietetics, 26(4), 359-368. doi:10.1111/jhn.12002
Charlson, M.E., Pompei, P., Ales, K.L.& MacKenzie, C.R. (1987). A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. Journal of Chronic Diseases, 40(5), 373-383. doi:10.1016/0021-9681(87)90171-8
Cella, D. F., Tulsky, D. S., Gray, G., Sarafian, B., Lloyd, S., Linn, E…Harris, J. (1993). The Functional Assessment of Cancer Therapy (FACT) scale: Development and validation of the general measure. Journal of Clinical Oncology, 11(3), 570-579.
Compton, C. C. (2003). Colorectal Carcinoma: Diagnostic, Prognostic, and Molecular Features. Modern pathology, 16(4), 376-388. doi:10.1097/01. MP.0000062859.46942.93
Craig, C. L., Marshall, A. L., Sjöström, M., Bauman, A. E., Booth, M. L., Ainsworth, B. E… Oja, P. (2003). International physical activity questionnaire: 12-country reliability and validity. Medicine & Science in Sports & Exercise, 35(8), 1381-1395. doi:10.1249/01.MSS.0000078924.61453.FB
Deyo, R. A., Cherkin, D. C., & Ciol, M. A. (1992).Adapting a clinical comorbidity index for Use with ICD-9-CM administrative databases. Journal. Clinical Epidemiology, 45, 613-619.
Davies, N. J., Batehup, L., & Thomas, R. (2011). The role of diet and physical activity in breast, colorectal, and prostate cancer survivorship: a review of the literature. British Journal of Cancer, 105(1), 52-73. doi:10.1038/bjc.2011.423.
EI-Shami, K., Oeffinger, K. C., Erb, N. L., Willis, A., Bretsch, J. K., Pratt-Chapman, M. L…. Cowens-Alvarado, R. L. (2015). American Cancer Society Colorectal Colorectal Cancer Survivorship Care Guidelines. CA: A Cancer Journal for Clinicians, 65(6), 427-455. doi:10.3322/caac.21286
Ekkarat, P., Boonpipattanapong T., Tantiphlachiva, K., & Sangkhathat, S. (2015). Factors determining low anterior resection syndrome after rectal cancer resection: A study in Thai patients. Asian Journal of Surgery, (15), 1-7. doi:10.1016/j.asjsur.2015.07.003.
Faul, F., Erdfelder E., Buchner, A., & Lang, A.G.(2009). Statistical power analyses using G*Power 3.1:Tests for correlation and regression analyses. Behavior Research Methods, 41(4), 1149-1160. doi:10.3758/BRM.41.4.1149
Fitzgerald, P. (2012). Body mass index as an independent predictor of postoperative complications following colorectal surgery. Gastrointestinal Nursing, 10(9), 16-21. doi.org/10.12968/gasn.2012.10.9.16
Fleming, M., Ravula, S., Tatishchev, S. F., & Wang, H. L. (2012). Colorectal carcinoma: Pathologic aspects. Journal of Gastrointestinal Oncology, 3(3), 153- 173. doi:10.3978/j.issn.2078-6891.2012.030
Frasson, M., Flor-Lorente, B., Rodríguez, J. L., Granero-Castro, P., Hervás, D., Alvarez Rico, M. A…. Garcia-Granero, E. (2015). Risk Factors for Anastomotic Leak After Colon Resection for Cancer: Multivariate Analysis and Nomogram From a Multicentric, Prospective, National Study With 3193 Patients. Annals of Surgery, 262(2), 321-330. doi:10.1097/SLA.0000000000000973
Ingrid, F., Bjørg, F., Trygve, H., Kristian, E., Geir, E. E., & Karl, S.(2013). Pre-operative anaemia in colon cancer patients became normal after more than a year post-operatively but did not influence oncological outcome in the final analysis. Scandinavian Journal of Gastroenterology, 48, 663-671
Graham, C. (2013). Understanding smoking and nicotine effects on the gastrointestinal tract, Clinical, 11(1), 44-48
Giovannucci, E., Ascherio, A., Rimm, E. B., Colditz, G. A., Stampfer, M. J., & Willett, W. C.(1995). Physical Activity, Obesity, and Risk for Colon Cancer and Adenoma in Men. Annals of Internal Medicine, 122(5), 327-334. doi:10.7326/0003-4819-122-5-199503010-00002
Garth, A. K., Newsome, C. M., Simmance, N., & Crowe, T. C. (2010). Nutritional status, nutrition practices and post-operative complications in patients with gastrointestinal cancer. Journal of Human Nutrition and Dietetics, 23(4), 393-401. doi:10.1111/j.1365-277X.2010.01058.x
Haggar, F. A., & Boushey, R. P. (2009). Colorectal Cancer Epidemiology: Incidence, Mortality, Survival, and Risk Factors. Clinic Colon Rectal Surgery, 22(4), 191-197. doi:10.1055/s-0029-1242458
Hyman, N., Manchester, T. L., Osler, T., Burns, B., & Cataldo, P. A. (2007). Annals of Surgery, 245(2), 254-258.
Hamama-Raz , Y., Shrira , A., Ben-Ezra, M., & Palgi, Y. (2015). The recursive effects of quality of life and functional limitation among older adult cancer patients: evidence from the Survey of Health, Ageing and Retirement in Europe. European journal of cancer care, 24(2), 205-212. doi:10.1111/ecc.12300
Hayden, D. M., Mora Pinzon, M. C., Francescatti, A. B., & Saclarides, T. J. (2014). Patient factors may predict anastomotic complications after rectal cancer surgery: Anastomotic complications in rectal cancer. Annals of Medicine and Surgery, 4 (1), 11–16. doi:10.1016/j.amsu.2014.12.002
Haskins, I.N., Baginsky, M., Amdur, R. L., & Agarwal. S. (2017).Preoperative hypoalbuminemia is associated with worse outcomes in colon cancer patients. Clinical Nutrition, 36(5), 1333-1338. doi.org/10.1016/j.clnu.2016.08.023
Inouye, S. K., Wagner, D. R., Acampora, D., Horwitz, R. I., Cooney , L. M., Hurst, L. D., & Tinetti, M. E. (1993). A predictive index for functional decline in hospitalized elderly medical patients. Journal of General Internal Medicine, 8(12), 645-652
Kim, M. J., Shin, R., Oh, H. K., Park, J. W., Jeong, S. Y., & Park, J. G. (2011). The impact of heavy smoking on anastomotic leakage and stricture after low anterior resection in rectal cancer patients. World Journal Surgery, 35(12), 2806-2810. doi:10.1007/s00268-011-1286-1
Kanera1, I. M., Bolman, C. A., Mesters, I., Willems, R. A., Beaulen, A. A., & Lechner, L. (2016). Prevalence and correlates of healthy lifestyle behaviors among early cancer survivors. BMC Cancer, 16(4). 1-18. doi:10.1186/s12885-015-2019-x
Kirchhoff, P., Clavien, P. A., & Hahnlose, D. (2010). Complications in colorectal surgery: risk factors and preventive strategies. Patient Safety in Surgery, 4(1), 5. doi:10.1186/1754-9493-4-5
Kilic, D., Yalman, D., Aksu, G., Atasoy, B. M., Igdem, A., Dincbas, F. O., & Yalcin, S. (2012). Impact of adjuvant chemoradiotherapy for rectal cancer on the long-term quality of life and late side effects: A multicentric clinical evaluation by the Turkish Oncology Group. Asian Pacific Journal of Cancer Prevention, 13(11), 5741-5746
Lee, J., Meyerhardt, J. A., Giovannucci, E., & Jeon, J. Y. (2015). Association between Body Mass Index and Prognosis of Colorectal Cancer: A Meta-Analysis of Prospective Cohort Studies. PLOS ONE, 10(3), e0120706. doi:10.1371/journal.pone.0120706
Lohsiriwat, V., Chinswangwatanakul, V., Lohsiriwat, S., Akaraviputh, T., Boonnuch, W., Methasade, A., & Lohsiriwat, D. (2007). Hypoalbuminemia is a predictor of delayed postoperative bowel function and poor surgical outcomes in right-sided colon cancer patients. Asia Pacific Journal of Clinical Nutrition, 16 (2), 213-217
Lewis, C., Xun, P., & He, K. (2014). Physical activity in relation to quality of life in newly diagnosed colon cancer patients: a 24-month follow-up. Quality of Life Research, 23(8), 2235-2246. doi:10.1007/s11136-014-0679-7
Leung, S., F, & Arthur, D. (2000). The alcohol use disorders identification test (AUDIT): validation of an instrument for enhancing nursing practice in Hong Kong. Internal Journal Nursing Studies. 37(1), 57-64. doi: 10.1016/S0020-7489(99)00052-8
Meyerhardt, J. A., Niedzwiecki, D., Hollis, D., Saltz, L. B., Hu, F. B., Mayer, R. J.…Fuchs, C. S. (2007). Association of dietary patterns with cancer recurrence and survival in patients with stage III colon cancer. JAMA, 298(7), 754-764. doi:10.1001/jama.298.7.754
McDermott, F. D., Heeney, A., Kelly, M. E., Steele, R. J., Carlson, G. L., & Winter, D.C. (2015). Systematic review of preoperative, intraoperative and postoperative risk factors for colorectal anastomotic leaks. British Journal of Surgery, 102(5), 462-479. doi:10.1002/bjs.9697
McKay, G. D., Morgan, M. J., Wong, S. K., Gatenby, A. H., Fulham, S. B., Ahmed, K.W…. Hitos, K. (2012). Improved short-term outcomes of laparoscopic versus open resection for colon and rectal cancer in an area health service: a multicenter study. Diseases of the Colon & Rectum, 55(1), 42-50. doi:10.1097/DCR.0b013e318239341f
Momeni, M., Ghanbari, A., Jokar, F., Rahimi, A., & Leyli, E. K. (2014). Predictors of quality of life in patients with colorectal cancer in Iran. Indian Journal of Cancer, 51(4), 550-556.
Mandell, L. A., Wunderink, R. G., Anzueto, A., Bartlett, J. G., Campbell, G. D., Dean, N. C…. Whitney, C. G. (2007). Infectious Diseases Society of America/American Thoracic Society Consensus Guidelines on the Management of Community-Acquired Pneumonia in Adults. Clinical Infectious Diseases, 44, S27-72. doi:10.1086/511159
NCCN (2014). Colon Cancer: Treatment guide. Retrieved from http://www.nccn.org /patients/guidelines/colon/index.html#17/z
National Cancer Institute (2015). Fruit & Vegetable Screeners in the Eating at America's Table Study (EATS): Overview. Retrieved from
http://epi.grants.cancer.gov/diet/screeners/fruitveg/
Onerup, A., Angerås, U., Bock, D., Börjesson, M., Fagevik, O. M., Gellerstedt, M….Angenete, E. (2015). The preoperative level of physical activity is associated to the postoperative recovery after elective cholecystectomy- A cohort study, International Journal of Surgery, 19, 35-41. doi:10.1016/j.ijsu.2015.05.023
Post-procedure recovery. (n.d.) Mosby's Medical Dictionary, 8th edition. (2009). Retrieved April 3 2016 from http://medical-Dictionary.thefreedictionary. com/post-procedure+recovery
Pan, L. H., & Tsai, Y. F. (2012). Quality of life in colorectal cancer patients with diarrhoea after surgery: a longitudinal study. Journal of Clinical Nursing, 21(15-16), 2357-2366. doi: 10.1111/j.1365-2702.2011.04034
Pelser, C., Arem, H., Pfeiffer, R.M., Elena, J.W., Alfano, C.M., Hollenbeck, A.R., & Park, Y. (2014). Prediagnostic lifestyle factors and survival after colon and rectal cancer diagnosis in the National Institutes of Health (NIH)-AARP Diet and Health Study. Cancer, 120(10), 1540-1547. doi:10.1002/cncr.28573
Richards, C. H., Campbell, V., Ho, C., Hayes, J., Elliott, T., & Thompson-Fawcett, M. (2012). Smoking is a major risk factor for anastomotic leak in patients undergoing low anterior resection. Colorectal Disease, 14(5), 628-633. doi:10.1111/j.1463-1318.2011.02718
Rock, C.L., Doyle, C.D., Demark-Wahnefried, W., Meyerhardt, J., Courneya, K.S., Schwartz, A.L…. Gansler, T. (2012). Nutrition and physical activity guidelines for cancer survivors. CA: A Cancer Journal for Clinicians, 62(4), 243-374. doi:10.3322/caac.21142
Stevinson, C., Lydon, A., Amir, Z. (2014). Adherence to physical activity guidelines among cancer support group participants. European Journal of Cancer Care, 23(2), 199-205. doi:10.1111/ecc.12145
Staiano, A. E., Reeder, B. A., Elliott, S., Joffres, M. R., Pahwa, P., Kirkland, S. A….Katzmarzyk, P. T. (2012). Body mass index versus waist circumference as predictors of mortality in Canadian adults. International Journal of Obesity, 36(11), 1450-1454. doi:10.1038/ijo.2011.268
Scheele, J., Lemke, J., Meier, M., Sander, S., Sander, S., Henne-Bruns, D., & Kornmann, M. (2015). Quality of Life After Sphincter-Preserving Rectal Cancer Resection. Clinical Colorectal Cancer, 14(4), e33-40. doi:10.1016/j.clcc.2015.05.012
Torre, L. A., Bray, F., Siegel, R. L., Ferlay, J., Lortet-Tieulent, J., & Jemal, A. (2015). Global cancer statistics, 2012. CA: A Cancer Journal for Clinicians, 65, 87–108.
Tønnesen, H., Nielsen, P. R., Lauritzen, J. B., & Møller, A. M. (2009). Smoking and alcohol intervention before surgery: evidence for best practice. British Journal of Anesthsia, 102(3), 297-306. doi:10.1093/bja/aen401
Thompson, F. E., Subar, A. F., Smith, A. F., Midthune, D., Radimer, K. L., Kahle, L. L. & Kipnis, V. (2002). Fruit and vegetable assessment: performance of 2 new short instruments and a food frequency questionnaire. Journal of the American Dietetic Association, 102(12), 1764-1772. doi:10.1016/S0002-8223(02)90379-2
Terry, B. (2012). Physical Activity and Colon Cancer Timing, Intensity, and Sedentary Behavior. Journal of the SAGE, 6(3), 204-215. Doi: 10.1177/1559827612436932
Warburton, D. E., Katzmarzyk, P. T., Rhodes, R. E., & Shephard, R. J. (2007). Evidence-informed physical activity guidelines for Canadian adults. Canadian Journal of Public Health, 98(2), S16-68. doi:10.1139/H07-123
World Cancer Research Fund International (2012). Worldwide data. 2016年04月05 日，Retrieved from http://www.wcrf.org/int/cancer-facts-figures/worldwide-data
World Health Orgnization (2015). Cancer. 2016年04月05日，Retrieved from http://www.who.int/mediacentre/factsheets/fs297/en/
Willett, W.C. (2005). Diet and Cancer: An Evolving Picture. JAMA, 293(2), 233–234. doi:10.1001/jama.293.2.233.
Wick, E. C., Hirose, K., Shore, A. D., Clark, J. M., Gearhart, S. L., Efron, J., & Makary, M.A. (2011). Surgical Site Infections and Cost in Obese Patients Undergoing Colorectal Surgery. Archives of Surgery, 146(9). 1068-1072. doi:10.1001/archsurg.2011.117
Yan, Y., Birman-Deych, E., Radford. M. J., Nilasena, D. S., & Gage, B. F. (2005). Comorbidity indices to predict mortality from medicare data: results from the national registry of atrial fibrillation. Medical Care, 43(11). 1073-1077.doi: 10.1097/01.mlr.0000182477.29129.86
Yang, Z., Lu, Y. B., Li, Y. F., Wan, C. H., Luo, J. H., Meng, Q., & Zhang, X. Q. (2007). Evaluation of the Functional Assessment of Cancer Therapy-Colorectal (V4.0) in Chinese Version, JOURNAL OF CLINICAL REHABILITATIVE TISSUE ENGINEERING RESEARCH, 11(43), P8753 – 8756. doi:10.3321/j.issn/;1673-8225.2007.43.047
Yoo, H. J., Kim, J, C., Eremenco, S, & Han, O, S. (2005). Quality of Life in Colorectal Cancer Patients with Colectomy and the Validation of the Functional Assessment of Cancer Therapy-Colorectal (FACT-C), Version 4. JOURNAL OF PAIN and SYMPTOM MANAGEMENT, 30(1), 24-32. doi.org/10.1016/j.jpainsymman.2004.12.009
Zhang, J., Su, X. Q., Zheng, J. Q., Gu, J., Zong, X. L., Wang, Y., & Ji, J. F. (2003). EFFECT OF BODY MASS INDEX ON COLORECTAL CANCER. Chinese Journal of Cancer Research, 15(3), 189-194. doi:10.1007/s11670-003-0024-0
Zhou, Y., Wu, L., Li, X., Wu, X., & Li, B. (2012). Outcome of laparoscopic colorectal surgery in obese and non obese patients: a meta-analysis. Surgical Endoscopy, 26(3), 783-789. doi:10.1007/s00464-011-1952-2
Zhu, Y., Yang, S. R., Wang, P. P., Savas, S., Wish, T., Zhao, J.…Campbell, P. T. (2014). Influence of pre-diagnostic cigarette smoking on colorectal cancer survival: overall and by tumour molecular phenotype. British Journal Cancer, 110(5), 1359-1366. doi:10.1038/bjc.2014.6