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研究生:李曉蘋
研究生(外文):LI, HSAIO-PING
論文名稱:癌症病患非預期入院的絕望感、靈性安適 與生活品質之探討
論文名稱(外文):The Exploration of Cancer Patients’ Hopelessness, Spiritual Well-Being and Quality of Life During Unexpected Hospital Admission
指導教授:劉芳劉芳引用關係
指導教授(外文):LIU, FANG
口試委員:黃采薇林彥光劉芳
口試委員(外文):HUANG, TSAI-WEILIN, YEN-KUANGLIU, FANG
口試日期:2022-05-31
學位類別:碩士
校院名稱:臺北醫學大學
系所名稱:護理學系碩士在職專班
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:2022
畢業學年度:110
語文別:中文
論文頁數:118
中文關鍵詞:非預期入院絕望感靈性安適生活品質
外文關鍵詞:Unexpected Hospital AdmissionHopelessnessSpiritual Well-BeingQuality of Life
相關次數:
  • 被引用被引用:1
  • 點閱點閱:232
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  • 下載下載:1
  • 收藏至我的研究室書目清單書目收藏:1
癌症是一個令人聞之色變的疾病,並且蟬聯台灣十大死因第一名數十年。當確診罹癌後所造成的情緒衝擊,容易帶給病患及家屬負面的影響,在面臨後續癌症本身及其治療方式,所造成的身體不適更是會降低生活品質及增加情緒困擾,進而產生出絕望感。本研究主要目的在探討癌症患者非預期入院的絕望感、靈性安適與生活品質,並了解三者的相關性,更進一步探討癌症病患在非預期入院時所帶來的衝擊,及靈性安適在這衝擊中的角色及保護機轉為何,本研究採橫斷式研究設計,共收集174位不同診斷的癌症患者,分別因不同原因住院治療,並以人口學資料、貝氏絕望感量表(BHS)、慢性疾病治療功能評估-靈性安適感量表(FACIT-Sp)、癌症治療功能性生活品質量表(FACT-G),做為資料收集工具。
研究發現超過一半癌症病患(52.9%)非預期入院時有低程度的絕望感(M = 8.35);靈性未獲得安適(M = 22.1)者共有145人(83.3%),148位患者(85.1%)對生活品質感到不滿意(M = 48.92)。在絕望感與靈性安適總分呈現顯著負相關(r = -0.780, p < .001),絕望感與靈性安適中的生活意義∕平靜與宗教力量兩部分(r = -0.799, p < .001;r = -0.567, p < .001),在統計學上均呈現顯著負相關,代表研究個案絕望感越高時, 
靈性安適程度會越低。在絕望感與生活品質總分有顯著負相關(r = -0.717, p < .001),代表絕望感越高,整體生活品質與各個面向的品質均越差。而在靈性安適與生活品質兩者總分則呈現顯著正相關(r = 0.811, p < .001),本研究進一步以迴歸分析檢驗靈性安適對絕望感和生活品質的中介效果(mediating effect),顯示靈性安適對絕望感和生活品質中介效果顯著(p < .001),表示絕望感會透過靈性安適影響生活品質。
綜合以上研究結果讓我們清楚知道,絕望感與靈性安適、生活品質三者呈現顯著相關,了解這三者的相關性後,也證實靈性安適在三者之間扮演保護緩解的角色,病患可以藉著靈性安適來提升生活品質,降低絕望感,藉此研究使臨床醫護人員更加了解癌症患者的需求,適時的給予患者幫助與對抗疾病的力量。

Cancer is a dreaded disease and has been ranked first among the top ten causes of death in Taiwan for decades.The emotional shock caused by the diagnosis of cancer can easily have a negative impact on patients and their families. The physical discomfort that comes with receiving the cancer itself and its treatment can reduce quality of life, increase emotional distress, and lead to hopelessness.The main purpose of this study is to explore the sense of hopelessness, spiritual well-being and quality of life of cancer patients who are unexpectedly admitted to hospital, and to understand the relationship between the three, and to further explore the impact of cancer patients when they are unexpectedly admitted to the hospital, the role of spiritual well-being as well as the impact and the protection mechanism of spiritual well-being.This study adopted a cross-sectional study design, collecting a total of 174 cancer patients with different diagnoses, hospitalized for different reasons, demographic data, Beck Hopelessness Scale(BHS), Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being(FACIT-Sp), and Functional Assessment of Cancer. Therapy-General Scale (FACT-G)as a data collection tool.
The study found that a total of 92 cancer patients(52.9%)had a low degree of hopelessness(M = 8.35)when they were unexpected to be admitted
to hospital, a total of 145(83.3%)felt spiritual discomfort(M = 22.1), 148 (85.1%)patients were dissatisfied with the quality of life(M = 48.92). there was a significant negative correlation between the total score of hopelessness and spiritual well-being(r = -0.780, p < .001); the statistical significance of sense of hopelessness and the spiritual well-being of meaning/Peace and religious strength shown negative correlation,(r = -0.799, p < .001; r = -0.567, p < .001)indicating that the higher the sense of hopelessness , the lower the spirituality in the study cases. the statistical significance of hopelessness and quality of life shown negative correlation(r = -0.717, p < .001), indicating that the higher the sense of hopelessness , the lower the quality of life in the study cases, there was a significant positive correlation between spiritual well-being and quality of life(r= 0.811, p < .001), a regression analyse assessed by generalized linear model showed spiritual well –being is a partial mediating have on quality of life, hopelessness(p < .001),indicating that hopelessness affects the quality of life through spiritual comfort.
The results of the study showed that the sense of hopelessness was significantly correlated with spiritual well-being and quality of life. After understanding the correlation,it is also confirmed that spiritual well-being has the ability to protect and relieve, patients can improve their quality of life and reduce their despair through spiritual comfort. This research enables clinicians and nurses to better understand the needs of cancer patients and give patients timely help and strength to fight the disease.

致謝........................................................I
中文摘要....................................................II
英文摘要...................................................III
目錄........................................................IV
圖表目次......................................................IX
圖目次.......................................................IX
表目次.......................................................X
第一章 序論..................................................1
第一節 研究動機 ..............................................1
第二節 研究重要性.............................................3
第三節 研究目的...............................................4
第二章 文獻查證 ...............................................5
第一節 非預期入院..............................................5
第二節 絕望感與靈性安適.........................................8
第三節 生活品質................................................17
第三章 研究方法................................................22
第一節 研究設計與架構...........................................22
第二節 研究場所與研究對象........................................24
第三節 研究工具及其效度..........................................25
第四節資料收集過程與倫理考量.......................................29
第五節資料分析方法................................................30
第四章 研究結果...................................................31
第一節 研究對象之基本資料、絕望感、靈性安適及生活品質................31
第二節癌症病患非預期入院的絕望感....................................38
第三節癌症病患非預期入院的靈性安適..................................45
第五節 癌症病患不預期入院的絕望感、靈性安適感與生活品質之相關性分析....68
第六節靈性安適於絕望感、生活品質關係間中介作用.......................70
第五章 討論.......................................................72
第一節病患非預期入院時的絕望感......................................72
第二節病患非預期入院時的靈性安適.....................................75
第三節病患非預期入院時的生活品質......................................77
第四節絕望感、靈性安適與生活品質之相關性...............................80
第五節靈性安適在癌症病患的絕望感與生活品質之中介效果....................81
第六章結論與建議......................................................82
第一節結論...........................................................82
第二節研究限制.......................................................83
第三節建議...........................................................84
參考文獻 ............................................................85
中文部分 ............................................................85
英文部分 ............................................................89
附件一 人口學資料調查表..............................................108
附件二 貝克絕望量表(BHS).............................................110
附件四 癌症治療功能性評估生活品質量表( FACT-G).........................112
附件五 FAICT-SP與 FACT-G問卷使用授權書................................114
附件六 研究倫理委員會審核通過證明文件..................................116
圖表目次
圖目次
圖一 靈性安適架構圖...................................................14
圖二 生活品質、身體功能狀態及幸福感之關係圖.............................19
圖三 癌症病患非預期入院的絕望感、靈性安適...............................23
圖四 絕望感、靈性安適與整體生活品質量表間之關係(中介作用).................71 
表目次
表4-1-1 個人基本資料與絕望感、靈性安適及生活品質變項分析.................33
表4-2-1 貝克絕望感量表(BHS)之答題情形..................................39
表4-2-2 絕望感之差異分析...............................................41
表4-3-1 慢性疾病治療功能評估-靈性安適感量表(FACIT-SP)之描述性分析........46
表4-3-2 靈性安適之差異分析.............................................48
表4-4-1 生活品質量表(FACT-G)之描述性分析................................57
表4-4-2 生活品質之差異分析..............................................60
表4-5-1 貝克絕望、靈性安適感與生活品質量表間之相關性......................69
表4-6-1「絕望感→靈性安適→生活品質」之中介效果回歸分析.....................70

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