臺灣博碩士論文加值系統

背景：乳癌是全世界女性最常見的癌症，占全部癌症11.6%，位居臺灣女性癌症首位，人類健康指標不僅著重罹病率和存活率，需要更加重視生活品質。失志是一種情緒不安狀態，婦女對病程進展充滿不安，將影響疾病預後及生活品質。
目的：探討乳癌病人失志狀態與生活品質之相關性。
方法：採橫斷式研究設計，以結構式問卷調查法，收案對象為北區某區域醫院血液腫瘤科門診乳癌婦女，問卷包含背景資料、中文版失志量表(量表總分以30分為分界，以上為高失志，以下為低失志)、臺灣簡明版世界衛生組織生活品質問卷(分數愈高，表示生活品質愈佳)。
結果：共收案114位乳癌婦女，79.8%為年齡51歲以上、罹癌時間超過5年以上有61.4%、98.2%曾經做過手術治療。個案生活品質量表平均數56.11±6.74，乳癌婦女有29.8%(34人)處在高失志狀態，在失志狀態與生活品質之相關性，結果顯示低失志的乳癌婦女在整體生活品質平均數高於高失志的婦女，且達統計上顯著差異(58.94>49.44，p＜0.001)；低失志的乳癌婦女在生活品質之環境、生理、社會關係以及心理範疇，平均數皆高於高失志婦女，均達統計上顯著差異(分別為15.04>12.77、14.99>12.35、14.56>13.18、14.35>11.14，p＜0.001)。
結論/實務應用：研究發現近三成乳癌婦女處於高失志程度且生活品質較低。乳癌是威脅女性健康原因，面對罹癌的衝擊與治療的擔憂，失志的狀態深切影響生活品質的變化，給予乳癌患者個別性之關懷，有效降低失志程度，有助於提升生活品質水平。

Background: Breast cancer was the most common form of cancer among women worldwide, accounting for nearly 11.6% of all cases. Breast cancer ranked first among all types of cancer in Taiwanese women. When assessing health indicators, clinicians should pay significant attention to quality of life, in addition to other factors such as morbidity and survival rate. Demoralization was a state of emotional anxiety. Excessive anxiety about disease progression among women could significantly affect disease progression and quality of life.
Objective: To explore the correlation between demoralization and quality of life in breast cancer patients.
Methods: We adopted a cross-sectional study design used a structured questionnaire survey for data collection. The participants were women with breast cancer, enrolled from the Hematology and Oncology Outpatient Clinic of a regional hospital in Northern Taiwan. The questionnaire included questions on patient’s background information, the Chinese version of demoralization scale (the total score was divided by a cut-off score of 30, wherein a score >30 points indicated a high level of demoralization and a score <30 points indicated a low level of demoralization), and the brief Taiwanese version of World Health Organization Quality of Life Questionnaire (the higher the score, the better the quality of life).
Results: A total of 114 women with breast cancer were enrolled. Among them, 79.8% were aged over 51 years, 61.4% had cancer for longer than five years, and 98.2% had undergone surgery. The average score on the quality-of-life scale was 56.11±6.74 points, and 29.8% (34 participants) women were highly demoralized. A correlation between demoralization and quality of life revealed that a low level of demoralization was linked to a higher average quality of life among women with breast cancer, which was higher than that in women with a high level of demoralization (58.94>49.44, P<0.001). In addition, the average quality of life scores assessed in terms of the environment, physiology, social relations, and psychology was higher among women with a low level of demoralization than in those with a high level of demoralization, with a statistically significant difference (15.04>12.77, 14.99>12.35, 14.56>13.18, 14.35>11.14, P<0.001).
Conclusion/Practical application: The study found that nearly 30% of the women with breast cancer had a high level of demoralization and low quality of life. Breast cancer was a significant threat to women’s health. While confronting the impact of cancer and treatment anxiety, the state of demoralization could profoundly impact the patient’s quality of life. Providing breast cancer patients with personalized care could effectively reduce demoralization and help improve the quality of life.

第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的 5
第三節 研究流程 6

第二章 文獻探討 7
第一節 乳癌之概況 7
第二節 乳癌與失志之探究 9
第三節 乳癌病人生活品質之相關因素 13
第四節 乳癌失志狀態和生活品質之相關性 14

第三章 研究方法 18
第一節 研究架構 18
第二節 名詞定義 19
第三節 研究對象 20
第四節 研究工具 21
第五節 研究步驟 24
第六節 資料處理與分析 25

第四章 研究結果 27
第一節 乳癌婦女失志狀態和生活品質之分布現況 27
第二節 乳癌婦女基本屬性及疾病特性與生活品質之相關性 33
第三節 乳癌婦女失志狀態與生活品質之相關性 44

第五章 討論 46
第一節 乳癌婦女失志狀態和生活品質之分布現況 46
第二節 乳癌婦女基本屬性及疾病特性與生活品質之相關性 48
第三節 乳癌婦女失志狀態與生活品質之相關性 50

第六章 結論與建議 52
第一節 結論 52
第二節 研究限制 53
第三節 建議 53

參考文獻 54

附錄一 本研究問卷量表 72
附錄二 失志量表研究工具使用同意書 76
附錄三 臺灣版世界衛生組織生活品質問卷使用授權書 77
附錄四 人體試驗倫理委員會研究同意證明書 78

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