| 摘要: | 本研究目的在探討乳癌患者身體症狀、睡眠品質及不確定感現況及影響因素，採橫斷性相關性研究設計，於北部某區域教學醫院門診收案，共收案150位乳癌婦女，請研究對象填答包含基本屬性、身體症狀量表、睡眠品質量表、不確定感量表之結構性問卷，使用描述性統計、t檢定、單因子變異數分析、皮爾森積差相關及逐步迴歸分析等推論性統計進行資料分析。
本研究對象之平均年齡57.7±9.4歲，罹患乳癌平均5.3±5.2年，多數為第一期(34%)及第二期(34.7%)患者，至少接受一項治療者佔76.7%。研究結果顯示，乳癌患者之身體症狀困擾程度不明顯(單題平均0.38分)，不確定感之單題平均2.01分，顯示對不確定感之題項多趨向「不同意」，但睡眠品質不良(平均6.53±4.04)。病人的宗教信仰、復發情形影響身體症狀困擾程度；教育程度、自覺健康狀態影響睡眠品質；自覺健康狀態、復發、轉移情形影響不確定感受。逐步迴歸分析顯示，乳癌患者身體症狀的預測因子包括睡眠品質總分及不確定感總分，可解釋總變異量的26.9%；睡眠品質的預測因子包括身體症狀總分、教育年數及不確定感總分等三項，可解釋總變異量的31.9%；不確定感的預測因子包括睡眠品質總分、醫護團隊支持及身體症狀總分，可解釋總變異量的19.2%。本研究對象存在睡眠品質問題較國外文獻嚴重，然使用安眠藥之人數卻低於國外文獻，可能因擔心長期使用安眠藥之副作用，惡性循環下導致平均睡眠時數不足七小時，建議護理師除主動提供改善睡眠問題之輔助與另類療法外，也應鼓勵個案善用藥物，舒緩睡眠品質問題，將有利於身體症狀困擾、不確定感之緩解。
The purpose of this descriptive cross-sectional study was to examine the levels of physical symptoms, sleep quality and uncertainty, their associated factors, relationships between them and predictors among breast cancer patients. A total of 150 breast cancer women were enrolled at a teaching hospital in northern Taiwan. The instruments used included Personal Data Questionnaire, the Physical Symptoms Scale, Pittsburgh Sleep Quality Index and Uncertainty in Illness Scale. Data were analyzed by descriptive statistic, t-test, one-way ANOVA, Pearson product-moment correlation and Stepwise regression.
The mean age of participants was 57.7 years (SD 9.4) who were 5.3 years post-diagnosis for breast cancer (SD5.2). With regard to cancer stage, 34.7% had StageⅡ and 34% StageⅠ. Most participans (76.7%) were received at least one type of cancer treatment. The results showed that women without obvious physical symptom distress (mean 0.38), lower levels of uncertainty (mean 2.01), and poor sleep quality (PSQI=6.53). Religion and recurrence were statistically associated with physical symptoms. Education and health status were statistically associated with sleep quality. Health status, recurrence and metastasis were statistically associated with physical symptoms. Sleep quality and uncertainty were significant predictors of physical symptoms, which could explain 26.9% of the total variance. Physical symptoms, education years and uncertainty were significant predictors of sleep quality, which could explain 31.9% of the total variance. Sleep quality, social support from health care providers and physical symptoms were significant predictors of uncertainty, which could explain 19.2% of the total variance. The subjects had poor sleep quality who slept less than seven hours per night. They may be worried about the side effects of long-term taking sleeping pills. Thus, this study suggested that the clinical nurses should provide information on complementary and alternative therapies. They also encourage patients to use sleeping pills properly. Improving sleep quality may be an important way to reduce the uncertainty and physical symptom distress among breast cancer patients. |
