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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 陳端容 | |
dc.contributor.author | Shyi-Gen Chen | en |
dc.contributor.author | 陳錫根 | zh_TW |
dc.date.accessioned | 2021-06-08T06:15:10Z | - |
dc.date.copyright | 2007-02-27 | |
dc.date.issued | 2007 | |
dc.date.submitted | 2007-02-01 | |
dc.identifier.citation | 【中文部分】
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/25480 | - |
dc.description.abstract | 研究目的: 乳癌發生率逐年攀升,為增加幅度最高的女性癌症,高居婦女癌症的第一位。乳癌的早期診斷治療,大幅提升了乳癌患者的存活率。但乳癌切除治療將使乳癌婦女喪失乳房,造成婦女生理、心理極大的衝擊。國外許多文獻顯示在切除乳房後,若配合適當的乳房重建手術對於乳癌術後婦女身、心、社會各方面都具有正面的影響結果。但在台灣,病患接受乳房重建與否的相關因素、乳房重建對身體形象的影響、滿意度或健康相關生活品質的研究不多,是相當值得研究的議題。
研究方法:本研究係採橫斷式、立意取樣、非開放式的結構型問卷收集資料。以北部四所醫學中心的乳癌病友團體為研究對象,共收案165位乳癌婦女。探討乳癌切除的婦女接受乳房重建與否與「個人特質」、「社會支持度」、「乳房疾病特徵」、「乳房重建認知」、之相關性。以「身體形像量表」、「健康相關生活品質」為研究工具,並分析乳房重建者的滿意度 。使用SPSS 12 for Windows電腦統計套裝軟體進行描述性與推論性統計分析。 結果:研究結果發現:病患平均年齡51± 10.2歲(24~80),其中52人(31.5%)接受乳房重建手術,重建手術的方法選擇用鹽水袋的有27人(51.92%),選擇自體組織的有25人(48.08%)。當時決定接受乳房重建最主要的考量因素為「穿衣服的方便」(44人, 17.3%)、其次是「心理上的需要」(38人, 14.9%)、「美觀」(35人, 13.7%)。當時如何決定接受重建以「自己決定」、「醫師建議」和「親人支持」為最主要因素,分別為38人(40%)、20人(21.1%)、18人(18.9%)。至於沒有接受重建手術的原因最主要為「害怕手術」(40人, 15.3 %),其次為「有沒有乳房無所謂」(34人, 13.0%)、「擔心手術併發症」和「費用太高」(28人, 10.7 %)。多變項羅吉士迴歸分析,在控制其他變項後,年齡、親人支持度和乳癌手術方式為影響是否接受乳房重建的顯著相關因素。乳癌切除後婦女的身體形象因素,雖然在雙變項以及初步迴歸中達到統計上的顯著意義,在最終模式中並無顯著意義;但有接受重建手術者,其術前術後身體形象分數顯著改善。至於是否接受乳房重建手術與健康相關生活品質之相關性,在生理功能(PF)、因身體健康所導致的角色限制(RP)、一般健康狀況(GH)、因情緒問題所導致的角色限制(RE)與生理面向健康生活品質,皆呈現了統計上的正相關顯著意義。對乳房重建的滿意度方面,整體的滿意度為可接受及滿意者達86.4%,92.2%的人會再一次選擇乳房重建,94.2%的人會推薦乳房重建手術給其他病友。 結論:(一) 本研究可促進臨床醫護人員對影響是否接受乳房重建之相關因素的了解,提供乳癌治療之完整性,並提升乳癌治療之品質。(二) 重建手術可以明顯改善乳癌切除婦女的身體形象。(三)接受乳房重建者比起未接受乳房重建者,在生理功能、因身體健康所導致的角色限制、一般健康狀況、因情緒問題所導致的角色限制與生理面向上,有較高的健康生活品質。(四)對乳房重建整體的滿意度相當高,而且樂意推薦其他病友,顯示乳房重建是值得推廣的手術。 | zh_TW |
dc.description.abstract | Background and Purpose: Breast cancer is the leading cancer of women in Taiwan nowadays and also in the western countries. Most studies are focused on the cancer epidermiology, pathology, diagnosis, and treatment modalities. The purpose of this study was to investigate the influence factors of breast cancer women’s decisions for or against breast reconstruction,, health-related Quality of life (QOL SF-36), and satisfaction of breast reconstruction.
Material and Method: We performed a cross-sectional, purposive sampling study in 4 breast-supporting groups in 4 teaching-based hospitals in Taipei. From Jan. 1997 to Dec. 2006, women had mastectomy and/or breast reconstruction at any of hospitals were considered eligible for the study. No age restrictions were imposed. However, women were excluded from the study if they had cancer metastasis. Postal Questionnaires were delivered and collected for analysis of patients' demographics, diseases profiles, social support, body image scale, and QOL SF-36. Data were analyzed using SPSS for Windows version 12. Result: Total 165 patients were valid for study including 52(31.5%) women who had postmastectomy breast reconstruction. Expert content validity and Cronbach's alpha reliability were reported in the context. The results showed that: (1) Age, family support, and mastectomy types were important factors for women’s decision for or against breast reconstruction. (2)The most frequently reason for not having breast reconstruction was fear of the reconstructive operation, followed by not essential for the breast, fear of the surgical complications, and expenses. The most frequently reason for having reconstruction was to be able to wear many different types of clothing, psychological demand, and cosmetic. (4) The participants who had undergone breast reconstruction had better global health-related quality of life. (5) The overall satisfaction of breast reconstruction was high and recommendable. Conclusion: This study provides important informations for clinical staffs to understand the determinants for women to have or not breast reconstrtuction. Family support is important factor for women to have breast reconstruction. Breast reconstruction can significantly improve patients’ body image scale and make a substantial contribution to health-realted Quality of life for breast cancer patients especially for the younger women. | en |
dc.description.provenance | Made available in DSpace on 2021-06-08T06:15:10Z (GMT). No. of bitstreams: 1 ntu-96-P93843014-1.pdf: 775512 bytes, checksum: a0e43ada22c73ebbf629514ed0567bb7 (MD5) Previous issue date: 2007 | en |
dc.description.tableofcontents | 誌謝……………………………………………………………………Ⅰ
中文摘要………………………………………………………………Ⅲ 英文摘要………………………………………………………………Ⅴ 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 第二章文獻探討…………………………………………………………6 第一節 乳癌流行病學、治療方式與預後……………………………6 第二節 乳癌切除手術對婦女的影響及乳房重建手術的介紹………15 第三節.乳癌切除婦女接受乳房重建的決定相關因素……………21 第四節.健康相關生活品質的概念…………………………………26 第五節綜合討論……………………………………………………28 第三章 研究設計與方法……………………………………………31 第一節.研究設計與架構………………………………………………31 第二節.研究變項………………………………………………………32 第三節.研究假說………………………………………………………33 第四節.研究對象與場所、研究工具…………………………………33 第五節.資料處理與分析……………………………………………38 第 四 章 研究結果……………………………………………………68 第一節描述性分析……………………………………………………68 第二節雙變項分析……………………………………………………75 第三節多變項分析……………………………………………………77 第五章討論……………………………………………………………110 第一節研究資料之品質………………………………………………110 第二節研究結果討論…………………………………………………111 第三節研究限制………………………………………………………115 第六章結論與建議……………………………………………………116 第一節結論……………………………………………………………116 第二節建議……………………………………………………………117 參考文獻………………………………………………………………118 附錄一參與研究同意書………………………………………………127 附錄二乳癌切除婦女是否接受乳房重建問卷………………………128 附錄三專家效度名單…………………………………………………142 附錄四專家效度評估分數之平均及CVI值…………………………143 附錄五、是否重建與身體形象(乳癌切除後)之比較(每一題)…………………………………………………………………………146 附錄六、乳房重建者接受重建前後身體形象之比較(每一題)…………………………………………………………………………147 表目錄 表2-1 民國92年與91年女性十大癌症發生率比較(不含原位癌)…………………8 表2-2 台灣地區歷年女性乳癌每十萬人口死亡率…………………10 表3-1 研究變項之操作型定義…………………40 表3-2-1 「社會支持滿意度」量表之Cronbach’s Alpha信度…………………67 表3-2-2 「身體形象」量表之Cronbach’s Alpha信度…………………67 表3-2-3 「SF-36」量表之Cronbach’s Alpha信度…………………67 表3-2-4 「乳房重建滿意度」量表之Cronbach’s Alpha信度.…………………67 表4-1 個人基本資料之描述性統計結果…………………80 表4-2 社會支持滿意度之描述性統計結果…………………83 表4-3 乳房疾病特徵之描述性統計結果…………………86 表4-4 是否接受乳房重建手術之描述性統計結果…………………87 表4-5-1 身體形象(乳癌切除後)之描述性統計結果……………88 表4-5-2 身體形象(乳房重建後)之描述性統計結果……………90 表4-6 SF-36各構面之評分結果……………………………………92 表4-7 乳房重建者問卷之描述性統計結果…………………93 表4-8 變項合併對照表……………………………………………96 表4-8-1 乳癌切除婦女是否接受乳房重建手術之雙變項分析(卡方)…………………………………………………98 表4-8-2 乳癌切除婦女是否接受乳房重建手術之雙變項分析(羅吉士迴歸)…………………101 表4-8-3 是否重建與身體形象(乳癌切除後)之比較………………………………101 表4-8-4 乳房重建婦女接受乳房重建前後身體形象之比較…………………………102 表4-8-5-1 生理功能(PF)與是否接受乳房重建手術之線性迴歸分析………………102 表4-8-5-2 因身體健康所導致的角色限制(RP)與是否接受乳房重建手術之線性迴歸分析…………………………102 表4-8-5-3 身體疼痛(BP)與是否接受乳房重建手術之線性迴歸分析………………103 表4-8-5-4 一般健康狀況(GH)與是否接受乳房重建手術之線性迴歸分析…………103 表4-8-5-5 活力狀況(VT)與是否接受乳房重建手術之線性迴歸分析………………103 表4-8-5-6 社交功能(SF)與是否接受乳房重建手術之線性迴歸分析………………104 表4-8-5-7 因情緒問題所導致的角色限制(RE)與是否接受乳房重建手術之線性迴歸分析……………………………………………………………...104 表4-8-5-8 心理健康(MH)與是否接受乳房重建手術之線性迴歸分析………………………………104 表4-8-5-9 生理面向與是否接受乳房重建手術之線性迴歸分析………………………105 表4-8-5-10 心理面向與是否接受乳房重建手術之線性迴歸分析………………………105 表4-9 乳癌切除婦女是否接受乳房重建手術之初步迴歸分析 (Logistic Regression)……………………………………………………….106 表4-10 乳癌切除婦女是否接受乳房重建手術之最終迴歸分析 (Final Logistic Regression)…………………………………………………109 表 5-1 各醫院之樣本回收率……………………………………………………….110 圖目錄 圖1.1 第一期乳管癌病患接受皮膚保留式乳房切除…………………………………3 圖1.2 以橫式腹直肌皮瓣重建乳房……………………………………………………3 圖1.3 以徽章式皮瓣重建乳頭…………………………………………………………3 圖1.4 乳房重建後之外觀、形狀、柔軟度……………………………………………3 圖2.1 第一期乳管癌病患接受皮膚保留式乳房切除…………………………………4 圖2.2 以橫式腹直肌皮瓣重建乳房……………………………………………………4 圖2.3 乳房、乳頭、乳暈重建後之外觀、形狀、柔軟度都接近對側乳房…………………4 圖3 文獻探討的思考邏輯圖……………………………………28 圖3-1 研究架構……………………………………………………31 | |
dc.language.iso | zh-TW | |
dc.title | 乳癌切除婦女接受重建與否的相關因素及其健康相關生活品質 | zh_TW |
dc.title | Determinants of Women’s Choice of Breast Reconstruction after Mastectomy and Health-Related Quality of Life | en |
dc.type | Thesis | |
dc.date.schoolyear | 95-1 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 季瑋珠,楊銘欽 | |
dc.subject.keyword | 乳癌,乳房重建,個人特質,社會支持,身體形象,健康生活品質(SF-36), | zh_TW |
dc.subject.keyword | breast cancer,breast recosntruciton,determinants,individual characteristics,social support,body image scale,health-related Quality of life (SF-36), | en |
dc.relation.page | 150 | |
dc.rights.note | 未授權 | |
dc.date.accepted | 2007-02-02 | |
dc.contributor.author-college | 公共衛生學院 | zh_TW |
dc.contributor.author-dept | 醫療機構管理研究所 | zh_TW |
顯示於系所單位: | 健康政策與管理研究所 |
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