肺癌病患主要照顧者照護需求及其相關因素探討

Abstract

本研究目的為探討肺癌病患主要照顧者的照護需求及其相關因素。研究設計採橫斷性、描述相關性研究法，以立意取樣針對北部某醫學中心100對肺癌患者與其主要照顧者為研究對象；而為探討照顧者照護需求是否與病人有關，本研究使用Karnofsky身體功能狀態、症狀嚴重度、醫院焦慮憂鬱量表與基本資料表來評估肺癌病患；照顧者照護需求部分則使用「支持性照護需求量表-照顧者44 (SCNS-P&C 44)」，此量表共分為七層面次量表，訊息需求、法律/經濟需求、心理/情緒需求、健康照護專業人員/健康照護需求、日常生活需求、溝通/人際關係需求與其他需求。研究結果顯示主要照顧者未滿足需求部分，前十項未滿足之需求中，以健康照護專業人員/健康照護層面需求為最多，共包含五項 (37%~50%)，二項屬於心理/情緒層面需求 (45%~58%)，二項與法律/經濟層面 (43%~52%) 有關，另三項屬於訊息需求層面 (40%~45%)。病患無職業、年齡較大、身體功能較差、焦慮程度較高、症狀較嚴重及年齡較大的女性、沒有結婚且受教育年數較少之主要照顧者有較多的照護需求。本研究有助於臨床醫護人員對於肺癌主要照顧者照護需求有更深入的了解，並提供未來臨床照護與研究方面的參考依據。

The purpose of the study was to identify the care needs and related factors in primary caregivers of lung cancer. A cross-sectional, correlational study was conducted. One hundred pairs of eligible patients and caregivers were recruited from the pulmonary outpatient clinics in a medical center in Taiwan by convenience sampling. A set of questionnaires was used to assess patients’ needs, including the Karnofsky’s Performance Status Index, Symptom Severity Scale (SSS), and Hospital Anxiety and Depression Scale (HADS) and Background Information Form; the caregivers’ care needs was evaluated using the Supportive Care Need Survey-Partners & Caregivers 44 (SCNS-P&C 44), the Supportive Care Need Survey-Partners & Caregivers 44 (SCNS-P&C 44) include the seven domains, information needs• health care professional/health care service needs• daily needs• coummnication / interpersonal needs• Legal/Financial Needs• psychological/emotional needs and other needs.The results indicated that : (1) primary caregivers’ reported top ten unmet needs with the five items in the “health care professional/health care service needs” domain (37%~50%), two items were in “psychological/emotional needs” domain (45%~58%), two items were in “legal/financial needs” domain (43%~52%) and three items in “information needs” domain (40%~45%). Patients without work, older age, lower performance status, higher anxiety, symptom severity, female caregivers’ with older age, unmarried and less education level that their primary caregivers had more likely care needs. In conclusion, our data provides more information about care needs by primary caregivers in lung cancer for further clinical care and related studies.