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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 李雅玲(Ya-Ling Lee) | |
| dc.contributor.author | Hsiang-Yun Lan | en |
| dc.contributor.author | 藍湘勻 | zh_TW |
| dc.date.accessioned | 2021-06-15T07:02:17Z | - |
| dc.date.available | 2013-10-07 | |
| dc.date.copyright | 2011-10-07 | |
| dc.date.issued | 2011 | |
| dc.date.submitted | 2011-08-19 | |
| dc.identifier.citation | 中文文獻
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Journal of Clinical Psychiatry, 65(8), 13-19. Yeh, C. H., Wang, C. H., Chiang, Y. C., Lin, L., & Chien, L. C., (2009). Assessment of symptoms reported by 10 to18-Year-Old cancer patients in Taiwan. Journal of Pain and Symptom Management, 38(5), 738-746. Yeh, C.H., Chiang, Y.C., Chien, L.C., Lin, L., Yang, C.P., & Chuang, H. L., (2008). Symptom clustering in older Taiwanese children with cancer. Oncology Nursing Forum, 35(2), 273-281. Yang, C. K., Kim, J. K., Patel, S. R., & Lee, J. H. (2005). Age-related changes in sleep/wake patterns among Korean teenagers. Pediatrics,115 (Supp11), 250-256. | |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/48564 | - |
| dc.description.abstract | 睡眠型態改變是癌症病童住院期間非常普遍的問題，是否影響癌症病童及主要照顧者住院期間的身心狀況，是值得探討的問題。因此，本研究主要目的為探討癌症病童住院期間之睡眠品質及相關因素，比較住院期間與出院後的睡眠品質差異，並探討影響睡眠品質的預測因子。
本研究採縱貫式及相關性之研究調查，以立意取樣方式於台北市某醫學中心之癌症兒童病房調查年齡為7-18歲住院中癌症病童，運用結構式問卷(包括「病童基本屬性資料表」、「睡眠衛生量表」、「兒童多向度疲憊量表」、「記憶症狀評估量表」、「睡眠品質量表」及睡眠日誌)、24小時活動監測器（腕動計）及病歷查閱來進行資料收集。分三個時間點進行資料收集，分別收集研究參與者住院接受化學治療中的第一天及第五天兩次資料及返家後五天的ㄧ次資料。 研究結果：本研究共收得20位研究參與者、總計60次的資料，其年齡分布7-17歲，平均年齡12±0.67歲，75％為男童，此次住院天數平均35.8±6.9天，疾病診斷以白血病（35％）及神經母細胞瘤（35％）居多。相關性分析結果，有使用止痛藥的研究參與者在住院第五天及返家，睡眠品質是顯著較差的(住院第五天F=5.88，p=0.03；返家F=4.24，p=0.05)，有使用安眠藥的研究參與者睡眠品質也是顯著較差的(F=5.09，p=0.04)；在身心健康部分，住院第五天與返家期間，疲憊總分皆與睡眠品質總分呈顯著正相關，表示疲憊情形越高，睡眠品質越差（r=0.44-0.46，p=0.04-0.05）；在記憶症狀部分，無論在住院第一天、第五天或返家，記憶症狀總分皆與睡眠品質總分呈顯著正相關（r=0.53-0.62，p=0.00-0.02），表示症狀發生的頻率、嚴重度及困擾程度越高，睡眠品質越差；而在睡眠衛生部分，無論在住院期間或返家後，睡眠衛生和睡眠品質之間並無明顯的相關性。 在住院期間與返家後睡眠品質的比較上，返家後的主觀睡眠品質比住院期間的主觀睡眠品質為佳(t=4.76，p<0.01)；在睡眠日誌部分及腕動計的部份，研究參與者住院期間平均夜間醒來次數明顯高於返家期間夜間醒來次數，且在每日主觀的睡眠品質及精神上，也顯示返家期間的睡眠品質及精神皆比住院期間好。經由線性混合分析模式(mixed model)檢定，記憶症狀及有無使用止痛藥是預測睡眠品質的重要因子。 期能以此研究結果作為臨床照護之依據，加強醫護人員對癌症兒童住院期間睡眠問題的重視，進而提升照護品質並改善癌症病童及家屬住院品質。 | zh_TW |
| dc.description.abstract | Changes in sleep patterns in children with cancer may be a very common problem during hospitalization. The quality of sleep in cancer children during hospitalization thus warrants detailed investigation. The purposes of current research were: (1) to investigate the quality of sleep and related factors, (2) to compare the differences in quality of sleep between hospitalization and after discharge, and (3) to explore predictors of quality of sleep in children with cancer.
A longitudinal and correlation design was used. Children with cancer aged 7-18 years old were enrolled from a medical center in Taipei. Data collection used a set of questionnaires including a Personal Information Form, the Adolescent Sleep Hygiene Scale, the PedsQL Multidimensional Fatigue Scale, the Memorial Symptom Assessment Scale, the Sleep Quality Index, a sleep log, and a 24-hour activity monitor (wrist actigraph) and chart review. Information was collected at three time points, the first day and fifth day of a cycle of hospitalization for chemotherapy and the fifth day after discharge. A total of 20 participants (with 60 pieces of data) were recruited for the analysis. The average age of participants was 12 ± .67 years with a range of 7-17 years. Seventy five percent of the participants were boys. Most of the participants were diagnosed with leukemia (35%) and neuroblastoma (35%). The average of length of hospital stay was 35.8 ± 6.9 days. The use of pain medicine was correlated with significantly poorer quality of sleep at both day 5 and at home after discharge (F = 5.88, P =.03, F = 4.24, P = .05, respectively). Those participants who used sleep medicine had significantly poorer quality of sleep (F = 5.09, P = .04). With respect to psycho-somatic health, fatigue was significantly positively correlated with negative quality of sleep at both day 5 and at home after discharge (r = 0.44-0.46, P = 0.04-0.05). The severity, frequency, perplexity of symptom was significantly positively correlated with negative quality of sleep at all three time points (r = 0.53-0.62, P = 0.00-0.02). That is, the higher the scores of frequency, severity and suffering scores, the poorer of quality of sleep. With respect to sleep hygiene, there was no significant correlation between hospitalization and sleeping at home, and between sleep hygiene and quality of sleep. Sleep at home was perceived to be of higher quality at home than that during hospitalization by participants (t = 4.76, P < 0.01). The results recorded by sleep log and wrist actigraph showed that the frequency of awakening at night was higher during hospitalization and subjects had better quality of sleep and mental health at home after discharge. Using the statistical method of Mixed model, the severity, frequency, perplexity of symptom and does use the pain-killer are the important variables to predict the sleep quality. The findings of the current study provide evidence for clinical practice and increase feasibility of this issue for the health care providers. They may also improve the quality of care and life during hospitalization for both cancer children and their caregivers. | en |
| dc.description.provenance | Made available in DSpace on 2021-06-15T07:02:17Z (GMT). No. of bitstreams: 1 ntu-100-R97426020-1.pdf: 1854216 bytes, checksum: bc828e60d3eacfa6f2adb4c29abade8a (MD5) Previous issue date: 2011 | en |
| dc.description.tableofcontents | 口試委員會審定書
誌謝 中文摘要..................................................................................................................i 英文摘要..................................................................................................................iii 圖目錄......................................................................................................................viii 表目錄......................................................................................................................ix 第一章 緒論 第一節 研究動機與重要性 ………………………………………………..1 第二節 研究目的............................................................................................1 第三節 研究問題……………………………………………………………2 第四節 名詞界定……………………………………………………………2 第二章 文獻查證 第一節 癌症與睡眠…………………………………………………………3 第二節 癌症病童睡眠問題…………………………………………………4 第三節 睡眠生理及重要性…………………………………………………5 第四節 影響睡眠品質之因素………………………………………………6 第五節 睡眠品質測量方法…………………………………………………12 第三章 研究方法 第一節 研究架構……………………………………………………………15 第二節 研究對象與場所……………………………………………………16 第三節 研究工具……………………………………………………………16 第四節 研究步驟……………………………………………………………20 第五節 資料處理……………………………………………………………23 第六節 研究倫理考量………………………………………………………23 第四章 研究結果 第一節 研究參與者基本屬性之描述………………………………………24 第二節 睡眠衛生、身心健康狀況及睡眠品質之描述……………………28 第三節 量表的信效度檢定…………………………………………………42 第四節 癌症兒童基本屬性與睡眠品質之關係……………………………42 第五節 癌症兒童身心健康狀況與睡眠品質之關係………………………46 第六節 癌症兒童睡眠衛生與睡眠品質之關係……………………………48 第七節 癌症兒童住院期間與返家後睡眠品質之差異……………………48 第八節 癌症兒童睡眠品質之預測因子……………………………………49 第五章 討論 第一節 研究參與者收案狀況………………………………………………51 第二節 基本屬性、睡眠衛生、身心健康狀況及睡眠品質現況討論……51 第三節 本研究量表的信度討論……………………………………………54 第四節 癌症兒童基本屬性與睡眠品質相關性之討論……………………54 第五節 癌症兒童身心健康狀況與睡眠品質相關性之討論………………55 第六節 癌症兒童睡眠衛生與睡眠品質相關性之討論……………………56 第七節 癌症兒童住院期間與返家後睡眠品質差異之討論………………57 第八節 癌症兒童睡眠品質之預測因子……………………………………59 第六章 結論與建議 第一節 結論…………………………………………………………………60 第二節 研究限制……………………………………………………………61 第三節 應用與建議…………………………………………………………61 參考文獻 中文文獻 ……………………………………………………………………63 英文文獻 ……………………………………………………………………66 附錄 附錄一 個案基本資料表……………………………………………………75 附錄二 睡眠衛生量表………………………………………………………76 附錄三 兒童多向度疲憊評估量表…………………………………………77 附錄四 記憶症狀評估量表…………………………………………………79 附錄五 兒童睡眠品質量表…………………………………………………83 附錄六 睡眠日誌……………………………………………………………84 附錄七 兒童版研究受試者說明同意書……………………………………85 附錄八 研究受試者說明同意書……………………………………………88 附錄九 量表使用同意書……………………………………………………93 | |
| dc.language.iso | zh-TW | |
| dc.subject | 腕動計 | zh_TW |
| dc.subject | 癌症兒童 | zh_TW |
| dc.subject | 睡眠品質 | zh_TW |
| dc.subject | 睡眠衛生 | zh_TW |
| dc.subject | childhood cancer | en |
| dc.subject | actigraph | en |
| dc.subject | sleep hygiene | en |
| dc.subject | quality of sleep | en |
| dc.title | 癌症兒童住院期間與返家後睡眠品質及相關因素之研究 | zh_TW |
| dc.title | Quality of Sleep and Related Factors in Children with Cancer During and After Hospitalization | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 99-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 劉仁沛,林東燦,蔡劭瑜 | |
| dc.subject.keyword | 癌症兒童,睡眠品質,睡眠衛生,腕動計, | zh_TW |
| dc.subject.keyword | childhood cancer,quality of sleep,sleep hygiene,actigraph, | en |
| dc.relation.page | 94 | |
| dc.rights.note | 有償授權 | |
| dc.date.accepted | 2011-08-19 | |
| dc.contributor.author-college | 醫學院 | zh_TW |
| dc.contributor.author-dept | 護理學研究所 | zh_TW |
| 顯示於系所單位： | 護理學系所 | |
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