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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 孫秀卿(Shiow-Ching Shun) | |
dc.contributor.author | Hsiang-Ying Lin | en |
dc.contributor.author | 林湘縈 | zh_TW |
dc.date.accessioned | 2021-06-16T09:47:50Z | - |
dc.date.available | 2020-03-01 | |
dc.date.copyright | 2017-03-01 | |
dc.date.issued | 2017 | |
dc.date.submitted | 2017-01-23 | |
dc.identifier.citation | 中文部分
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/59967 | - |
dc.description.abstract | 結直腸癌發生率逐年攀升且有年輕化趨勢,近幾年治療的進步使病人存活率逐年增加,生活品質的議題備受重視,其中性生活是影響生活品質的重要因素,但目前性議題在臺灣較少被重視及探討且以往的研究多採橫斷式研究設計,顯少將術前性功能列入評估,亦未將人格特質因素列入影響性功能之考量,因此本研究目的為探討:(1)結直腸癌病人手術前後六個月內Type D人格特質、症狀嚴重程度及男女性功能之現況及改變;(2)手術前後六個月內結直腸癌病人性功能的差異;(3)結直腸癌病人術手術前後六個月內性功能改變影響因素,包括人口學特性、疾病及治療相關性、症狀相關資料及Type D人格特質。
本研究自105年1月3日至105年12月1日於台北市某醫學中心大腸直腸外科病房進行收案,採用縱貫式研究方法及立意取樣,收案時間點包含手術前一個月、手術後一個月、手術後六個月,藉由問卷收集資料,包括個人基本資料、疾病相關資料表、症狀嚴重程度評估、女性性功能指數、國際勃起功能指標量表、臺灣版DS14修訂版(DS14-TR),資料分析方法包括描述性統計和推論性統計,藉由描述性統計分析病人基本屬性、疾病相關資料、症狀嚴重程度評估、Type D人格特質及男女性功能;以重複測量變異數分析(Repeated measure ANOVA)分析結直腸癌病人手術後六個月內症狀嚴重程度、Type D人格特質及男女性功能之改變,以卡方檢定(Chi-square)分析結直腸癌病人性功能的差異,以廣義估計方程式(Generalized estimating equation, GEE) 探討結直腸癌病人術後六個月內性功能改變影響因素。本研究總共有99人完成手術前一個月的資料收集,83人完成手術後一個月的追蹤、78人完成手術後六個月的追蹤,研究結果顯示:(1)接受手術前後六個月,整體症狀嚴重程度屬輕微,且手術前後六個月整體症狀嚴重程度無顯著差異(p = 0.106),從個別症狀分析有六項症狀在手術前後六個月有顯著的不同,個別症狀分數隨著時間增加包括噁心(p = 0.017)、不自主放屁(p = 0.046)及排便次數增加(p = 0.001),個別症狀分數手術後一個月分數下降然後手術後六個月分數上升的症狀包含掉髮或毛髮減少(p = 0.016)、腹瀉(p = 0.012)及焦慮(p = 0.003);(2)Type D人格特質總分於手術後一個月顯著低於手術前一個月(p = 0.006),而負向情感部分手術後一個月(p = 0.003)及手術後六個月(p = 0.046)分數顯著低於手術前一個月;(3)手術前後六個月內性功能變化的部分,結直腸癌男性病人在國際勃起功能指標量表總分(p < 0.001)及次量表包含勃起(p < 0.001)、性高潮(p < 0.001)、性交滿意度(p < 0.001)、性慾望(p = 0.001)及整體滿意度(p = 0.006)等性功能,於手術後一個月顯著低於手術前一個月,手術後六個月分數上升。女性性功能指數總分(p = 0.007)及次量表包含性興奮(p = 0.003)及性高潮(p = 0.011)手術後一個月分數顯著低於手術前一個月,然後手術後六個月分數上升;(4)手術前後六個月內結直腸癌病人性功能障礙無顯著差異(P > 0.05);(5)以廣義估計方程式之邏輯斯迴歸分析影響研究參與者性功能變化之重要因子,研究結果發現結直腸癌病人在手術後一個月(Odds ratio = 5.008;p = 0.004)、年齡越大(Odds ratio = 1.091;p = 0.002)、女性(Odds ratio = 35.170;p < 0.001)、化學治療病人(Odds ratio = 3.899;p < 0.011)具有性功能障礙的風險越高。 性功能障礙是結直腸癌病人接受手術後常見的問題,因此臨床照顧者應在結直腸癌病人手術後一個月,根據病人年齡、性別及接受化學治療病人者,由健康照護人員主動開啟性功能議題,依病人個別性給予指導及早期轉介。 | zh_TW |
dc.description.abstract | The incidence of colorectal cancer (CRC) is increasing and patient is younger than before. Recently, the advanced multidisciplinary treatments has led to a substantial improvement in prognosis, which also rise up the issue for the quality of life, and one of the main factory for it is the sexual function. However, it has limited understandings and less been discussed on this sexual function topic for those CRC patients in Taiwan. The previous studies are mostly predominantly cross-sectional design, lacking of preoperative sexual function evaluation and discussion about Type D personality with sexual issue. Therefore, the purposes of this study were to explore (1)changes of severity of symptom, Type D personality and sexual function after surgery within six months; (2)the difference of sexual function between colon and rectal cancer after surgery within six months; and (3)the significant factors related to sexual function in patients with CRC after surgery within six months.
A longitudinal design study was conducted by recruiting the CRC patients at colorectal surgical wards in a medical center in Taipei from 3rd January to 1st December in 2016. Participants were selected by purposive sampling. Data were collected during preoperative about one month (T0), and one-(T1) and six-month (T2) after surgery. Questionnaires included demographic information, disease-related characteristics, severity of symptom, Female Sexual Function Index, International Index of Erectile Function and DS14-TR. Data analysis included descriptive and inferential statistics. The descriptive statistics was used to analyze the demographic and disease-related information, severity of symptom, Female Sexual Function Index, International Index of Erectile Function and DS14-TR. Inferential statistics contained repeated measure ANOVA, Chi-square test and generalized estimating equation. Repeated measure ANOVA was used to analysis the change of severity of symptom, sexual functions and Type D personality within six months. Chi-square test was used to analysis the difference of sexual function between colon and rectal cancer after surgery within six months. Generalized estimating equation was used to explore change of sexual function and its related factors in patients with CRC after surgery within six months. A total of 99, 83, and 78 patients completed the survey at T0, T1 and T2, respectively. The results showed that (1)the severity of symptom was mild and the average of symptom was no significant change in patients with CRC after surgery within six months (p = 0.106). But the individual symptoms were significant change in patients with CRC after surgery within six months. The symptoms including nausea (p = 0.017), increasing frequency of stool (p = 0.001) and unintentional gas (p = 0.046) increased over times. The other symptom including loss of hair (p = 0.016), diarrhea (p = 0.012) and anxiety (p = 0.003) decreased at T1 and increased at T2. (2)Type D personality (p = 0.006) decreased significantly at T1 as compared with T0. Negative affectivity decreased significantly at T1 (p = 0.003) and T2 (p = 0.046) as compared with T0. (3)International Index of Erectile Function (p = 0.001) and subscales included erectile function (p < 0.001), orgasmic function (p < 0.001), intercourse satisfaction (p < 0.001), sexual desire (p = 0.001) and overall satisfaction (p = 0.006) were decreased significantly at T1 and increased at T2. Female Sexual Function Index (p = 0.007) and subscales including arousal (p = 0.003) and orgasm (p = 0.011) decreased significantly at T1 as compared with T0. (4)Sexual function was no significantly difference between colon and rectal cancer after surgery within six months (P > 0.05). (5)Generalized estimating equation was used to explore change of sexual function and its related factors. The result showed that the higher risk of sexual dysfunction in patients with CRC were in the first month after surgery (Odds ratio = 5.008;p = 0.004), older age (Odds ratio = 1.091;p = 0.002), female (Odds ratio = 35.170;p < 0.001) and receiving chemotherapy (Odds ratio = 3.899;p = 0.011). Sexual dysfunction is a common problem in patients with CRC after surgery. Therefore, health care profession should raise sexual issue in patients with CRC with high risk population such as older age and female in the first month after surgery or during chemotherapy. | en |
dc.description.provenance | Made available in DSpace on 2021-06-16T09:47:50Z (GMT). No. of bitstreams: 1 ntu-106-R02426012-1.pdf: 4543447 bytes, checksum: ad18a3d3b691b04e4b4be436a7d7bdaa (MD5) Previous issue date: 2017 | en |
dc.description.tableofcontents | 目錄
口試委員審定書 I 中文摘要 II 英文摘要 IV 第一章 緒論 1 第一節 研究動機與重要性 1 第二節 研究目的 4 第二章 文獻查證 5 第一節 結直腸癌之簡介及其治療 5 第二節 性功能相關定義 8 第三節 性功能與人格特質之相關性 10 第四節 結直腸癌性功能之相關影響因素 13 第五節 概念架構 19 第三章 研究方法 20 第一節 研究設計 20 第二節 研究問題 21 第三節 研究假設 22 第四節 研究場所及研究對象 23 第五節 名詞解釋與操作型定義 25 第六節 研究工具 27 第七節 研究步驟 30 第八節 資料處理與分析 31 第九節 研究倫理考量 33 第四章 研究結果 34 第一節 結直腸癌患者之人口學特性與疾病相關資料 35 第二節 結直腸癌患者之症狀嚴重程度評估分析 38 第三節 結直腸癌患者之Type D人格特質分析 42 第四節 結直腸癌患者手術前後六個月性功能變化及差異 45 第五節 結直腸癌患者於手術前後六個月性功能變化之重要影響因子52 第五章 討論 55 第一節 收案族群與台灣目前結直腸癌患者的人口學及疾病資料之差異 55 第二節 症狀嚴重程度分析之探討 57 第三節 Type D人格特質分析之探討 59 第四節 性功能改變之相關分析探討 60 第六章 結論與建議 67 第一節 結論 67 第二節 建議 69 參考文獻 73 附錄 81 附錄一 研究倫理委員會通過函 81 附錄二 研究受試者同意書 83 圖目錄 圖 1研究概念架構 19 圖 2資料收集之流程圖 30 圖 3收案流程圖 34 表目錄 表 4-1、研究參與者之個人基本屬性 36 表 4-2、研究參與者之疾病相關資料 37 表 4-3、手術前後六個月症狀嚴重程度排序 40 表 4-4、手術前後六個月症狀嚴重程度之差異 41 表 4-5、手術前後六個月Type D人格特質 43 表 4-6、手術前後六個月Type D人格特質之差異 44 表 4-7、手術前後六個月男性性功能變化 47 表 4-8、手術前後六個月男性功能之差異 48 表 4-9、手術前後六個月女性性功能變化 49 表 4-10、手術前後六個月女性功能之差異 50 表 4-11、手術前後六個月結直腸癌病人性功能之差異 51 表 4-12、以廣義估計方程式之邏輯斯迴歸分析影響性功能變化之重要因子 53 | |
dc.language.iso | zh-TW | |
dc.title | 結直腸癌病人術後六個月內之性功能改變及其影響因素 | zh_TW |
dc.title | Change of Sexual Function and its Related Factors in Patients with Colorectal Cancer after Surgery within Six Months | en |
dc.type | Thesis | |
dc.date.schoolyear | 105-1 | |
dc.description.degree | 碩士 | |
dc.contributor.coadvisor | 張秀如(Shiow-Ru Chang),姜正愷(Jeng-Kai Jiang) | |
dc.subject.keyword | 結直腸癌,性功能,Type D人格, | zh_TW |
dc.subject.keyword | Colorectal cancer,Sexual function,Type D personality, | en |
dc.relation.page | 92 | |
dc.identifier.doi | 10.6342/NTU201700173 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2017-01-23 | |
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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