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  1. NTU Theses and Dissertations Repository
  2. 醫學院
  3. 護理學系所
Please use this identifier to cite or link to this item: http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/70451
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???org.dspace.app.webui.jsptag.ItemTag.dcfield???ValueLanguage
dc.contributor.advisor賴裕和
dc.contributor.authorKai-Lin Youen
dc.contributor.author游鎧璘zh_TW
dc.date.accessioned2021-06-17T04:28:28Z-
dc.date.available2020-10-05
dc.date.copyright2018-10-05
dc.date.issued2018
dc.date.submitted2018-08-13
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20version_20171204_Y.pdf
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dc.identifier.urihttp://tdr.lib.ntu.edu.tw/jspui/handle/123456789/70451-
dc.description.abstract近年因標靶藥物酪氨酸激酶抑制劑的發明,胃腸道基質瘤病患的存活期大有提升,但長時間或終生服用標靶藥物卻也可能產生問題和需求,目前相關的研究仍有限,故本研究目的在探討接受口服標靶基立克 (Glivec) 治療之胃腸道基質瘤病患的照護需求現況,及其與身體及心理困擾和重要之人口學特質之相關性。
本研究為橫斷式設計,於北部某一所醫學中心的外科門診區進行連續取樣,採用結構式問卷訪談,問卷包含:支持性照護需求調查簡表、症狀嚴重度量表、醫院焦慮憂鬱量表、Karnofsky身體功能狀態量表和疾病基本資料表,收集之資料以敘述性統計、斯皮爾曼相關係數檢定、無母數統計和羅吉斯迴歸進行分析。
本研究符案病人共83位,研究結果顯示口服基立克之胃腸道基質瘤病人整體身體功能良好,症狀平均為輕度至中度嚴重,其中嚴重度最高的前五項為皮膚顏色改變、疲倦、眼眶水腫、睡眠問題和肌肉痙攣; 五大層面之支持性照護需求程度,由高至低為:(1) 健康系統與資訊、(2) 心理、(3) 病人照護及支持、(4) 生理及日常生活、(5) 性需求層面,平均值依序為27.2 (19.3)、18.4 (18.2)、16.4 (16.3)、15.9 (19.0) 和7.7 (20.1)。病人之平均症狀嚴重度、焦慮及憂鬱程度與五大層面照護需求呈現顯著低度至中度相關,進一步以羅吉斯迴歸分析,發現整體支持性照護需求主要的相關因素為憂鬱程度和皮膚顏色改變。
整體而言,使用口服標靶基立克治療之胃腸道基質瘤病人的整體支持性照護需求雖然較其他癌別低,但仍有部分的病人呈現出中高程度照護需求、焦慮和憂鬱的問題,建議未來應於門診篩檢,針對這些病人,發展進一步的介入措施,改善不足之照護需求,以增進病人的生活品質。
zh_TW
dc.description.abstractBackground The advent of oral targeted tyrosine-kinase inhibitor (TKI) therapy, such as Imatinib (Glivec), has made a promising survival for patients with Gastrointestinal Stromal Tumor (GIST). However, patients might suffer from side effects of Imatinib and have supportive care needs. Limited studies have approached this problem. The purposes of this study are to (1) examine levels of supportive care needs; and (2) the relationships between supportive care needs and physical and psychological distress, and selected demographic characteristics in GIST patients taking Imatinib.
Method This is a cross-sectional study using consecutive sampling to recruit GIST patients receiving Imatinib therapy in surgical outpatient clinics at a medical center in northern Taiwan. GIST patients were assessed by Supportive Care Needs Survey-Short Form 34 (SCNS-SF34), Symptom Severity Scale (SSS), Hospital Anxiety and Depression Scale (HADS), Karnofsky Performance Status Index (KPS), and background information form.
Results A total of 83 patients were recruited in the study. In general, patients reported to have mild to moderate symptoms. The top five symptoms as the descending order of severity were: skin discoloration, fatigue, periorbital edema, sleep problems, and muscle cramp. Patients had low level of unmet supportive care needs. The supportive care need domains as their ranking order were (1) health system and information needs, (2) psychological needs, (3)patient care and support needs, (4) physical and daily living needs, and (5) sexuality needs with mean scores as 27.2 (19.3), 18.4 (18.2), 16.4 (16.3), 15.9 (19.0), and 7.7 (20.1), respectively. Patients with higher symptoms severity, anxiety, and depression revealed higher care needs with generally moderate correlations. Further analysis by logistic regression, we found that depression and skin coloration were those two robust variables related to patients’ overall supportive care needs.
Conclusion Although the overall supportive care needs of GIST patients treated with Imatinib are lower than those of other cancer types, some GIST patients are still enduring moderate to high level of unmet care needs, anxiety, and depression. Therefore, we suggest that we should do the screening in outpatient clinics and develop further interventions in order to meet these patients’ unmet care needs.
en
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dc.description.tableofcontents目錄
謝辭 i
中文摘要 ii
Abstract iii
第一章 緒論 1
第一節 研究背景與重要性 1
第二節 研究目的 3
第二章 文獻查證 4
第一節 胃腸道基質瘤疾病簡介與診斷 4
第二節 胃腸道基質瘤治療與存活 10
第三節 胃腸道基質瘤病人之身心困擾 14
第四節 癌症患者的照護需求與因素 17
第三章 研究方法 20
第一節 研究設計 20
第二節 研究架構與操作型定義 21
第三節 研究假設 23
第四節 研究工具 24
第五節 研究流程與倫理考量 27
第六節 資料分析方法 29
第四章 研究結果 30
第一節 人口學特性與疾病治療特性 30
第二節 生理及功能因素與心理因素現況 32
第三節 照護需求現況 34
第四節 照護需求與自變項之相關性及差異分析 36
第五節 照護需求與相關因素 41
第五章 討論 44
第一節 人口學特性、疾病治療特性與照護需求探討 44
第二節 身體活動功能、症狀嚴重程度及心理因素與照護需求探討 46
第三節 照護需求現況探討 49
第六章 結論與建議 51
第一節 結論 51
第二節 研究限制與建議 53
第三節 護理上應用 54
參考文獻 55
dc.language.isozh-TW
dc.subject基立克zh_TW
dc.subject照護需求zh_TW
dc.subject症狀zh_TW
dc.subject焦慮zh_TW
dc.subject憂鬱zh_TW
dc.subject胃腸道基質瘤zh_TW
dc.subjectCare Needsen
dc.subjectDepressionen
dc.subjectImatiniben
dc.subjectAnxietyen
dc.subjectSymptomen
dc.subjectGlivecen
dc.subjectGastrointestinal Stromal Tumoren
dc.title接受口服標靶藥物胃腸道基質瘤患者之照護需求及相關因素探討zh_TW
dc.titleCare Needs and the Related Factors in Gastrointestinal Stromal Tumor Patients Undergoing Oral Targeted Therapyen
dc.typeThesis
dc.date.schoolyear106-2
dc.description.degree碩士
dc.contributor.oralexamcommittee楊卿堯,李芸湘
dc.subject.keyword胃腸道基質瘤,基立克,照護需求,症狀,焦慮,憂鬱,zh_TW
dc.subject.keywordGastrointestinal Stromal Tumor,Imatinib,Glivec,Care Needs,Symptom,Anxiety,Depression,en
dc.relation.page74
dc.identifier.doi10.6342/NTU201803142
dc.rights.note有償授權
dc.date.accepted2018-08-13
dc.contributor.author-college醫學院zh_TW
dc.contributor.author-dept護理學研究所zh_TW
Appears in Collections:護理學系所

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