乳癌病友自覺疾病歸因與行為改變關聯之探討

Abstract

乳癌為我國婦女發生率第一位的癌症，因此罹患乳癌後接受治療、預防復發與身心調適在許多婦女的生活中至關重要。病友對自身健康行為之控制，容易受其生活態度和疾病相關認知的影響；過去研究顯示，病友的自覺歸因會引起其行為改變，以預防乳癌再度復發。因此，本研究探討台灣乳癌病友自覺歸因與其行為改變之間的關聯，以便未來透過合適的衛教協助病友度過療程至康復。本研究透過門診醫師轉介，招募29位20歲以上、距初次診斷出乳癌達半年以上之女性；並使用質性研究方法，依照研究目的設計之訪談大綱，進行半結構式深度訪談，之後整理訪談逐字稿並進行分析。經整理與分析後，本研究發現，病友自覺歸因著重在自身生活型態，並進行相應的行為改變；再者，現代罹患乳癌的女性日趨增加，加上醫學技術進步、預後良好，已成當代文明病，不會歸因於運氣不好、宿命等難以控制之因素；另外，職場變動對女性病友生活管理影響顯著；最後，癌症復發、絕症的風險與恐懼卻仍深植人心，調整生活型態並搭配定期檢查能降低焦慮。

Breast cancer is the most frequent cancer among women in Taiwan. Treatments, prevention and coping with the disease play important roles in cancer survivors’ life. Survivors’ behaviors are easily affected by their perceptions of the disease. Research shows that cancer survivors’ perceived causes would lead to behavior change to prevent recurrence. Few studies focus on the relationship between their perceived causes and their behavior change in Taiwan, so the research aims to examine the connection between them to provide implications for maintaining the health of cancer survivors. 29 women who aged above 20 are recruited above 6 months of their first diagnosis with breast cancer through physicians’ referrals. Following a qualitative, explanatory research method, the researcher conducts semi-structured, in-depth interviews with a well-designed interview guide. Interviews are audio-recorded, transcribed verbatim and used to analyze the results. The research has the following results. First, survivors tend to attribute breast cancer to lifestyle factors, and the causal beliefs correspond to their behavior change. On the other hand, survivors refuse to attribute breast cancer to fatalism and bad luck due to the rising incidence rate of breast cancer and the improvement of medicine. Besides, career change due to breast cancer affects how survivors live their lives. Last, fear of recurrence is still deeply rooted in survivors’ minds. Behavior change towards a healthy lifestyle as well as regular follow-ups can help relieving the anxiety of recurrence.