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| ???org.dspace.app.webui.jsptag.ItemTag.dcfield??? | Value | Language |
|---|---|---|
| dc.contributor.advisor | 李芸湘(Yun-Hsiang Lee) | |
| dc.contributor.author | Zi-Xuan Gao | en |
| dc.contributor.author | 高子媗 | zh_TW |
| dc.date.accessioned | 2022-11-25T05:35:14Z | - |
| dc.date.available | 2024-12-28 | |
| dc.date.copyright | 2021-12-30 | |
| dc.date.issued | 2021 | |
| dc.date.submitted | 2021-12-28 | |
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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/82072 | - |
| dc.description.abstract | 隨著科技醫療的進步，現今的癌症治療已進入新興免疫療法階段，促使愈來愈多癌症病人接受免疫治療，有著持續存活的機會，也表示有更多的家屬照顧者需要提供更長時間的照護工作，更突顯家屬照顧者的重要。反觀臨床上，病人及其家屬照顧者對免疫治療的療效、副作用的不確定性外，還有著諸多的心理壓力問題，但家屬照顧者不滿足的支持性照顧需求相關的研究卻十分有限，故本研究將針對癌症病人接受免疫治療期間之家屬照顧者支持性照護需求進行探討。 本研究採橫斷式描述性和相關性研究設計，經倫理委員會審查通過後，以立意取樣方式於北部某醫學中心腫瘤科病房收案，運用結構式問卷收集共70位成對之病患及家屬照顧者，研究工具包含：病人人口學特性與疾病特徵資料表（含財務安適度評估COST-FACIT）、免疫治療相關嚴重度評估分級表（CTCAE 5.0）、症狀困擾量表（SSS）、情緒溫度計量表（DT）；家屬照顧者人口學特性與照顧相關特性資料表、症狀困擾量表、情緒溫度計量表、照顧者反應評估量表（CRA）、支持性照護需求量表（SCNS-P C），以描述性及推論性統計進行分析。 研究結果顯示：（1）免疫治療相關不良事件常見為皮膚乾燥、搔癢、丘疹；（2）病患及家屬照顧者症狀困擾前三名皆為疲倦、睡眠問題及疼痛；（3）病患及家屬照顧者情緒困擾分數平均各為3.6分與3.8分，大於等於4分以上，建議需要進一步轉介的比例各為47%及44%；（4）治療期間家屬照顧者之整體照顧負荷平均2.6分；（5）照顧者支持性照護需求前三項依序為訊息需求51.2分、免疫治療照護需求50.9分、健康照護服務需求41.9分；（6）病患症狀困擾、情緒困擾以及家屬照顧者的職業、經濟狀態、症狀困擾、情緒困擾、與整體照顧負荷程度皆與照顧者本身之支持性照護需求有顯著相關。 本研究結果發現接受免疫治療病患症狀如口腔炎，家屬照顧者症狀如疲倦、睡眠困擾的處理，以及情緒支持都是滿足家屬照顧者各層面支持性照顧需求的重要相關因素，顯見醫護人員對於情緒評估的重要性，此外；家屬照顧者的經濟狀態與照顧負荷程度也是重要相關因素，必要時，可以與醫療團隊討論並進行適當轉介；在家屬照顧者的免疫治療照護需求層面，建議未來能設置完善的後續居家照護諮詢管道，以滿足家屬照顧者的支持性照護需求。 | zh_TW |
| dc.description.provenance | Made available in DSpace on 2022-11-25T05:35:14Z (GMT). No. of bitstreams: 1 U0001-1612202122130300.pdf: 2447140 bytes, checksum: 141f3dc4ef5c9fa48f6782a65fed286d (MD5) Previous issue date: 2021 | en |
| dc.description.tableofcontents | 口試委員審定書......i 致 謝......ii 摘 要......iii Abstract......v 第一章 緒論......1 第一節 研究背景與重要性......1 第二節 研究問題與研究目的......4 第二章 文獻查證......5 第一節 癌症與免疫療法......5 第二節 癌症病人及其家屬照顧者之身心衝擊......9 第三節 家屬照顧者之支持性照護需求及其相關因素......12 第三章 研究方法......17 第一節 研究架構......17 第二節 研究設計......18 第三節 研究場所與對象......19 第四節 研究假設......21 第五節 名詞界定與操作型定義......22 第六節 研究工具......24 第七節 資料收集過程......28 第八節 資料處理與分析......29 第九節 研究倫理考量......31 第四章 研究結果......32 第一節 病患及家屬照顧者之人口學特性、疾病治療特質、財務安適度現況與家屬照顧相關特性......32 第二節 免疫治療相關不良事件嚴重度及發生率......39 第三節 症狀嚴重度、情緒困擾程度、照顧負荷程度及照護需求現況......43 第四節 人口學特性、疾病特徵、免疫不良事件嚴重度、照顧相關特性及經濟狀態之家屬照護需求差異......57 第五節 人口學特性、症狀及情緒困擾程度、財務安適度及照顧負荷程度與家屬照護需求之相關性......63 第五章 討論......66 第一節 免疫治療相關不良事件發生率與嚴重度、症狀困擾、情緒困擾與照顧負荷程度之現況探討......66 第二節 免疫治療期間家屬照顧者支持性照護需求之現況探討......69 第三節 免疫治療期間病患及家屬照顧者之人口學特性、症狀嚴重度、情緒困擾、照顧負荷程度及照護需求之相關性探討......71 第六章 結論......73 第一節 結論與建議......73 第二節 限制......75 參考資料......76 附錄一 自擬問卷之專家名單......88 附錄二 倫理委員會審查通過函......89 圖目錄 圖 1、研究架構圖......17 圖 2、資料收集流程圖......28 表目錄 表1、研究目的與統計分析方法......30 表 2、個案基本屬性(N=70)......33 表 3、疾病治療特質(N= 70)......35 表 4、病人財務安適度現況及分佈(N=70)......36 表 5、家屬照顧者基本屬性(N= 70)......38 表 6、免疫治療相關不良事件發生率及嚴重程度(N= 70)......41 表 7、不同治療組合間之免疫治療相關不良事件嚴重程度與分佈(N= 70)......42 表 8、病人身體症狀嚴重程度平均值及分佈(N= 70)......44 表 9、病人情緒困擾程度平均值及分佈(N= 70)......45 表 10、家屬照顧者身體症狀嚴重程度平均值及分佈(N= 70)......47 表 11、家屬照顧者情緒困擾程度平均值及分佈(N= 70)......48 表 12、家屬照顧者照顧負荷程度平均值排序及分佈(N= 70)......51 表 13、家屬照顧者照顧負荷程度單題平均值排序及分佈(N= 70)......52 表 14、家屬照顧者支持性照護需求平均值排序及分佈(N= 70)......53 表 15、家屬照顧者支持性照護需求單題平均值排序及分佈(N= 70)......54 表 16、家屬照顧者照護需求與病人及家屬本身之人口學特性差異(N= 70)......58 表 17、家屬照顧者照護需求與病人疾病特徵差異(N= 70)......59 表 18、家屬照顧者照護需求與免疫治療相關不良事件嚴重度差異(N= 70)......60 表 19、家屬照顧者照護需求與照顧相關特性差異(N= 70)......61 表 20、家屬照顧者照護需求與病人及家屬本身經濟狀態差異(N= 70)......62 表 21、家屬照顧者照護需求與病患及照顧者本身之年齡、教育程度、情緒困擾、症狀困擾與照顧負荷程度之相關性分析(N= 70)......65 | |
| dc.language.iso | zh-TW | |
| dc.subject | 支持性照護需求 | zh_TW |
| dc.subject | 癌症 | zh_TW |
| dc.subject | 免疫療法 | zh_TW |
| dc.subject | 家屬照顧者 | zh_TW |
| dc.subject | Supportive Care Needs | en |
| dc.subject | Immunotherapy | en |
| dc.subject | Family Caregiver | en |
| dc.subject | Cancer | en |
| dc.title | 家屬照顧者於癌症病人接受免疫治療期間之支持性照護需求及其相關因素探討 | zh_TW |
| dc.title | Related Factors and Supportive Care Needs in Family Caregivers with Cancer Patients undergoing Immunotherapy | en |
| dc.date.schoolyear | 110-1 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 洪佳黛(Hsin-Tsai Liu),梁逸歆(Chih-Yang Tseng) | |
| dc.subject.keyword | 癌症,免疫療法,家屬照顧者,支持性照護需求, | zh_TW |
| dc.subject.keyword | Cancer,Immunotherapy,Family Caregiver,Supportive Care Needs, | en |
| dc.relation.page | 89 | |
| dc.identifier.doi | 10.6342/NTU202104540 | |
| dc.rights.note | 同意授權(限校園內公開) | |
| dc.date.accepted | 2021-12-28 | |
| dc.contributor.author-college | 醫學院 | zh_TW |
| dc.contributor.author-dept | 護理學研究所 | zh_TW |
| dc.date.embargo-lift | 2024-12-28 | - |
| Appears in Collections: | 護理學系所 | |
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| File | Size | Format | |
|---|---|---|---|
| U0001-1612202122130300.pdf Access limited in NTU ip range | 2.39 MB | Adobe PDF |
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