積極監測型攝護腺癌病人之害怕疾病進展及照護需求探討

Abstract

攝護腺癌是全球男性常見的癌症之一，通常疾病進展速度較慢，會採用積極監測(Active Surveillance, AS)作為治療方式。故本研究目的為(1)探討積極監測型攝護腺癌病人之害怕疾病進展及照護需求，(2)探討病人照護需求之相關因素，(3)探討影響照護需求之重要預測因子。 本研究為橫斷性研究，於台灣北部某醫學中心之泌尿科門診進行收案，研究個案為採取積極監測型之攝護腺癌病人，以結構式量表進行訪談，包含評估整體照護需求調查、害怕疾病進展、焦慮、憂鬱、攝護腺症狀、勃起功能及人口學特性，本研究取得倫理試驗委員會同意後開始進行資料收集，由已受訓之研究助護理師協助病人逐題進行填答，資料以描述性及推論性統計進行分析。 本研究收集102位個案並完成資料分析，研究結果顯示個案整體身體功能良好，五大層面之整體照護需求由高至低分別為：(1)健康系統與資訊需求、(2)心理需求、(3)病患照顧與支持需求、(4)性需求、(5)生理與日常生活需求，平均分數及標準差依排序為36.4(28.4)、31.6(25.9)、18.3(22.8)、13(24.8)、13(18.9)。害怕疾病進展、焦慮、憂鬱、較短積極監測時間、攝護腺症狀與整體照護需求及各五大層面大部分呈現低度至中度相關，疲倦及害怕疾病進展為影響整體照護需求之最有力預測因子。 本研究結果將提供積極監測型攝護腺癌病人照護需求相關之實證依據，有助於臨床醫護人員了解、評估此類型病人之需求及後續影響，並從而發展出相關之照護及介入措施。

Background Prostate cancer is one of the most common cancers in men worldwide. Because the disease usually progresses slowly, active surveillance (AS) is used as a treatment method. Therefore, the purpose of this study is (1) to explore the fear of disease progression and care needs in patients with active surveillance prostate cancer, (2) to explore the related factors of patients' care needs.(3) to explore the robust factors impact care needs. Method This study is a cross-sectional study. Cases were accepted in the urology clinic of a medical center in northern Taiwan. The subjects were prostate cancer patients with active surveillance. Interviews were conducted with structured scales, including surveys to assess overall care needs, fear of disease progression, anxiety, depression, prostatic symptoms, erectile function, and demographic characteristics. This study began to collect data after obtaining the approval of the ethics trial committee. In particular, trained study nurses assisted patients to complete questionnaires. The data were analyzed descriptively and correlatively. Results This study collected 102 cases and completed the data analysis. The results of the study show that the overall physical function of the cases is good. The five domains of supportive care need were ranked (1) health system and information needs, (2) psychological needs, (3) patient care and support needs, (4) sexuality needs, (5) physiological and daily living needs, the average scores and standard deviations are 36.4 (28.4), 31.6 (25.9), 18.3 (22.8), 13 (24.8), 13 (18.9). Fear of disease progression, anxiety, depression, shorter active surveillance time, prostate symptoms revealed low to moderate correlations in most of the five domains and overall supportive care needs. Fatigue and fear of disease progression are the robust factors impact care needs among prostate patients on active surveillance. Conclusion The results of this study will provide an empirical basis for the care needs of patients with active surveillance prostate cancer. They also help clinical medical staff understanding and evaluating the needs and subsequent impact of this type of patients and developing relevant care and intervention measures.