口腔及口咽癌患者於治療後身體活動狀況探討

Abstract

癌症的治療，常導致患者在治療完成後存有諸多症狀，如疲憊、睡眠與症狀嚴重度，而規律身體活動對改善疲憊、睡眠與症狀嚴重度有幫助。因此本研究目的為：(1) 口腔與口咽癌患者於治療後的身體活動現況；(2) 患者於治療完成後之身體活動和人口學特性、其他、及疾病治療相關特質相關性；(3) 疲憊、睡眠困擾或症狀嚴重度與身體活動間之關聯。 採橫斷式研究設計、立意取樣，79位患者遴選自北部某醫學中心及南部分院。以結構式問卷分析基本資料、身體活動狀況、疲憊、睡眠與症狀嚴重度情形，並搭配實際體適能測量，包括握力與髖曲肌肌力（肌力）、身體質量指數及腰臀圍（身體組成）、頸部關節活動度與站姿體前彎（柔軟度）。收集的資料以描述性統計、單因子變異數分析及事後多重檢定進行分析。 結果發現：患者於治療後從事之運動類型多為輕度活動，其體適能測量值結果與台灣常模相比，皆落在較差部份，顯示患者雖有從事運動，但因身體活動強度不足，因此無益於體能的提升，此情形在較年輕的患者更為明顯。 運動達建議標準者，在疲憊對生活干擾程度及持續時間較低、且症狀嚴重度分數較低，雖與睡眠問題未顯著相關，但達運動建議標準組的睡眠問題及睡眠障礙情形較未運動者低。顯示增加身體活動對緩解疲憊及症狀嚴重度是有益的，若欲改善患者睡眠，則需加強身體活動強度及持續時間。本研究可作為臨床進行身體活動衛教之參考，未來研究亦可依據此結果，設計相關的介入措施。

The cancer treatment caused damage to the patients. Even after completing the treatment, patient still suffer from the side effects of treatment, especially is fatigue, sleep disturbance, and symptom severity. The regular physical activity is benefit to relieve fatigue, sleep disturbance, and symptom distress. For this reason, the aims of this study were (1) to examine the status of physical activity after cancer treatment; (2) to examine the relationship between physical activity, sleep disturbance, and symptom distress in oral cavity and oropharyngeal cancer patients in Taiwan. Using cross-sectional study design and purposeful sampling, then 79 patients were recruited from one medical center in Northern Taiwan and its Southern branch hospital in this study. We collected data by the structured questionnaires which included basic information, physical activity status, fatigue, sleep disturbance, and symptom distress situations. In addition to the questionnaires, the data was coordinated with the actual measurement of physical fitness including muscle power (gripping power and hip flexor muscle power), body composition (body mass index and waist-hip ratio), and flexibility (cervical range of motion and standing forward bending test). The collected data were using descriptive statistics, one way ANOVA, and multiple comparison procedures to analyze. The results showed that patients usually engaged in light exercise after completed the treatment. Comparing the measured values of physical fitness in patients with norm group in Taiwan, the physical fitness in patients was in the poor grades. Even though the patients had done exercise, the physical fitness wasn’t enhancement because of the activity intensity was not enough. This situation is most common in younger patients. The movement was meted the proposed standards in patients who had lower degree of fatigue interference (p <0.01) and shorter duration of fatigue (p <0.05), and less symptom distress (p =0.05). Although physical activity was not significantly associated with sleep problems, the patient who meted the recommended standards had lower mean score in sleep problem and sleep disturbance than sedentary participants. This study showed increasing physical activity is helpful to reduce fatigue and symptom distress. If the goal is to improve the patients’ sleep quality, it will be required to strengthen the intensity and duration of physical activity. The result in this study might be a reference for health education in physical activity in clinical care, and may be the basis for further study to design related interventions.