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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 賴裕和(Yeur-Hur Lai) | |
| dc.contributor.author | Chia-Yu Lin | en |
| dc.contributor.author | 林家瑜 | zh_TW |
| dc.date.accessioned | 2021-06-13T03:52:50Z | - |
| dc.date.available | 2013-10-07 | |
| dc.date.copyright | 2011-10-07 | |
| dc.date.issued | 2011 | |
| dc.date.submitted | 2011-07-28 | |
| dc.identifier.citation | 行政院衛生署( 2 0 0 9 )：《9 7 年度死因統計記者會發布資料─
死因統計結果分析》。摘自行政院衛生署網站， http://www.doh.gov.tw/CHT2006/DisplayStatisticFile.aspx? d=71700&s=1 田沁潔，賴惠玲，許文林，彭逸稘，李茹萍 (2007)．護理衛教對頭 頸部癌症病人口腔照顧認知、健康信念及自我效能之成效．實證 護理，3(3)， 8-10。 林硯農，魏靚華，黃媺淳，張光華，邱俊傑 (2007)．頸部淋巴結切 片手術後脊副神經損傷引起肩頸部疼痛及疑似硬塊：病例報告． 臺灣復健醫學雜誌,，35(4)，224-228。 林玲華，陳景彥，劉嘉逸，陳美伶(2002)．癌症住院病患憂鬱狀態的 盛行率及預測因素．臺灣醫學， 6(4)，535-545。 林頌凱，曾愷平，張煥禎(2007)．肌筋膜疼痛症候群．基層醫 學， 22(4)，146。 林維君 (2010)．癌症患者失眠的認知行為治療：系統性的文獻回 顧．中華心理學刊，52(2)，186-188。 陳佩英，史麗珠，王正旭，賴裕和，張獻崑，陳美伶 (1999)．疼痛 對癌症病患焦慮與憂鬱之影響．臺灣醫學， 3(4)，373-382。 孫嘉玲，林佳靜，蔡佩珊，周桂如 (2008)．失眠之概念分析．護理 雜誌， 55(5)，82-84。 陳美慧，賴裕和 (2007)．頭頸部癌症病人溝通與生活品質之探討． 榮總護理，24(2)，159-162。 曾堯人，顏兆熊 (2010)．老人慢性疼痛之藥物治療．家庭醫學與基 層醫療， 25(2)，49-52。 曾憲彰，蔡銘修，花俊宏，高嘉鴻，林智一 (2004)．放射線定位前 哨淋巴結在口腔癌頸部淋巴轉移之應用．臺灣耳鼻喉頭頸外科雜 誌，39(5)，195-198。 程慧娟，劉維潔 (2006)．頭頸部癌症的安寧療護．慈濟醫學雜誌， 18(4)，51。 黃盈菁，王桂芸 (2009)．照顧一位口腔癌病患接受口顎重建手術後 之護理經驗．腫瘤護理雜誌，9(2)，54-59。 戴世光，張學逸(2002)．口腔癌手術治療的結果分析．中華民國耳鼻 喉科醫學雜誌,，37(5)，341-346。 李秀枝，吳聖良 (2010)．病人主訴術後疼痛強度與護理人員評估結 果差異之比較．護理雜誌，57(3)，63-68。 周繡玲，廖珍娟，姚鍾太 (2007)．癌症病人的失眠困擾．腫瘤護理 雜誌，7(2)，32-35。 賴裕和 (1998)．門診接受化學治療病人之症狀困擾及居家護理需求 探討．護理研究，6(4)，279-289。 羅惠敏，徐南麗，邱慧洳，廖惠娥，劉欣怡 (2004)．癌症病患症狀 困擾與不確定感關係之探討．慈濟護理雜誌，3(1)，72-80。 韓定寰，謝瑩滿，韓晶彥 (2009)．照顧一位口腔癌病患術後之護理 經驗．高雄護理雜誌，26(2)，48-52。 于普華 (2009)．女性護理人員睡眠品質之探討．碩士論文，嘉義:南 華大學。 方圓媛 (2010)．口腔及口咽癌患者於治療後身體活動狀況探討．未 發表碩士論文，台北:國立台灣大學。 林純美 (2009)．頭頸部癌症病人間功能於不同量表之比較．未發表 碩士論文，台北:國立台灣大學。 陳淑卿 (2007)．口腔癌病患手術重建及放射線治療期間照護需求及 相關因素之探討．未發表博士論文，台北:台北醫學大學。 謝佩芸 (2010)．頭頸部癌症病人疼痛特質與其因應策略之探討．未 發表碩士論文，台北:國立台灣大學。 廖媛美 (2008)．中文版本疼痛行為量表之建立與信效度檢測．碩士 論文，台北: 台北醫學大學。 劉瀞美 (2007)．愛滋病毒感染者疼痛症狀、憂鬱及睡眠品質的線況 與相關性探討．未發表碩士論文，台北:國立台灣大學。 Ahlberg, A., Nikolaidis, P., Engstrom, T., Gunnarsson, K., Johansson, H., Sharp, L., & Laurell, G. 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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/32495 | - |
| dc.description.abstract | 頸部廓清術(Neck Dissection) 是大部份頭頸部癌症病患手術治療中最常合併的治療方式。由於手術過程中頸部廓清術或其他相關治療可能對脊副神經 (Spinal Accessory Nerve)有所損傷，而導致病患術後發生肩部功能受限或肩功能不全 (Shoulder Dysfunction)情形。故本研究目的為：（1）探討接受頸部廓清術後三個月內肩頸功能、身體功能狀態及疼痛之變化；（2）鑑別接受頸部廓清術後三個月期間病患身體功能改變之相關因子。本研究於台灣北部某醫學中心採手術前後縱貫式（Longitudinal）資料收集，為期三個月，訪談四個時間點（術前、術後一個月、術後二個月、術後三個月），採用結構式問卷收集資料，每次訪談時間約25-30分鐘，訪談內容包括基本資料表、肩痛及失能指數量表 (Shoulder Pain and Disability Index, SPADI)、簡易疼痛評估中文量表 (Brief Pain Inventory, BPI)、McGill疼痛簡短版量表 (Short-Form McGill Pain Questionnaire, SF-MGP)、身體功能狀態量表 (Karnofsky’s Performance Status, KPS)、症狀嚴重度量表 (Symptom Severity Scale, SSS）、頸部轉頭角度評估。並使用廣義推估方程式（Generalized Estimated Equation, GEE）分析預測身體功能狀態變化之相關因子。
本研究共收60名符案病患，研究結果顯示病患於術後三個月期間肩功能、頸部轉頭角度與身體功能狀態顯著下降；多數病患術後疼痛性質以酸痛、刺痛為主，術後的疼痛干擾、憂鬱、症狀困擾與肩功能不全呈正相關。且於頸部廓清術後一到三個月內，若病患有較好的肩功能、較低的焦慮憂鬱、較少的疼痛干擾與症狀嚴重度，在身體功能部分會有較好的表現。研究結果得知，頭頸部癌症病患接受手術後仍有許多身體復健相關問題，若能給予適切復健指導與照護，相信更能改善術後身體功能狀態之表現，進而增進日後生活品質。 | zh_TW |
| dc.description.abstract | Neck dissection (ND) is one of the major procedures for most head and neck cancer receiving surgery. Due to the potential harm to the spinal accessory nerve from ND or other related treatments, patients might experience limited shoulder function or even dysfunction. The purposes of this study were to (1) explore the levels of neck and shoulder function, physical function, and pain problems in head and neck cancer patient receiving neck dissection within three months of operation (OP); and (2) identify the factors related to the changes of physical f performance over the first three months of receiving neck dissection. A 3-month longitudinal study with 5 time data collections (Pre-OP, 2 weeks Post-OP, and 1 to 3 months post OP) was conducted to recruit head and neck patients in a medical center in Northern Taiwan. Patients were assessed by Shoulder Pain and Disability Index, Brief Pain Inventory, Short-Form McGill Pain Questionnaire, Karnofsky’s Performance Status, Symptom Severity Scale and Background Information Form. The Generalized Estimating Equation (GEE) was used to analyze the factors related to the changes of physical performance.
A total of 60 subjects were recruited. The results showed the declining function in shoulder function, neck rotation angles and performance status in the first three months. Most of patients had pain characterized as aching and stabbing. Postoperative pain interference, depression and symptom severity were positively correlated with severity of shoulder dysfunction. Patients with better shoulder function, less anxiety, lower depression, less pain interference, and lower symptom severity reported to have better physical performance over the first three months of receiving neck dissection. The results suggest that head and neck patients receiving surgery still have many problems needed to be cared. With better care of these problems are necessary and it would better help patients’ recovery in their physical performance. | en |
| dc.description.provenance | Made available in DSpace on 2021-06-13T03:52:50Z (GMT). No. of bitstreams: 1 ntu-100-R97426011-1.pdf: 739329 bytes, checksum: f432a193e9645a5bf54bdd30ef5ce8f6 (MD5) Previous issue date: 2011 | en |
| dc.description.tableofcontents | 中文摘要…………………………………………………………… I
英文摘要…………………………………………………………… II 第一章、緒論 第一節 研究動機與重要性…………………………………… 1 第二節 研究目的……………………………………………… 3 第二章、文獻查證 第一節 頭頸部癌症患者……………………………………… 4 第二節 頸部擴清術與肩頸功能之相關性…………………… 5 第三節 頭頸部癌症患者之疼痛……………………………… 9 第四節 頭頸部癌症患者之身體功能狀態…………………… 12 第三章、研究方法 第一節 研究設計……………………………………………… 15 第二節 研究場所與對象……………………………………… 15 第三節 研究假設……………………………………………… 16 第四節 名詞解釋與操作型定義……………………………… 17 第五節 研究工具……………………………………………… 18 第六節 資料收集步驟………………………………………… 22 第七節 資料處理與分析……………………………………… 23 第八節 研究倫理考量………………………………………… 24 第四章、研究結果 第一節 頭頸部癌症病患基本資料及疾病特性……………… 25 第二節 肩頸功能與身體活動功能之改變…………………… 27 第三節 疼痛特質與生活干擾………………………………… 30 第四節 症狀嚴重度特質……………………………………… 32 第五節 肩功能及身體活動功能之預測因子………………… 33 第五章、討論 第一節 肩頸功能、身體活動功能與其相關因素之改變…… 35 第二節 肩功能及身體功能狀態之相關性與預測因子……… 38 第六章、結論與建議 第一節 結論…………………………………………………… 40 第二節 研究限制與建議……………………………………… 41 第三節 護理上的應用………………………………………… 42 參考資料 中文文獻 ……………………………………………………… 43 英文文獻 ……………………………………………………… 45 圖 目錄 研究架構…………………………………………………………14 表 目錄 表一、資料分析一覽表…………………………………………23 表二、人口學特性………………………………………………50 表三、疾病治療特質……………………………………………51 表四、頸部擴清術後病患肩痛及失能指數變化………………53 表五、術後一個月病患肩痛及失能指數量表百分比…………54 表六、術後二個月病患肩痛及失能指數量表百分比…………55 表七、術後三個月病患肩痛及無力指數量表百分比…………56 表八、總體病患接受頸部擴清手術前後轉頭角度之變化……57 表九、病患分組後身體活動功能變化…………………………58 表十、術後肩功能、疼痛干擾、身體活動功能之相關………59 表十一、病患接受頸部廓清術前後疼痛性狀情形……………60 表十二、病患接受頸部廓清術前後疼痛性狀情形(續)………61 表十三、總體病患接受頸部廓清術前後疼痛變化情形………62 表十四、病患接受頸部廓清術前後疼痛變化情形……………63 表十五、病患頸部廓清術合併皮瓣重建前後疼痛變化………64 表十六、總體病患手術前後症狀嚴重度變化…………………65 表十七、無皮瓣重建病患手術前後症狀嚴重度變化…………66 表十八、皮瓣重建病患手術前後症狀嚴重度變化……………67 表十九、肩功能、身體活動功能之顯著預測因子……………68 | |
| dc.language.iso | zh-TW | |
| dc.subject | 身體功能狀態 | zh_TW |
| dc.subject | 頭頸癌 | zh_TW |
| dc.subject | 頸部廓清術 | zh_TW |
| dc.subject | 肩頸功能 | zh_TW |
| dc.subject | 疼痛 | zh_TW |
| dc.subject | Pain | en |
| dc.subject | Head and Neck Cancer | en |
| dc.subject | Karnofsky’s Performance Status | en |
| dc.subject | Neck Dissection | en |
| dc.subject | Shoulder Function | en |
| dc.title | 頭頸部癌症病患術後三個月內肩頸功能與身體功能之探討 | zh_TW |
| dc.title | Shoulder Dysfunction and Physical Performance in Head and Neck Cancer Patients Receving Surgery – Three Month Changes | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 99-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 孫秀卿(Shiow-Ching Shun),王成平(Cheng-Ping Wang),林至芃(Zhi-Peng Lin) | |
| dc.subject.keyword | 頭頸癌,頸部廓清術,肩頸功能,疼痛,身體功能狀態, | zh_TW |
| dc.subject.keyword | Head and Neck Cancer,Neck Dissection,Shoulder Function,Pain,Karnofsky’s Performance Status, | en |
| dc.relation.page | 69 | |
| dc.rights.note | 有償授權 | |
| dc.date.accepted | 2011-07-28 | |
| dc.contributor.author-college | 醫學院 | zh_TW |
| dc.contributor.author-dept | 護理學研究所 | zh_TW |
| 顯示於系所單位： | 護理學系所 | |
文件中的檔案：
| 檔案 | 大小 | 格式 | |
|---|---|---|---|
| ntu-100-1.pdf 未授權公開取用 | 722 kB | Adobe PDF |
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