成年白血病門診病患之疲倦問題與相關因素探討

Abstract

疲倦是癌症病患常見的症狀困擾，也是影響病患生活品質最嚴重的困擾因素。本研究採橫斷式研究法，以描述性統計、獨立t-檢定、單因子變異數分析與皮爾森積差相關（Pearson’s correlation）等分析方法，探討台北某醫學中心血液腫瘤科門診之成年白血病病患之疲倦程度及其疾病不確定感、睡眠干擾問題之相關性。共收集80位成年白血病病患，以量表訪談來評估病患之疲倦嚴重程度、疾病不確定感現況及睡眠干擾情形。 本研究之研究目的在探討（1）成年白血病病患疲倦的嚴重程度及對其生活的干擾；（2）成年白血病病患之疾病不確定感現況及睡眠狀況；（3）成年白血病病患之人口學特性、治療與疾病相關特質等與疲倦嚴重程度之相關性；（4）成年白血病病患的疲倦程度、疾病不確定感、睡眠干擾間之關係。結果發現：（1）白血病病患之疲倦程度屬於中度疲倦。發生之型態大多沒有固定的時間，對個人生活影響之程度，以對一般活動影響程度最高（3.6分）；（2）白血病病患整體之疾病不確定感亦屬中等程度之不確定感，睡眠干擾則以「我的頭腦仍持續反覆想著一些事情」（2.9分）為最高分；（3）與成年白血病病患疲倦程度有關的變項分別是：病患日常體能狀態、疾病是否達到緩解、疾病不確定感、睡眠干擾情形。研究結果發現病患之睡眠干擾、疾病不確定感及疲倦程度之間會有相互之影響。建議在疾病初期即開始評估病患之需求，提供病患支持與減低其內心之衝擊，減少其疾病不確定感並改善睡眠品質，降低病患疲倦程度，提供更好之護理照護品質。

The purpose of this study was to explore the fatigue experiences and its association with uncertainty and sleep disturbance. A cross-sectional study design was applied to recruit adult leukemia patients from hematology outpatient clinics in a medical center in Taipei. Instruments used for data collection were Fatigue Symptom Inventory (FSI), Mishel’s Uncertainty in Illness Scale-Community (MUI-community), and Sleep Disturbance Questionnaire (SDQ). Descriptive statistics, Pearson’s correlation, t-test and ANOVA were applied to analyze the data. A total of 80 subjects were recruited. The results indicated: (1) these patients perceived mild to moderate level of fatigue and fatigue interference; the highest interference from fatigue was on “general activities”; (2) Patients perceived moderate level of illness related uncertainty; and (3) Patients had higher fatigue level was found to have lower performance status, disease status, higher uncertainty and more sleep disturbance. In conclusion, our results suggested that fatigue is a problem in leukemia patients, including those with or without remission. Clinicians need to assess patients’ fatigue problem and its related factors to enhance their life quality.