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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 陳端容(Duan-Rung Chen) | |
| dc.contributor.author | Yu-Chieh Huang | en |
| dc.contributor.author | 黃郁絜 | zh_TW |
| dc.date.accessioned | 2022-11-23T09:09:22Z | - |
| dc.date.available | 2022-02-15 | |
| dc.date.available | 2022-11-23T09:09:22Z | - |
| dc.date.copyright | 2022-02-15 | |
| dc.date.issued | 2022 | |
| dc.date.submitted | 2022-02-10 | |
| dc.identifier.citation | 1. World Health Organization. Cancer Pain Relief and Palliative Care. Technical Report Series No. 804. Geneva: World Health Organization, 1990. 2. https://www.mohw.gov.tw/cp-5017-61533-1.html 3. https://www.who.int/news-room/fact-sheets/detail/cancer 4. Cancer Registry Annual Report, 2017 (Taiwan) [(accessed on 20 January 2020)]. 5. Lin YL, Lin IC, Liou JC. Symptom patterns of patients with head and neck cancer in a palliative care unit. J Palliat Med. 2011 May;14(5):556-9. Doi: 10.1089/jpm.2010.0461. Epub 2011 Mar 17. PMID: 21413849. 6. Barber, B., Dergousoff, J., Slater, L., Harris, J., O’Connell, D., El-Hakim, H., Biron, V. L., Mitchell, N., Seikaly, H. (2016). Depression and survival in patients with head and neck cancer. JAMA Otolaryngology- Head and Neck Surgery, 142(3), 284. https://doi.org/10.1001/jamao to.2015.3171; 7. Dunne, S., Mooney, O., Coffey, L., Sharp, L., Desmond, D., Timon, C., O’Sullivan, E., Gallagher, P. (2017). Psychological variables associated with quality of life following primary treatment for head and neck cancer: A systematic review of the literature from 2004 to 2015. Psycho-Oncology, 26(2), 149–160. https://doi.org/10.1002/ pon.4109 8. EARLE, Craig C., et al. Trends in the aggressiveness of cancer care near the end of life. Journal of Clinical Oncology, 2004, 22.2: 315-321. 9. Muni S, Engelberg RA, Treece PD, et al. The influence of race/ethnicity and socioeconomic status on end-of-life care in the ICU. Chest 2011; 139:1025–1033. 10. Barnato AE, Anthony DL, Skinner J, et al. Racial and ethnic differences in preferences for end of life treatment. J Gen Intern Med 2009; 24:695–701. 11. CHANG, Chun-Ming, et al. Low socioeconomic status is associated with more aggressive end-of-life care for working-age terminal cancer patients. The oncologist, 2014, 19.12: 1241. 12. CHANG, Ting-Shou; SU, Yu-Chieh; LEE, Ching-Chih. Determinants for aggressive end-of-life care for oral cancer patients: a population-based study in an Asian country. Medicine, 2015, 94.4. 13. Huang, Chih-Yuan, et al. 'The association between individual income and aggressive end-of-life treatment in older cancer decedents in Taiwan.' PLOS One 10.1 (2015): e0116913 14. LIU, Li N., et al. Preferences for aggressive end-of-life care and their determinants among Taiwanese terminally ill cancer patients. Cancer nursing, 2015, 38.3: E9-E18. 15. Falchook, Aaron D., et al. 'Aggressive end-of-life care for metastatic cancer patients younger than age 65 years.' JNCI: Journal of the National Cancer Institute 109.9 (2017). 16. North, Alexander S., et al. “The unmet needs of patients with advanced incurable head and neck cancer and their carers: A systematic review and meta‐ethnography of qualitative data.” European Journal of Cancer Care (2021): e13474.) 17. Hollingshead, August B. 'Four factor index of social status.' (1975): 47-55. 18. https://ws.moi.gov.tw/001/Upload/OldFile/news_file/109年第12週內政統計通報_教育程度.pdf 19. Woo, Jennifer A., Guy Maytal, and Theodore A. Stern. 'Clinical challenges to the delivery of end-of-life care.' Primary care companion to the journal of clinical psychiatry 8.6 (2006): 367. | |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/79738 | - |
| dc.description.abstract | "研究背景: 2020年度台灣衛生福利部的統計，口腔癌為第六大癌症死因，相較於同年度世界衛生組織的統計，口腔癌並不屬於前十大癌症死亡名單，這表示台灣口腔癌族群明顯與世界趨勢不同。許多研究提出低社會經濟地位的病患，在癌症生命末期死亡前三十天，偏向堅持可能痛苦而且醫學原理上無效的治療。過度積極的治療包含1.接受化學治療，2. 曾經到過急診求助3. 住院超過一次 4. 住院超過十四天 5. 加護病房收治 6. 死亡於急性醫院。 研究目的與方法：本研究針對基隆長庚醫院，頭頸癌病患於2016/01/01至2018/12/31於基隆長庚醫院與情人湖院區死亡，死前三十天的病歷記錄統計，驗證低社會經濟地位（包含性別、工作、婚姻狀態、教育程度）與堅持過度醫療是否有正相關。 研究結果：總共103位頭頸癌病患納入研究統計，其中7位無關頭頸癌本身因素死亡而排除，最終符合者為96位，平均死亡年齡為60歲，89位為男性、國小以下學歷40位、國中23位、高中職23位而大學學歷只有10位。有工作35人、已退休22人、沒有工作39人。未婚15人、已婚60人、離婚17人、喪偶4人。 死前三十天內，接受化學治療34 (35.4%) 位，曾經到過急診求助47 (49%) 位，住院超過一次13 (13.5%) 位，住院超過十四天68位（70.8％），加護病房收治28 (29.2%) 位，死亡於急性醫院96 （100%）位。六項分別給予過度醫療一分，去癌末臨終前接受過度醫療的程度判定，總分零到六分。最後發現平均每位病患有3.69分。 研究結論：96名病患平均接受3.69項過度醫療，經過ＳＰＳＳ軟體計算，發現無論是性別、工作、婚姻狀態、教育程度都不會與死前三十天過度醫療有顯著相關(p>0.05)。值得一提的是，喪偶者可能比其他婚姻狀態者選擇更少的死前三十天過度醫療 (B=-0.882, SE=0.470, p=0.064)，因為先前的文獻從未提及喪偶與否在婚姻狀態的重要性，此一發現值得近一步的探討與研究。 雖然在組間的比較沒有顯著差異，但是整體平均分數(平均3.69，標準差0.86)相較先前台灣的全癌種 (平均1.46，標準差1.26) 或是口腔癌 (平均2.68，標準差1.37)，各項過度臨終醫療的佔比，也都比之前的文獻高：化學治療10.1%~14.1%，住院超過一次或超過14天55.3%~59.3%，加護病房收治15.9%~20.6%。 此研究結果顯示，頭頸癌末期病患，不管社會經濟地位如何，整體接受過度生命末期醫療的比例就是比較高。也許只有喪偶者比較傾向不要太積極。" | zh_TW |
| dc.description.provenance | Made available in DSpace on 2022-11-23T09:09:22Z (GMT). No. of bitstreams: 1 U0001-0502202223322400.pdf: 505662 bytes, checksum: b2f55466ead5b80d9f5f211701bfde41 (MD5) Previous issue date: 2022 | en |
| dc.description.tableofcontents | Contents Chapter 1: Introduction……………………………………………………Page1~4 Chapter 2: Material and Methods…………………………………………Page 4~5 Chapter 3: Result…………………………………………….…………… Page 5~9 Chapter 4: Conclusion and discussion …….……………………………… Page 9~11 Reference………………………………………….……………………… Page12~13 List of figures and tables： Table 1. Descriptive statistics for demographic variables (n = 96) …………Page 5~6 Table 2. Descriptive distribution of Education level in Taiwan in year 2019… Page 6 Table 3. Aggressive EOL care among 96 patients …………………………… Page 7 Table 4. Score of aggressive EOL care…………………………………… Page 7 Table 5. Distribution of demographic variables and aggressive EOL care for terminal patients of head and neck cancer (n = 96) ………………………………… Page 8 Table 6. Regression analysis of demographic variables versus aggressive EOL care for terminal patients of head and neck cancer (n = 96) ……………………… Page 9 | |
| dc.language.iso | en | |
| dc.subject | 社會經濟地位 | zh_TW |
| dc.subject | 癌末過度醫療 | zh_TW |
| dc.subject | Aggressive terminal end-of-life care | en |
| dc.subject | socioeconomic status | en |
| dc.title | 末期頭頸癌病患接受臨終積極治療的社會經濟因素 | zh_TW |
| dc.title | Socioeconomic Determinants of aggressive end-of-life care for terminal patients of head and neck cancer | en |
| dc.date.schoolyear | 110-1 | |
| dc.description.degree | 碩士 | |
| dc.contributor.author-orcid | 0000-0003-2302-207X | |
| dc.contributor.oralexamcommittee | 張厚台,王正旭 | |
| dc.subject.keyword | 癌末過度醫療,社會經濟地位, | zh_TW |
| dc.subject.keyword | Aggressive terminal end-of-life care,socioeconomic status, | en |
| dc.relation.page | 13 | |
| dc.identifier.doi | 10.6342/NTU202200293 | |
| dc.rights.note | 同意授權(全球公開) | |
| dc.date.accepted | 2022-02-10 | |
| dc.contributor.author-college | 公共衛生學院 | zh_TW |
| dc.contributor.author-dept | 公共衛生碩士學位學程 | zh_TW |
| 顯示於系所單位： | 公共衛生碩士學位學程 | |
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