Taipei Medical University Institutional Repository:Item 987654321/5463
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    題名: 疑似乳癌婦女未確立診斷前之心理狀態與照護需求初探
    Preliminary Study of Psychological Status and Care Demand in Suspected Breast Cancer Women
    作者: 陳清香
    Ching-Hsiang Chen
    貢獻者: 護理學研究所
    關鍵詞: 乳癌
    焦慮
    癌症憂慮
    不確定感
    照護需求
    日期: 2004
    上傳時間: 2009-09-11 15:33:06 (UTC+8)
    摘要: 癌症長久以來居十大死因之首，以女性而言，乳癌居女性癌症死因第四位，以女性在一個家庭具多重角色而言，若罹患乳癌絕不僅只是個人健康影響而已，對家庭的結構功能更是威脅；然而目前關於乳癌的研究或照護多著重於已罹患乳癌的婦女族群，對於疑似乳癌的婦女所面臨的心理、情緒的壓力及照護需求鮮少探討。本研究目的在發展本土化照護需求量表，測量疑似乳癌婦女確立診斷前照護需求，並針對疑似乳癌婦女未確立診斷前焦慮、癌症憂慮、不確定感及照護需求進行初步探討，透過此研究結果可讓臨床醫護人員更具體瞭解此類婦女的心理狀態，提供更適切與人性的關懷照護。本研究分為二階段，第一階段採質性研究法於乳房外科門診收集10位疑似乳癌婦女，以事先擬定之訪談指引進行深度訪談，目的在瞭解面臨可能罹癌的心理狀態與照護需求後發展結構式照護需求評估工具；第二階段以結構式問卷為工具，採縱貫式調查法，收集疑似乳癌婦女焦慮、癌症憂慮、不確定感及照護需求等資料。研究結果顯示：
    一、 經過初探研究的測試，初步認為此工具信效度皆良好，值得被測量疑似乳癌婦女確立診斷前的照護需求。
    二、 疑似乳癌婦女確立診斷前的焦慮程度處於高度焦慮狀態癌症憂慮程度處於中度癌症憂慮；面臨中等程度的不確定感；對每個照護需求項目的需要程度平均介於「頗為需要」至「非常需要」間。
    三、 良性診斷者，確立診斷後的焦慮、癌症憂慮、不確定感均下降；惡性診斷者焦慮及不確定感均有下降，但癌症憂慮上升。
    四、 年齡與焦慮有關，焦慮與癌症憂慮有關，不確定感與照護需求有關。
    根據本研究結果提出以下列建議：一、加強醫護人員對疑似乳癌婦女心理狀態的察覺，適時提供相關訊息、情緒支持，減輕焦慮與不確定感，主動給予協助，讓此類婦女能在身心安適的狀態下接受進一步治療。二、能具體應用個案管理模式於乳癌病患照護中，以達完整且持續的照護。三、加強醫護人員情緒照護教育課程。
    關鍵字：乳癌、焦慮、癌症憂慮、不確定感、照護需求
    Breast cancer is a common disease in females. Most studies focus on physiologic or psychological burden on diagnosed breast cancer women. Only few study focused on the psychological status of suspected patients. The purposes of this study was to develop a care demand scale especially for suspected breast cancer women in Taiwan, then to determine the associations between care demand and anxiety, cancer worry, disease uncertainty. Ten suspected breast cancer women were interviewed using a semi-structured survery. The interview results were analyzed to develop a care demand questionnaire through content analyses. Then thirty-one suspected breast cancer women participated in longitudinal survey to determine the difference of anxiety, cancer worry, and uncertainty before and after confirmation of diagnosis.
    Study results were as followed:
    1. A care demand assessment questionnaire for suspected breast cancer women in Taiwan was developed with good reliability and validity.
    2. Suspected breast cancer women suffered with from moderate to high levels of anxiety, cancer worry and uncertainty. The every detail aspect of care demand is either “needed“ or “very needed” to these suspected breast cancer women.
    Bases on the study results, we suggested: 1. Health professionals should be aware of the psychological status of the suspected breast cancer women. 2. Health professionals should provide informational, emotional and tangible supports as well. 3. Enhance continues care for suspected breast cancer women by case management.
    Key words: Breast Cancer, Anxiety, Cancer Worry, Uncertainty, Care Demand
    資料類型: thesis
    顯示於類別:[學士後護理學系] 博碩士論文

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