以健康信念模式探討頭頸癌患者之運動行為

Abstract

頭頸癌患者在癌後除了要面對疾病帶來的外觀與生理功能改變之外，治療後也常要面對憂鬱、生活品質低落的問題。運動在癌症患者的康復過程中扮演著至關重要的角色，不僅有助於改善患者的心肺功能、維持肌力和體能外，同時能減輕癌症相關的疲勞、改善心理健康並增強生活品質，使患者能更好地耐受治療並促進康復。過往研究較少深入了解影響頭頸癌患者運動行為的相關因子，因此，本研究旨在運用健康信念模式 (Health Belief Model) 探討頭頸癌患者在罹癌前、後的運動行為及其影響因素。研究共收案六位頭頸癌患者進行半結構式訪談，了解其在治療過程中的自覺罹患性、自覺嚴重性、自覺行動利益、自覺行動阻礙、行動線索及自我效能對於運動行為的影響。研究結果顯示，多數患者於罹癌前缺乏運動習慣，且對頭頸癌風險認知不足。罹癌後，為了減緩副作用與恢復身體機能，開始嘗試步行、自行車等較為溫和且可調控的運動形式，研究亦發現，自我效能在運動行為意圖改變在實際行動中扮演關鍵角色，相較於健康信念模式中的其他構面，其影響層面更為深遠，不僅能強化行動動機，亦能協助患者克服行動障礙。建議在未來頭頸癌病友的運動計畫中，應強化患者的自我效能，透過短期目標的建立形塑正向的運動經驗。而後續研究亦可再進一步探討未持續運動患者的行為阻礙與心理歷程。In addition to coping with the physical and functional changes brought by the disease, head and neck cancer patients often face depression and a decline in quality of life after treatment. Exercise plays a crucial role in the recovery process of cancer patients. It not only helps improve cardiopulmonary function, maintain muscle strength and physical fitness, but also alleviates cancer-related fatigue, enhances mental well-being, and ultimately improves quality of life—enabling patients to better tolerate treatment and promote recovery. However, few studies have thoroughly explored the factors influencing exercise behavior specifically among head and neck cancer patients. This study aims to investigate the exercise behaviors and influencing factors before and after cancer diagnosis using the Health Belief Model (HBM). A total of six head and neck cancer patients were included in the study and participated in semi-structured interviews to examine how perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy affected their engagement in physical activity during the treatment process. Results showed that most patients lacked regular exercise habits prior to diagnosis and had limited awareness of head and neck cancer risk. After diagnosis, patients began engaging in mild and manageable forms of exercise such as walking and cycling, aiming to relieve side effects and restore bodily function. Among all HBM constructs, self-efficacy emerged as a key factor in translating exercise intention into action. It not only strengthened motivation but also helped patients overcome behavioral barriers.