某醫院癌症病患出院前之症狀困擾疾病不確定感社會支持與自我效能之研究

Abstract

本研究的目的是在探討癌症病患住院接受治療（無論是化學治療、放射線治療）情況已穩定，醫師判定可以出院的病患，探討其症狀困擾、疾病不確定感、社會支持與自我效能影響出院之相關性，研究方法以結構式問卷調查法針對台北地區一所醫學中心，採立意取樣，進行面對面訪談90位癌症病患，本研究之重要結果歸納如下： 1.人口基本資料中，社經地位與症狀困擾、疾病不確定感、社會支持與自我效能各變項有顯著性差異；年齡則與症狀困擾、疾病不確定感、自我效能有顯著性差異；身體功能狀態則與症狀困擾、自我效能有顯著性差異；住院天數與各變項都有顯著性差異。 2.變項中的症狀困擾、疾病不確定感、社會支持、自我效能與出院狀態 有顯著性差異。 3.四個變項間互有相關：症狀困擾與疾病不確定感呈顯著正相關； 症狀困擾與社會支持呈顯著負相關；症狀困擾與自我效能呈顯著負相關；社會支持與自我效能呈顯著正相關；自我效能與疾病不確定感呈顯著負相關；自我效能與疾病不確定感呈顯著負相關。 4.影響癌症病患出院情形的預測因子有「症狀困擾」、「社會支持」、「自我效能」，其中以「自我效能」為最重要之預測因子。 關鍵字：症狀困擾、疾病不確定感、社會支持、自我效能The purposes of this study were to investigate cancer inpatients were discharged under stable condition and judged by doctors after treatment to survey the relationship of discharge with cancer symptom distress、perception of disease uncertainty、social support and self-efficacy. The instruments of this study were structured questionnaires, descriptive sampling which carried face to face interviewed with ninety cancer patients in a medical center in Taipei. The study results as follows: 1. In basic characteristic of population: variables of symptom distress、perception of disease uncertainty、social support and self-efficacy were significantly difference with socioeconomic status; variables of symptom distress、perception of disease uncertainty and self-efficacy were significantly difference with age ; variables of symptom distress and self-efficacy were significantly difference with physical function status ; variables of symptom distress、perception of disease uncertainty、social support and self-efficacy were significantly difference with duration of hospitalization. 2. Variables of symptom distress、perception of disease uncertainty and self-efficacy were significantly difference with discharge status 3. There were cross relationship between four variables: symptom distress was significantly positive relationship with perception of disease uncertainty; symptom distress was significantly negative relationship with social support; symptom distress was significantly negative relationship with self-efficacy; social support was significantly positive relationship with self-efficacy; self-efficacy was significantly negative relationship with perception of disease uncertainty. 4. Predictors which affected cancer patients discharge included 「symptom distress」、「social support」、「self-efficacy」; 「self-efficacy」was the strongest predictor Key words: symptom distress, perception of disease uncertainty, social support, self-efficacy