dc.description.abstract | The threat of Hepatocellular Carcinoma (HCC) remains high in Taiwan, and it is accounted for the top one of the cause of cancer death in male and the second in female. Due to its high recurrent rate, patients with HCC face the illness of uncertainty from diagnose stage to survival. In addition, personality affects how patients evaluate the uncertainty and thus affect their quality of life. However, there is no study to examine the relationships among symptom distress, personality, and uncertainty in survivors with HCC. The aims of this study were to (1) explore status and relationships among the symptom distress, personality and uncertainty in survivors with HCC, and (2) identify the significant factors for the illness of uncertainty. A cross-sectional correlated design was used and patients were recruited by purposive sampling from outpatient departments at a medical center in Taipei. A set of structured questionnaires were used to collect data including patients’ demographic data sheet, Symptom Distress Scale, Type D Scale-14 and Mishel Uncertainty in Illness Scale: Community Form. Data were analyzed by descriptive, correlations, and generalized estimating equation by SPSS 18.0 software. Totally, 163 patients were recruited.
The results of this study found that: (1) the survivors of HCC experienced mild level of symptom distress and moderate level of uncertainty. (2) the patients who with younger age, poor performance status, fewer number of medical treatments, hepatitis C infection, and the longer period of hepatitis C infection had more tendency with negative affectivity; meanwhile, social inhibition was not correlated with any demographic or disease characteristics. (3)there were 19% of patients with type D personality. The patients with negative affectivity or social inhibition perceived higher level of symptom distress and uncertainty. Also, the patients with younger age, poor performance status, fewer number of medical treatments, more times of recurrence, time after completing treatment in years, and more symptom distress perceived higher level of uncertainty, and (4) negative affectivity(β= .283, p = .018)was the significant factor related to the uncertainty.
Based on our study results, clinical nurses are suggested to pay more attention to those with higher risk factors of uncertainty in hepatocellular carcinoma survivors. Nurses should take care not only for the patients’ symptom distress, but also assessing their psychological problems and personality in order to understand the source of uncertainty, and provide them appropriate health education, mental support, and caring to help patients to reduce their uncertainty, and to have better quality of life. | en |