2015-08-012024-05-18https://scholars.lib.ntu.edu.tw/handle/123456789/703181摘要：背景: 雖然早期肺癌(期別 I、II、IIIA)有相對較好的疾病進展，但五年存活率與其它癌症相比仍相對較低，這群病人可能受苦於對疾病的不確定感與疾病、治療造成的身體變化，但針對這群病人多於門診追蹤，其問題需求及相關照護可能深受限制，如何使用有效的問題篩檢病人問題，以提供量身訂做措施運用於個別病人需求的照護刻不容緩。 目的:主要研究目的: (1)發展與建構以實證和服務為導向的病人教育與電腦化之肺癌照護模式，分別包括: (a)控制組為接受院內常規照護組 (UC)及 (b) 實驗組: 電腦輔助門診個人支持性照護計畫組 (COPSCCP)(計畫第一年的前四個月將進行方案內容與電腦系統建置工作)。(2)比較二組之自我報告的生活品質、身體症狀、肺功能、憂鬱、焦慮、未滿足之需求與復發率。每位病人將追踪 2 年，如果病人復發、轉移或死亡將停止個案的追踪，但病人會到腫瘤醫學部照顧。 方法: 符案的病人為新診斷早期肺癌(期別 I、II、IIIA)且接受手術治療，研究以癌症期別進行隨機化配對，將受試者分為二組：實驗組的病人將於手術後接受為期 6 個月的介入措施內容，2 組的每位病人都將於 2 年內追踪 6 個時間點: 基準點(出院前)、手術後第1、3、6、12、24 個月(T1-T6)。結果指標包括:心理、生理/疾病、症狀、肺功能、復發率相關變項。樣本數推估: 預計每組將收錄 150 位病人，共計 300 位病人被收錄於本計畫案，結果主要以廣義推估模式(GEE)與存活進行分析。進行研究前將通過倫理委員會審查(IRB)，並透過研究期待發展與測試以服務為導向之支持癌症照護介入方案成效，並推廣本研究發展之照護模式於臨床實務的癌症照護系統中。<br> Abstract: Background: Although there is a relatively better prognosis, the 5-year survival rate for early stage lung cancer (Stage I, II, IIIA) is still relatively low compared to those other types of cancer. These patients might suffer lots from the uncertainty and substantial disease and treatment related physical changes. How to provide a feasible OPD personalized supportive care program is important. Purpose: Main purpose of the study: (1) Develop and construct the contents, related patient education materials and computerized systems of the three evidence and service-based lung cancer care programs, including (a) Control as usual care (UC), and (b) Computer Assisted OPD Personalized Supportive Care Program (COPSCCP) (will be developed and structured the contents and computer system in the first 4 months of this research project); and (2) Compare the effects of COPSCCP and care as usual on self-report quality of life (QOL), physical symptoms, lung function, Depression, Anxiety, fear of recurrence, Unmet Cancer Needs, recurrence rate. Each patient will be follow for 2 years. Patients with recurrence, metastasis will be dropped out from the study (and refer to medical oncology). Method: Eligible patients will be newly diagnosed early stage lung cancer patients (patients in stage I, II, & IIIA) who have received surgery. A 2-group randomized control trial (RCT) matching with cancer stages will be conducted. For the COPSCCP, patients will be intervened for 6 months from the first time during hospitalization of receiving surgery or before hospital discharge and then OPD intervention. Each patient will be followed 6 time points for 2 years (will be drop and refer to medical oncology while having recurrence, metastasis or death): baseline (pre-discharge from hospital) and 1, 3, 6, 12, and 24 months after discharge from hospital, T1-T6, respectively. The outcomes indicators will include: psychological variables, physical/disease variables, symptoms, lung function, and recurrence rate during 2 years. The estimated subjects would be 150 for each group, totally 300 subjects recruited in the beginning of the study. Results would be analyzed mainly by GEE and survival analysis. IRB approval will be received before the RCT. We expect to develop and test the supportive cancer care interventions and generalize the interventions into the cancer care system after the study if prove good outcomes.