2012-01-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/648135摘要：肺癌是最具侵襲及威脅生命的癌症之一，在台灣，由於肺癌的高死亡率及其疾病的進展快速，造成病患及其家屬嚴重的衝擊，然而，目前探討對於侵襲性肺癌病人其家屬照顧者生活品質的研究仍十分有限，為了解該群病人與家屬的問題，及進一步提供以家庭為中心的介入措施來協助他們為當務之急。因此，本始自2009年的五年期的研究計畫，在前兩年主要為縱貫性觀察病人及其家屬在接受診斷後頭六個月的生活品質及影響因素，第三年起則根據前兩年的研究結果發展及測試以家庭為中心之照顧模式。本報告主要呈現第一階段之研究結果，以及第二階段的以家庭為中心的照顧模式發展及前驅測試之情形。2009年至2011年共收241對侵襲性肺癌之新診斷個案及其主要照護之家屬，在六個月期間病人有中等程度的生活品質，有較低的角色及社會功能。2012年開始積極發展FCCC (Family-Centered Cancer Care, FCCC)照顧模式，已完成發展各12次課程的病人及家屬FCCC照顧模式、工作手冊、病人及家屬衛教單張及手冊。由於肺癌臨床治療非常複雜，病人差異極大，因此如何發展一個可符合各種不同治療模式及不同病人特質的照護模式是一大挑戰。我們已開始在台灣大學附設醫院進行FCCC的前驅測試，實驗組研究對象須接受12的月的追蹤，在基準點的測量後，我們立即實施6個月的FCCC課程。經過此前驅測試，克服收案流程及研究環境的困難後，我們預期在2012年將可使第二階段研究順利進行，預計收取180對病患及其家屬並隨機分派於控制組(90對)及FCCC組(90對)。本研究無論在國內外都是第一個以侵襲性肺癌病人及家庭照顧者為研究對象的隨機分派控制介入性研究，從前驅研究的初步結果可看到研究對象對此介入措施正向反應。預期本研究結果將能幫助醫護人員，更暸解侵襲性肺癌病人與家屬再診斷六個月間之問題，及提供更有效的照護模式，以協助肺癌病患及其家屬有更好的因應能力，並增進生活品質。<br> Abstract: Lung cancer is one of the most invasive and life threatening cancers in the world. The poor progression and high mortality nature of the disease lead to tremendous negative impacts on patients and their families. However, very limited research simultaneously focuses on both advanced lung cancer patients’ and their caregivers’ quality of life (QOL). This two-phase 5 year project (starting from 2009) aims to explore the patients and their families’ QOL and related factors and further to develop and test the effectiveness of the family-centered cancer care model (FCCC).A total of 241 advanced lung cancer patient-family dyads were recruited from March 2009 to Nov. 2011. The results showed that the patients having moderate level of QOL across the 6-month with relatively low level in social function and role function. Caregiver had moderate levels of QOL across the 6 months with the lowest scores on baseline. From 2012, we continue our FCCC Program has been developed since 2011 which comprises of 12 sessions for patients and families during the first 6 months since treatment commencement. Since the complexity of clinical lung cancer treatments and the heterogeneity of patient characteristics, it is a challenge for us to develop a comprehensive model to tailor to all patients’ needs. We have conducted the FCCC pilot study in NTU hospital this year. The interventions were conducted right after the baseline assessment for those patients in experimental group and the subjects were assessed for 12 months. We expect to have all intervention study going on since 2012 and will recruited 90 patient-family dyads for experimental group and another 90 dyads for control group.This is the first intervention study focusing on advanced lung cancer patients and their families’ adjustment and QOL worldwide. We expect this study will help health care professionals to better understand this population and provide more effective supportive care to help them to cope well with cancer.肺癌生活品質家屬自我效能症狀調適lung cancerquality of lifecaregiversymptomadaptation