2018-08-012024-05-18https://scholars.lib.ntu.edu.tw/handle/123456789/703009摘要：目的.第一年和第二年計畫的研究目的為探討於14 個月追蹤期間，非小細胞肺癌存活者經由正念合併身心靈團體治療介入後，對改善憂鬱症狀，身體困擾(身體症狀和身體功能)，心理安適(正念狀態、整體安適狀態、生命意義)，可體松壓力反應以及肺癌復發率之長期成效。第三年探討非小細胞肺癌存活者於參與介入計畫後，對於參與團體過程如何影響他們成長經驗以及對於肺癌存活期憂鬱照護方案的建議之主觀看法。研究方法.設計 第一年和第二年的研究設計採隨機控制實驗法。本研究將於胸腔外科和腫瘤科門診收案預計邀請110 位年齡介於20 至65 歲且完成癌症治療(手術，化療，標靶或/放射治療)的非小細胞肺癌0 至IIIA 期別的病患參與本研究。經由單純隨機法將病患隨機分配至兩個組別：控制組接受每周1 次每次120 分鐘共2 個月衛教暨支持團體。於同時期，實驗組接受每周1 次每次120 分鐘共2 個月的正念合併身心靈團體治療，團體內容除了控制組所涵蓋的衛教內容外，還包含正念技巧和身心靈的賦能方案。測量工具 結構式問卷包含BDI-II 憂鬱量表、European Organization for Research and Treatmentof Cancer Core Cancer Quality of Life Questionnaire (EORTC QLQ-C30)以及lung cancerspecific complementary measure (EORTC QLQ-LC13), Taiwanese Five Facet MindfulnessQuestionnaire (T-FFMQ)中文版，Holistic Well-being Scale (HWS)中文版、State-TraitAnxiety Inventory (STAI)焦慮量表、MLQ 生命意義量表。唾液可體松樣本的收集時間為睡醒、睡醒後30 和45 分鐘、12:00, 17:00 及 21:00。成效追蹤時間為:前測(T0)、後測為第二個月(完成介入後)(T1)，第五個月(T2)，第八個月(T3)，以及第十四個月(T4)。第三年計畫是以焦點團體訪談收集質性資料。焦點團體會以半結構訪談指引進行探討存活者參與正念合併身心靈團體治療或是衛教暨支持團體之後，對於參與團體如何影響其成長經驗以及對於存活期憂鬱照護方案建議的主觀看法。資料分析 第一年和的二年將以Generalized estimating equation models 比較兩組在五次測量時於依變項(dependentvariables)平均值的差異，每次追蹤的評估將與前測作重複的比較測量並且將疾病和治療變項作為covariates。兩組於肺癌復發率之差異將使用multi-level survival analysis 分析。質性資料將使用內容分析法分析焦點團體訪談內容的資料。<br> Abstract: Aims and objectives. For the first and second years, this 14-month study aims to examine thelong-term effects of mindfulness added to body-mind-spirit group therapy on improvingdepressive symptoms, physical distress (physical symptoms and functions), psychologicalwell-being (mindfulness status, holistic well-being, meaning in life), cortisol stress responsesand cancer recurrence rates among NSCLC survivors. For the third year, NSCLC survivors’views of their growth experiences after participating in the intervention study were explored.Methods. Design For the first and second years, this study adopts the randomized controlledtrial (RCT) design. Total 110 patients who are the stage 0-IIIA of non-small cell lung cancer(NSCLC), aged between 20 and 65 years old and complete surgery, chemotherapy, targettherapy, and/or radiotherapy will be recruited from outpatient department of divisions ofthoracic surgery and oncology. With simple random assignment, subjects in a control groupwill receive 120 minutes every week for 2-month education with supportive group. In thesame period of time, in addition to contents of education provided in control group, subjectsin an experimental group will also receive 120 minutes every week for 2-month mindfulnessadded to body-mind-spirit group therapy (mindfulness with BMS) (mindfulness skills andboy-mind-spirit empowerment strategies). Measures The questionnaires include BDI-IIdepression scale, European Organization for Research and Treatment of Cancer Core CancerQuality of Life Questionnaire (EORTC QLQ-C30) and its lung cancer specificcomplementary measure (EORTC QLQ-LC13), Taiwanese Five Facet MindfulnessQuestionnaire (T-FFMQ), Holistic Well-being Scale (HWS), State-Trait Anxiety Inventory(STAI), the meaning in life questionnaire (MLQ) and salivary cortisol will be collected athome at six time points: upon waking, 30 and 45 minutes after waking, and at 1200 hours,1700 hours, and 2100 hours. Outcome measurement time points are at baseline (T0), the 2ndmonth (the end of intervention) (T1), the 5th month (T2), the 8th month (T3), and the 14thmonth (T4). For the third year, the qualitative interview with taped focus group will be used tocollect the qualitative data. The semi-structured interview guide will be used regarding abouthow the mindfulness with BMS group therapy or education with supportive group influencessurvivors’ growth experiences and their suggestions about depression care program. Dataanalysis For the first and second years, comparisons of mean scores in the outcome variablesbetween two groups over these five time-points will use the generalized estimating equationmodels with each follow-up assessment as a repeated measure and pre-intervention baselinescore, and patient demographics with disease and treatments as covariates. The multi-levelsurvival analysis will be used to test the hypothesis of the lower lung cancer recurrence ratesin patients with experimental group than those in control group. For qualitative data, contentanalysis will be conducted to analyze the data from focus group interviews.肺癌存活者正念身心靈團體治療憂鬱症狀焦慮生命意義心理安 適身體困擾唾液可體松壓力反應Non-small cell lung cancer survivorsmindfulnessbody-mind-spiritgroup therapydepressive symptomsanxietymeaning in lifephysical distresspsychological well-beingsalivary cortisol stress responses