2016-08-012024-05-18https://scholars.lib.ntu.edu.tw/handle/123456789/705156摘要：目的.第一年研究目的為探討何為影響非小細胞肺癌存活者憂鬱症狀的主要因素，以及存活者對於憂鬱成因和心理照護需求的主觀看法。第二年研究目的為根據理論和第一年研究結果發展和探討正念合併身心靈治療於改善憂鬱症狀之成效，以及了解存活者對於在治療經驗中何種治療策略能改善其憂鬱症狀之看法以及對治療的建議。研究方法.設計 第一年研究採橫斷式相關設計，結構式問卷和焦點團體質性訪談分別使用於收集量性和質性資料。第二年介入措施研究採隨機控制實驗法，成效追蹤時間為:介入前、介入後以及介入後第三個月、六個月和十二個月。本研究將邀請醫院腫瘤科門診年齡介於20 至65 歲且完成癌症積極治療(手術，化療或/放射治療)的非小細胞肺癌0至IIIA 期別的病患參與本研究。病患將經由單純隨機法的方式分別至兩個組別：實驗組接受每周1 次每次150 分鐘共2 個月正念合併身心靈團體治療，控制組接受每周1 次每次120 分鐘共2 個月身心靈團體治療。測量工具 問卷將使用BDI-II 憂鬱量表、European Organization for Research and Treatment of Cancer Core Cancer Quality of LifeQuestionnaire (EORTC QLQ-C30) 以及lung cancer specific complementary measure(EORTC QLQ-LC13), Taiwanese Five Facet Mindfulness Questionnaire (T-FFMQ)中文版，Holistic Well-being Scale (HWS)中文版、State-Trait Anxiety Inventory (STAI)焦慮量表、MLQ 生命意義量表及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。質性資料部份，第一年半結構式訪談指引將使用於收集參與者對於導致憂鬱症狀的成因、所經歷的困難以及有哪些關於處理憂鬱未被滿足的需求內容。第二年訪談指引內容詢問參與者對於團體治療如何能有效處理憂鬱症狀的看法，以及對治療的建議。資料分析 第一年將使用the multiple linear regression model 分析影響憂鬱症狀的主要因子。第二年Generalized estimating equation models 將比較兩組在五次測量時於依變項(dependent variables)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-levelsurvival 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 year, the study examines what factors are associated withdepressive symptoms in NSCLC survivors and their views of the causes of depression andtheir needs of psychological care for managing depressive symptoms. For the second andthird years, the study develops and examines the effects of the mindfulness added tobody-mind-spirit therapy (Mindfulness with BMS) for managing depression based on thetheories and results of the first year. NSCLC survivors’ views of what strategies learn intherapy improves their depressive symptoms will be also explored.Methods. Design For the first year, the study will adopt the cross-sectional correlation design.The structured questionnaires and the qualitative interview with taped focus group are used tocollect the quantitative and the qualitative data. For the second and third years, theintervention study adopts the randomized controlled trial (RCT) design. Follow uptime-points include pre intervention, post intervention, & then 3, 6, 12 months after the end ofintervention. NSCLC patients who are the stage 0-IIIA, aged between 20 and 65 years old andcomplete surgery, chemotherapy, and/or radiotherapy are recruited from outpatientdepartment of oncology. With simple random assignment, the subjects in an experimentalgroup will receive 150 minutes every week for 2-month mindfulness with body-mind-spirit(Mindfulness with BMS) group therapy while those in a control group will receive 120minutes every week for 2-month body-mind-spirit (BMS) group therapy in the same period oftime. Measures The questionnaires include BDI-II depression scale, European Organizationfor Research and Treatment of Cancer Core Cancer Quality of Life Questionnaire (EORTCQLQ-C30) and its lung cancer specific complementary measure (EORTC QLQ-LC13),Taiwanese Five Facet Mindfulness Questionnaire (T-FFMQ), Holistic Well-being Scale(HWS), State-Trait Anxiety Inventory (STAI), the meaning in life questionnaire (MLQ) andsalivary cortisol levels. For qualitative data, for the first year, the semi-structured interviewguide will be used regarding what you think are the causes of your depression, whatdifficulties you have been experiencing, and what are the unmet needs of managing yourdepression. For the second year, the interview guide is used regarding what you learn in grouptherapy helps you to manage depression. Data analysis For the first year, the multiple linearregression model will use to determine which are the main predictors of depressive symptoms.For the second year, Comparisons of mean scores in the outcome variables between twogroups over these five time-points will use the generalized estimating equation models witheach follow-up assessment as a repeated measure and pre-intervention baseline score, andpatient demographics with disease and treatments as covariates. The multi-level survivalanalysis will be used to test the hypothesis of the lower cancer recurrence rates in patientswith experimental group than those in control group. For qualitative data, content analysiswill 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焦慮生命意義心理安適生活品質唾液可體松濃度可體松晝夜型態Non-small cell lung cancer survivorsmindfulnessbody-mind-spirit group therapydepressionanxietymeaning in lifequality of lifepsychological well-beingsalivary cortisol levelsdiurnal cortisol patterns