熊秉荃Hsiung, Ping-Chuan臺灣大學:護理學研究所陳品貝Chen, Pin-PeiPin-PeiChen2010-05-052018-07-072010-05-052018-07-072009U0001-0408200903240100http://ntur.lib.ntu.edu.tw//handle/246246/180428目的：本研究目的為(1)瞭解電話追蹤介入對於台灣東部乳癌婦女的焦慮、鬱結狀態及癌症因應行為的效果，以及(2)乳癌婦女對於電話追蹤介入療效的看法。法：本研究採隨機控制試驗(randomized controlled trial)設計。於2009年1月16日至2009年4月20日於花蓮某醫學中心外科及腫瘤科門診及病房收案，以單純隨機方式將收案對象分為實驗組和控制組，最後共有實驗組14人及控制組14人完成研究。實驗組除了接受醫院例行性門診照護外，另有電話追蹤介入，每週一次，共八次，對照組僅接受醫院的例行性門診照護。成效測量以結構式自填量表，於試驗前後測量，量表包括『焦慮狀態量表』、『鬱結量表』、『癌症因應行為量表-簡短版』。實驗組另外於最後一次電話追蹤時，以電話訪談個案，以瞭解個案對於電話追蹤介入療效的看法。論：研究結果發現實驗組的『焦慮狀態』和『鬱結』量表後測分數下降，『癌症因應行為』量表後測分數上升；而控制組的『焦慮狀態』、『鬱結』量表後測分數上升，『癌症因應行為』量表分數下降，經Mann-Whitney U test檢定兩組前後測差異，焦慮狀態量表(Z= -.622，p=.534)、鬱結量表(Z= -.621，p=.535) 皆未達統計顯著差異，但在『癌症因應行為』量表中『對於治療引起副作用的因應』次量表(Z= -2.468，p=.014)則達到統計上顯著差異。結果說明經由電話諮詢的介入會增加乳癌病患對於治療引起副作用的因應行為。透過個案主觀對於介入療效的看法，發現經由電話追蹤介入，提供衛教及諮詢，發揮『提供資訊』、『增加對療程的自信心』、『建立人際支持網絡及抒發情緒』、『協助角色調整的適應』、『發展面對癌症、生命的正向觀點』的功能。論：對於偏遠地區乳癌婦女提供電話追蹤服務，過程中給予病患疾病及治療的衛教指導和心理社會的支持，以協助發展癌症的正向因應行為，未來可根據此模式擴大研究樣本以檢驗其效果。Aims：The aims of this study were to examine (1) the effects of telephone follow up intervention on reducing the sense of anxiety, status of stagnation and increasing the cancer coping behavior for women with breast cancer in eastern area of Taiwan, and (2)what aspects of telephone follow up intervention worked to contribute to the therapeutic effects in the views of women with breast cancer.ethods：This study was a randomized trial design. The subjects were recruited from outpatient and inpatient departments of breast cancer surgery and oncology of medical center in Hualien from January 2009 to April 2009. The subjects were randomly assigned to the experimental or control group by using simple random method. The 14 subjects in the experimental group and the 14 subjects in the control group completed the study. In addition to the physician’s usual care, the subjects in the experimental group received the 8-session telephone follow up intervention. The subjects in the control group only received physician’s usual care. The measurement time included pre and post tests. The outcome measures were State Anxiety Inventory, Stagnation Scale and Cancer Coping Behavior Inventory-Brief. In the last session of telephone follow up, the subjects in the experimental group were invited to express their views on the therapeutic mechanisms of telephone follow up intervention.esult：The results revealed that at post-test, the scores of State Anxiety Inventory and Stagnation scale decreased and scores of Cancer Coping Behavior Inventory-Brief increased in the experimental group. Differently, in the control group, the scores of State Anxiety Inventory and Stagnation scale increased and scores of Cancer Coping Behavior Inventory-Brief decreased. According to the Mann-Whitney U test, the results indicated that there were no significant differences in the scores of State Anxiety Inventory (Z= -.622，p=.534) and Stagnation Scale (Z= -.621，p=.535) between the experimental group and the control group. However, there was a significant difference in the score of Coping the Side Effect of Treatment Induced Subscale of the Cancer Behavior Inventory-Brief scale. The findings illustrated that the telephone follow up intervention could increased the coping behaviors of coping with side effects caused by treatment in the patients with breast cancer. In the views of women with breast cancer, the therapeutic mechanisms of telephone follow up intervention included “impart information”, “improve confidence about the therapy”, “establish social support network and express emotions”, “assist to adapt the sick roles”, and “develop positive views of suffering from cancer and meanings of life”.onclusion：The positive cancer coping behaviors in breast cancer women living in the remote area could be achieved through telephone follow up providing information about disease and treatments and psychosocial support. The future study may enlarge sample size to demonstrate the effects of the telephone follow up intervention.口試委員會審定書 I謝 II文摘要 III 文摘要 IV-V 一章 緒論一節 研究動機和背景 1-2二節 研究目的 3二章 文獻查証一節 乳癌的診斷和治療方式 4-7二節 症狀困擾 8-11三節 偏遠地區婦癌婦女困擾及需求 12-14四節 電話追蹤運用在乳癌病患之相關研究 15-21 五節 研究架構 22三章 研究方法一節 研究設計 23二節 實驗組介入措施 24-25三節 研究對象 26四節 研究假設 27五節 研究工具 28-29六節 研究分析 30七節 研究步驟 31四章 分析與結果一節 研究樣本的相關資料 32-43二節 實驗組的前後測資料比較 44-45三節 控制組的前後測資料比較 46-47四節 實驗組與控制組在電話追蹤前後兩組的差異 48-49五節 電話追蹤成效的探討 50-55五章 討論一節 樣本特性 56-56二節 樣本的焦慮、鬱結狀態、癌症因應行為分析 57-57三節 電話追蹤成效的探討 58-62六章 結論與建議一節 研究結論 63-63二節 研究限制 64-64三節 研究貢獻與建議 65-65考資料文文獻 66-67文文獻 67-75錄 76-80錄一 IRB通過函 76-76錄二 研究問卷 77-80一、電話追蹤的概念架構 22一、國外乳癌電話追蹤介入措施及結果 15-20二、研究設計 23三、電話追蹤介入內容 24-25四、統計方法 30五、研究樣本基本資料 33-33六、研究樣本之疾病相關資料 34-34七、研究樣本前測之相關資料 36-36八、焦慮狀態量表排序 39-39九、過度執著次量表排序 40-40十、鬱結次量表排序 41-41十一、情感-姿勢抑制次量表排序 42-42十二、癌症因應行為量表排序 43-43十三、實驗組焦慮狀態、鬱結、癌症因應行為前後測的變比較 45-45十四、控制組焦慮狀態、鬱結、癌症因應行為前後測的 改變比較 47-47十五、實驗組與控制組在電話追蹤兩組前後的差異 49-49application/pdf827182 bytesapplication/pdfen-US乳癌婦女電話追蹤焦慮鬱結癌症因應行為women with breast cancertelephone follow up interventionanxietystagnationcancer coping behavior[SDGs]SDG3http://ntur.lib.ntu.edu.tw/bitstream/246246/180428/1/ntu-98-R94426027-1.pdf