2011-01-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/648276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，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，及進一步分析以家庭為中心來協助他們為當務之急。因此，本五年期計劃分為二大段，第一階段（2009-2010）之研究目的，為探討ⅢB及Ⅳ非小細胞肺癌病患以及主要家屬照顧者，由診斷開始頭六個月接受治療期間生活品質變化，及其自我效能程度上變化的情形；第二階段 (2011-2012) 目地為發展以家庭為中心的癌症照護模式 (Family-Centered Cancer Care, FCCC)，並以採隨機臨床對照實驗設計，將病患分成實驗組及對照組，測試此模式對病患及家屬之生活品質改善之成效，並提供給未來臨床照護人員提升肺癌病患及家屬在接受癌症治療期間生活品質的實證依據。 本年度為第二階段之開始，將以隨機分派臨床試驗研究，測試FCCC對促進肺癌病患以及家屬生活品質之成效。依第一階段的結果，顯示病人在「社會功能」及「角色功能」則相對較差，此結果與病人及家屬在「情緒調整」及「尋求社會支持」的自我效能有類似的趨向。因此，FCCC主要內容包括(1)問題解決訓練；(2)情緒管理技巧；(3)症狀處理的知識及技巧；(4)建立希望感及生命存在意義；(5)放鬆技巧訓練；(6)與醫療人員的溝通技巧與社交網絡的建立。預計收取240對病患及其家屬並隨機分派於控制組(120對)及FCCC組(120對)，FCCC組將接受為期6個月共11次的諮商及討論，第1次於首次化學或標把治療前，為期1個月每週1次，每次1小時的諮商共4次，接下來的第2個月及第3個月，則提供每2週一次，每次半小時的諮商共計4次；之後則為每個月1次，每次半小時的諮商共計3次。最後將於治療前(T1)、四週後(T2)、12週後(T3)及24週後(T4)追蹤諮商的成效。 預期本研究結果將能幫助醫謢人員，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: In Taiwan, the high mortality rate and progressive nature of the lung cancer has severely impacted patients and their family. Very limited research was found which simultaneously examine both lung cancer patients’ life quality and their family caregivers’ care reactions and quality of life, and their relationship. Therefore, this 5-year project will be conducted in the two phases with the purposes to (1) explore the changes of QOL and level of self-efficacy in newly diagnosed lung cancer patients receiving chemotherapy and/or target therapy and their key health provider within the first 6 months of diagnosis (Phase I); and (2) develop Family-Centered Cancer Care psycho-education program (FCCC) and test its effects on improving lung patients and their primary family caregivers’ life quality (Phase II). This year, we will conduct the Phase II study of this project (years 3-5). The Family-Centered Cancer Care (FCCC) will be developed according to the results of the phase I. A randomized control clinical trial will be conducted in a medical center in Northern Taiwan from the 3rd year to test its effects. The major contents of FCCC will include: (1) problem-solving training, (2) emotional disclosure and regulation, (3) symptom management knowledge and skills, (4) spiritual-meaning and mind-body driven exploration, (5) relaxation skills training, (6) negotiating support and resources skill training, and (7) communication training. The FCCC will include 11 sections of patient-family dyad education and counseling. The effects of the FCCC will be examined in the dyads by collecting data from baseline (before first interview, T1), after completing the 4th counseling (end of week 4, T2), the end of 3rd month (T3), and the end of 6th month (T4). We expect this study will help health care professional to understand and provide more effective and supportive care to help lung cancer patients and their family caregivers to have better coping abilities with cancer and to improve quality of life.肺癌生活品質家屬自我效能症狀調適lung cancerquality of lifecaregiversymptomadaptation