癌症病患住院期間之需求及其相關因素探討

Needs of Cancer Patients during Hospitalization

癌症不僅威脅生命，更嚴重影響到病患日常生活品質。本研究目的為：(1)探討癌症病患於住院期間之需求程度；(2)探討癌症病患人口學特性、疾病特徵與需求之相關性；(3)探討癌症病患自我照顧能力與需求之相關性。研究採橫斷式相關設計，以方便取樣，針對南部某醫學中心內科及腫瘤科病房之住院癌症病患，以基本資料表、癌症病患需求評估量表、身體功能狀態量表，進行結構式問卷訪談，共收得84位個案。研究結果顯示：(1)病患有中等程度的需求，其中又以心理調適較高；(2)不同日常生活照顧能力之病患其需求有顯著差異，依序為可完全自我照顧之病患、少部分須他人協助、完全需他人協助、大部分須他人協助；(3)住院天數與需求呈負相關(p< .001)，放射治療次數與需求呈負相關(p< .05)，化學治療次數與放射治療次數與住院次數呈正相關(p< .001；p< .05)，住院次數與發病期間呈正相關(p< .001)。本研究結果建議臨床護理人員於臨床照護可以藉由病患每日的護理活動時透過溝通技巧的運用，給予會談及心理諮商，加強因應問題的能力，使癌症病患一旦面臨緊急變化及死亡逼近的恐懼時，能夠以正向的態度面對。

Cancer not only threatens life, but also affects patients’ daily quality of life. The purposes of this study were to 1) preliminarily examine the needs of cancer patients during hospitalization, 2) examine the relationships among demographic characteristics, illness characteristics, and needs in cancer patients and 3) examine the relationships between self-care ability and needs in these patients. A cross-sectional study was conducted using convenience sampling. Eighty-four subjects were recruited from medical and oncology inpatient departments in a medical center of Southern Taiwan. Structured interviews were conducted to collect data. The 'Patient Needs Assessment Tool' and the 'Eastern Cooperative Oncology Group' instruments were used. Demographic data was also collected. There were three major findings. First, the patients had a moderate degree of needs, especially psychological adjustment was the most frequently perceived need during hospitalization. Second, differences in needs were significantly related to patients' self-care ability. As anticipated, patients who needed total care perceived higher needs than those who did not need total care. Finally, inpatient days negatively correlated with need (p< .001); radiotherapy frequency negatively correlated with inpatient frequency (p< .05); radiotherapy and chemotherapy frequency positively correlated with needs (p< .001; p< .05); and inpatient frequency positively correlated with time of illness (p< .001). Results suggest that nurses in clinical settings need to use effective communication skills in daily nursing activities, interviews, and psychological assessments in order to ascertain cancer patients' needs and perceptions. Such skills enhance patients' coping ability, help them manage emergency states and fear of feeling near death, and facilitate their development of a positive psychological state.