接受導管肝動脈化學藥物栓塞術肝癌病患之生活品質

Quality of Life for Patients with Hepatocellular Carcinoma Receiving Transcatheter Aterial Chemoembolization

本研究為瞭解接受導管肝動脈化學藥物栓塞術肝癌病患之生活品質的相關性研究。探討病患人口學變項、疾病特性、身體症狀、情緒狀態、社會支持與生活品質的相關性。採立意取樣，以高雄市某醫學中心肝膽內科門診，栓塞治療後第一次回診之肝癌病患為研究對象，共收案 83 人，以結構性問卷會談法收集資料，研究工具為「生活品質量表」「身體症狀量表」「情緒狀態量表」「社會支持量表」。研究結果：栓塞治療肝癌患者之生活品質為中等程度（ M=20.07，SD=2.25 ）；生活品質五個因素中，親密因素得分最高，依序是家庭因素、心理社會因素、環境因素及健康因素，即親密因素對研究對象而言是重要且滿意的生活部份，健康因素則是重要卻不滿意的生活部份。研究對象多為輕度負向情緒狀態，負向情緒最多者為「不感到快樂」與「鬱悶」。身體症狀為輕微困擾程度，以「疲倦」症狀最嚴重。研究對象覺得所接受到的社會支持有中等的幫忙程度，覺得幫忙最多的為「有人會關心身體狀態」。婚姻狀況在生活品質達顯著性差異，情緒狀態、身體症狀與社會支持和整體生活品質成顯著性相關，即有偶者、情緒越正向、身體症狀困擾越輕、社會支持幫助越大者，其生活品質越好。對生活品質有預測力之因子為：情緒狀態、身體症狀、婚姻狀況、社會支持四個自變項。The purposes of this correlational research were to explore the levelof quality of life (QOL) for patients with hepatocellular carcinoma receivingthranscather arterial chemoembolization. This research was concerned withdemographics, disease characteristics, physical symptoms, emotional state, andsocial support in regards to QOL. Samples were obtained by purposive sampling inhepatology (OPD) medical center, in Kaohsiung. Instruments included (1) Qualityof Life Index (QLI) examining five factors, namely: health, environment, phychosocial state, family and intimacy; (2) symptom distress scale; (3) emotionstate scale; and (4) social support scale.The sample consisted of 68 men and 15 women, ranging in age from 30 to 82 years.The findings of the research included that (1) the level of QOL for hepatomapatients with T.A.C.E. was moderate; (2) the subjects showed a slightly negativeemotional state; (3) their physical symptoms were slightly retarded; (4) theyfelt they received a moderate level of social support; and (5) marital situationhad significant difference in QOL. Emotional state, physical symptoms, andsocial support had significant relation with the total QOL; i.e. when thepatient had a spouse, his emotions were more positive, physical symptomretardation was slight and the QOL was better. The more social support hereceived, the better QOL he obtained. The four factors which could predict theQOL were the following: emotional state, physical symptoms, marital situation, and social support.