卵巢癌婦女接受手術和化學治療經驗中的行為反應

8ehavioral Responses of Women with Oravian Cancer Recetring Surgical Treatment and Chemotherapy

本研究以質性研究探討接受手術和化學治療的卵癌婦女於治療經驗中的行為反應。研究者於個案手術前一天至第三次化學治療止約二個月期間以「觀察者即參與者」的方式收集資料，再以內容分析法將行為過程中語言行為部作有系統的整理分析，歸類，編碼和統計。 研究結果發現：卵巢癌婦女於治療經驗中的行為反應歸納出2671個行為單元包括認知行為、情緒反應和處置行為三大類。以認知行為佔62.8%最多，其次為情緒反應佔19.5%，處置行為佔17.7%。認知行為中依序包括確認、評價和比較行為；情緒反應包括負向及正向情緒，負向情緒為多，依序有焦慮、抱怨、憂傷、自責，正向情緒有滿意與感恩。處置行為依次為自我協助、尋求協助、迴避行為、調整維持和遵從配合。行為反應所關注的治療經驗事項，也歸納出身體經驗、醫療經驗、社會性經驗三部份，身體經驗以身體感覺關注最多依次為身體功能、身體結構；醫療經驗中依序為醫療處置、疾病特性和醫療環境；社會性經驗涵蓋自我角色、家庭角色關係、社會互動和工作狀況。整個治療過程以針對身體感覺、身體功能和醫療處置、疾病特性所呈現之行為居前四位。 研究結果亦呈現，行為反應及所關注之經驗事項隨不同治療時段、情境而有所變化。認知行為和處置行為針對身體的改變出現較多，情緒反應則多因疾病本身特性和醫療處置之影響。The purpose of this qualitative study was to explore the behavioral responses of four patients with a diagnosis of ovarian cancer, after they received a debulking surgery and during the course of receiving the 3nd session of chemotherapy. Adopting 'observer-as participant' approach, clinical field was used to collect data for this study. Data were collected while the nurse-researcher was participating the action and interaction with the patients in every nursing care session and in a narrative form, that was in the form of 'process-recordings'. By using content analysis method, verbal responses of the patients then, systematically interpreted and categorized according to operational definition of the behavioral themes and units. As a result, a total of 2671 bhehavioral unis were inductively generated.The major findings of this study included three behavioral themes. The most commonly used behavior by these patients was cognitive behavior which accunted for 62.8 percent of total behavioral units, following by affective behavior with 19.5 percent while intervening behaviors were the least used behaviors which accounted for 17.7 percent. Cognitive behaviors included, orienting (expressed in affirmation, inquiry, speculation and expectation), evaluating and comparing. Affective behaviors included negative emotion such as anxiety, sadness and self-reproach, and positive emotion such has satisfaction and gratification. Intervening behaviors included self-help, help-seeking, avoidance behaviors, regulatory and maintenance behaviors, and compliance behaviors. Patients' treatment experiences were also classified into three parts, namely, body experience(48.8%), medical experience(33.5%), and social experience(17.7%). Under body experience, body sensation was the most frequently mentioned experience, following by body function and body structure. Under medical experience, the characteristics of the disease were the most often referred. Social experience involved four areas including self, family role and relationship, social interaction and job responsibility. It was also found that behavioral responses changed as the patients were being experienced in the different period of treatment course. Both cognitive and intervening behaviors were tended to related to body experience while affective behaviors tended to related to medical experience.