癌痛病患的焦慮、憂鬱及其相關因素之探討

Anxiety, Depression and Related Factors in Cancer Patients with Pain

疼痛會導致癌症病患身體上與心理上的困擾，以及生活品質負向的衝擊。本研究目的主要在探討癌痛病患的焦慮、憂鬱及其影響因素，藉由調查法，針對124位癌痛病患，以「健康控制重心量表」、「焦慮反應量表」及「憂鬱量表」等問卷收集資料。重要研究發現：（1）癌痛病患中有55.6%出現輕度焦慮，20.2%中度焦慮；而34.7%有嚴重憂鬱，28.2%中度憂鬱。（2）癌痛病患的焦慮與宗教信仰、平均疼痛程度、最痛程度、疼痛部位總數、疼痛表達方式及日常生活功能等變項有關。（3）癌痛病患的憂鬱與平均疼痛程度、最痛程度、疼痛部位總數、疼痛表達方式、大常生活功能及健康控制重心傾向等變項有關。（4）癌痛病患人口學特性、疾病特徵及健康控制重心在焦慮與憂鬱的預測方面，其中「平均疼痛程度」、「健康控制重心傾向」、「疼痛部位總數」及「日常生活功能」等四個變項可解釋「憂鬱」總變異量的46.96%；而「日常生活功能」、「平均疼痛程度」「疼痛表達方式」及「教育程度」等四項可解釋「焦慮」總變異量的21.80%。根據研究結果提出之建議有其在護理實務上的應用價值。Pain can cause both physical and psychological distress that has a negative impact on cancer patients quality of life. The purpose of this exploratory study was to investigate the relationships among anxiety, depression and related factors in cancer patients with pain. The study used a survey design with 124 subjects. The test instruments used in the study were 'Multidimensional Health Locus of Control Scale', 'Anxiety Scale' and 'Depression Scale'. The major finding of this study were: (1)55.6% of the subjects showed mild anxiety, and 20.2% of the subjects showed moderate anxiety, whereas 34.7% of the subjects showed severe depression, and 28.2% of the subjects showed moderate depression, (2) Religion, the average level of pain, the highest level of pain, number of pain sites, pain expression style and activities of daily living were significantly associated with anxiety (p<0.05). (3) The average level of pain, the highest level of pain, number of pain sites, pain expression style, activities of daily living and health locus of control were significantly associated with depression (p<0.05). (4) Patient's anxiety and depression could be predicted by demographic characteristics, characteristics of disease and health locus of control. Average level of pain, health locus of control, numbers of pain site and activities of daily living could predict 46.96% total variance on depression; whereas activities of daily living, average level of pain, pain expression style and educational level could predict 21.80% total variance on anxiety. The nursing implications and further study were also suggested.