非小型細胞肺癌病人之睡眠品質及其影響因素之探討

Sleep Quality and Its Effecting Factors in Patients with Non-small Cell Lung Cancer

肺癌為台灣癌症死亡之首要原因，也是許多已開發國家之癌症死亡之首位。然而目前有關對肺癌病人罹病經驗之了解極為有限。睡眠困擾在肺癌病人是相當普遍且常發生的健康問題。睡眠品質與健康狀況息息相關， 不好的睡眠品質將造成健康功能更為下降、罹病率與死亡率增高。睡眠品質監測與評估的方式雖國外已有大量文獻，但反觀國內過去研究中，發現本土之非小型細胞肺癌病人之睡眠障礙實證肯料仍付闕如。本研究之目的 為：（1）探討非小型細胞肺癌之睡眠品質之程度及其相關；（2）分析非小型細胞肺癌之睡眠品質之預測因子。個案選自北部醫學中心，共204人。研究工具包括個人及疾病基本資料、臺灣版安德森症狀量表及中文版匹茲堡睡眠量表。統計方法則包括描述性統計、皮爾森積差相關、及單因子變異數、t-test及複迴歸分析等。結果顯示肺癌病人以匹茲堡睡眠量表總分之平均分數為10.20分，屬於睡眠品質不良且高達78%病人有睡眠困擾 之問題。教育年數、工作狀態有無、及Karnofsky功能狀況與睡眠品質呈現顯著相關。另Karnofsky功能狀況可預測睡眠品質之程度。本研究之結果將可提供國內本土化之實證資料，以做為爾後提供病人之睡眠改善之建議與發展有效的解決睡眠困擾方式。Lung cancer is the number one cause of cancer death in Taiwan, as in much of the industrialized world, yet studies describing the experience of patients living with lung cancer are limited. Sleep disturbance has been reported as a health problem in lung cancer patients. Poor sleeping quality results in a decline of the functional status of health. Although there have been many studies related to sleep measures and assessment, little attention has been paid to the incidence and severity of sleep quality and their impact on lung cancer patients, especially in Taiwan. The purpose of this study was (1) to investigate prevalence of sleep disturbance in patients with advanced non-small cell lung cancer; (2) to analyze the predictors of sleep quality. A cross-sectional research design was utilized for this study, including 204 samples. Measurements included demographic and disease characteristic sheets, M.D. Anderson Symptom Inventory Taiwan Form, and Chinese Version Pittsburgh Sleep Quality Index (CPSQI) . Statistical analyses included descriptive statistics, Pearson’s correlation, t-test, ANOVA, and multiple regression analysis. The average global score of the CPSQI was 10.20 which indicated poor sleep in patients with lung cancer. 78% patients in this study have had sleep disturbance. The relationships between educational level, working status, and Kamfsky and CPSQI scores were significant. Kamofsky scores can serve as predictor in sleep quality. Results from this study can provide an important basis for possible development of new strategies to manage sleep disturbance in non-small lung cancer patients, which may have a great potential to improve the quality of sleep for patients with non-small cell lung cancer.