頭頸癌病人術後接受放射化學治療之症狀困擾與生活干擾程度探討

Effects of Symptom Distress and Symptom Interference of Daily Life in CCRT Patients with Head and Neck Cancer

放射線治療是頭頸癌病人常見治療方式，術後接受放射線治療造成頭頸癌病人嚴重的身、心、社會各方面症狀困擾，可能中斷治療甚至造成生命威脅，本研究目的在探討頭頸部癌症病人接受放射線治療過程第一至六週其症狀困擾強度與生活干擾程度，採縱貫性研究設計，研究工具為台灣版安德森症狀量表（MDASI-T），以方便取樣於北市某教學醫院進行收案，共有100位頭頸部癌症病人。結果發現治療前的症狀困擾為心裡難過、鬱悶，治療過程之症狀為口乾、疼痛、睡眠混亂及沒胃口，治療過程的後三週則以口乾、疼痛及睡眠混亂為主要症狀困擾，症狀困擾與生活干擾總分間具有顯著相關性。本研究結果提供未來研究或臨床專業知識建構之參考，期能減緩或改善病患治療期間的症狀困擾，以利於預防症狀困擾對生活之干擾。Radiation therapy is common for head and neck cancer. Surgery with radiation therapy can cause symptom distress in term of physical-psycho-social aspects. These conditions may be associated with interrupted treatment and further exert an impact on patients' life. The aims of the study were to (1) examine changes in symptom distress severity, and (2) identify the symptom distress severity correlated to interference of daily life in head and neck cancer patients undergoing 6 weeks of postoperative RT. A time-series longitudinal study with convenience sampling was conducted and the M.D. Anderson Symptom Inventory-Taiwan Form (MDASI-T) was used to do an evaluation in each week. One hundred patients were enrolled in the study. Data were analyzed by using descriptive statistics and Pearson's correlation. Our result revealed that the symptom distress and symptom interference of daily life are significantly correlated from the first to sixth week of treatment. Results from this study have provided important implications for clinical practice and future research to improve or reduce the symptom distress and symptom interference of the patient during radiotherapy and chemotherapy.