結腸直腸癌病人疼痛、憂鬱、焦慮與睡眠品質之相關性探討

A Correlational Study of Pain, Depression, Anxiety and Sleep Quality in Patients with Colorectal Cancer

本研究主要探討結腸直腸癌病人疼痛、憂鬱、焦慮與睡眠品質的相關性，採橫斷式相關性研究，以南部某區域教學醫院及北部某醫學中心結腸直腸癌患者為抽樣對象，採立意取樣，收案數為131人，於病人回門診追蹤時收集資料，研究工具採結構式問卷，問卷包括病人基本屬性問卷、簡明疼痛量表、醫院焦慮憂鬱量表、匹茲堡睡眠品質量表等收集資料，資料統計採用個人電腦SPSS 17.0中文版的統計軟體，以描述性統計分析研究對象的基本屬性、疼痛、憂鬱、焦慮及睡眠品質的平均值及標準差，而以推論性統計包括皮爾森積差相關、多元迴歸探討各變項的相關程度及睡眠品質的預測因子。研究結果發現：（1）憂鬱程度與睡眠品質呈顯著正相關（r=0.231，p=0.008）；亦即憂鬱程度愈高，睡眠品質愈差；（2）焦慮程度與睡眠品質呈顯著正相關（r=0.208，p=0.017）；亦即焦慮程度愈高，睡眠品質愈差；（3）疼痛程度與睡眠品質在統計上無顯著相關（r=0.009，p=0.921）；（4）病人睡眠品質預測方面，以憂鬱程度（p=0.022）及治療方式（p=0.048）在迴歸分析中達顯著水準，對於睡眠品質的預測值為0.14。故建議在臨床上，護理人員若能改善結腸直腸癌病人的憂鬱及焦慮程度，將可提升病人睡眠品質。The purpose of this study was to explore the relationships among pain, depression, anxiety and sleep quality in patients with colorectal cancer. The research participants were recruited from the outpatient units at a medical center in the North and a regional teaching hospital in the South. Convenient sampling was used to collect 131 colorectal cancer patients. Research instruments included ”Personal Attributes Scale”, ”Brief Pain Inventory-Chinese version, ” ”Hospital Anxiety and Depression Scale, ” and ”Pittsburgh Sleep Quality index.” The data were analyzed by descriptive statistical analysis, t-test, one-way ANOVA, Pearson's correlation, and multiple regression using SPSS for Window version 17.0 .The findings are as follows: 1. Depression and sleep quality in colorectal cancer patients showed a positive correlation (r=0.231, p=0.008); 2. Anxiety and sleep quality in colorectal cancer patients showed a positive correlation(r=0.208, p=0.017); 3. Pain intensity did not show a statistically significant difference with respect to sleep quality (r=0.009, p=0.921); and 4. Depression (p=0.022) and treatment method (p=0.048) were significant predictive factors for sleep quality. Therefore, we can enhance the sleep quality of the colorectal cancer patients by lowering the depression and anxiety degree.