肝癌患者接受肝動脈栓塞治療術後症狀困擾與疲倦感之相關性研究

Relationship between Symptom Distress and Fatigue in Hepatocellular Carcinoma Patients Who Received Transcatheter Arterial Embolization

背景：國內外有許多文獻探討癌症病人的疲倦感與症狀困擾，但少有針對肝動脈栓塞治療所引起的疲倦感與症狀困擾進行探討。目　的　本研究主要目的在探討肝癌接受肝動脈栓塞治療患者症狀困擾、疲倦感及相關因素。方　法　採用橫斷式研究設計，以立意取樣方式選取100位南部某醫學中心肝癌住院患者接受肝動脈栓塞治療者為對象，以結構式問卷收集接受肝動脈栓塞治療術後第一天到第三天患者資料。結　果　研究結果發現（1）疲倦感與症狀困擾在肝動脈栓塞治療後有顯著逐漸下降之情形。（2）疼痛、疲倦、失眠、發燒、腹脹是術後三天中最困擾的情形。（3）婚姻狀態、有無親屬陪伴、身體功能狀態、年齡及症狀困擾情況是疲倦感的預測因子。結　論／實務應用　醫護人員應加強對肝癌患者接受治療時症狀困擾及疲倦感及治療後可能發生的情形加以說明，提供個別性及有效緩解症狀及疲倦之方式，減輕患者的心理負擔。

Background: The fatigue and symptom distress of cancer patients have been researched extensively. However, few studies have focused on the fatigue and symptom distress experienced by hepatic cancer patients following transcatheter arterial embolization (TAE) treatment. Purpose: This study explores the levels of symptom distress and fatigue in hepatic cancer patients and related factors. Methods: This cross-sectional study used purposive sampling to recruit 100 hepatic cancer patients who had received TAE treatment from a medical center in southern Taiwan. Structured questionnaires were used to collect the data from the first, second, and third days following the TAE treatment. Results: Notable reductions in fatigue and symptom distress levels were observed in post-TAE-treatment patients. The 5 main symptoms were abdominal pain, fatigue, sleeplessness, fever, and abdominal distention. Factors identified as influencing the level of fatigue were marital status, family members' accompaniment during the TAE treatment, physical performance status, age, and symptom distress. Conclusions / Implications for Practice: Physicians treating hepatic cancer patients should better explain to patients the symptoms and fatigue associated with TAE treatment. Physicians should also provide interventions that may reduce the related symptoms, fatigue levels, and mental distress.