消化系統癌症惡病質病患的個人基本屬性、營養狀況與日常生活活動能力及生活品質之相關性

Activities of Daily Living, Quality of Life and Related Factors in Cachectic Gastrointestinal Cancer Patients

癌症為國人十大死因之首；惡病質指明顯的體重下降及營養不良，為晚期癌症患者常見之併發症與主要死因之一。本研究之目的，為探討南部某一醫學中心之40位消化系統癌症惡病質病患的個人基本屬性、營養狀況與日常生活活動能力及生活品質之相關性。採描述相關性設計，以結構式問卷，內容包括個人基本屬性量表、感知日常生活活動能力量表及台灣簡明版生活品質量表等三部份。營養狀況評估經由測量體重和三頭肌皮脂厚度。研究結果發現：(1)病患日常生活活動能力總分平均值 5.73分（總分77），屬中上程度。(2)病患生活品質標準化得分5 .71分，屬中等程度；四範疇以社會關係範疇得分最高，生理健康範疇得分最低。(3)年齡及體重減輕百分比與日常生活活動能力有顯著差異及相關。(4)職業、身體症狀影響程度及理想體重百分比與生活品質有顯著差異及相關。(5)日常生活活動能力與生活品質、生理健康範疇及環境範疇有顯著相關。建議健康照護團隊除了提供症狀處理及照護外，更應針對與日常生活活動能力及生活品質之相關因素做進一步探討瞭解其影響程度，以做為日後改善病患日常生活活動能力及生活品質的參考。

Cancer is the leading cause of death in Taiwan. Cachexia, which causes significant weight loss and malnutrition, is a common complication and one of the major causes of death in advanced cancer patients. The purpose of this study was to explore the association between personal characteristics, nutritional status, activities of daily living (ADL) and quality of life (QOL) in 40 cachectic gastrointestinal tract cancer (GI cancer) patients in southern Taiwan. A descriptive correlation study design and three structured questionnaires (including the Personal Characteristics, Index of Self-Report ADL and WHOQOL-BREF) were used. Nutritional status was assessed by measurement of body weight and triceps skin-fold thickness. The results showed that: (1) The mean ADL score was 65.73 out of 77, a medium-high score. (2) The standardized QOL score was 58.71, a medium score, with the highest score in the social relationships domain and the lowest score in the physical health domain. (3) There were some significant differences and correlations to the ADL were age and percentage of body weight loss; (4) there were some significant differences and correlations to the QOL were employment, the level of the physical symptoms influence and %IBW; (5) ADL was significantly correlated to the QOL, physical health domain and environment domain . The results indicate that in addition to providing symptoms management and care, the health care team should also further examine the impact of ADL and QOL related factors. The information will be helpful in improving the ADL and QOL of patients in the future.