肺癌化學治療後病人照護需求與相關因素之探討

Exploration of the Care Needs of Post-Chemotherapy Lung Cancer Patients and Related Factors

背景：化學治療為肺癌主要治療方式之一，然其治療期間所衍生的副作用，易造成病人的症狀困擾、日常活動干擾及照護需求。目的：探討肺癌病人接受化學治療後之照護需求及相關因素。方法　採橫斷式研究設計，取樣於南部某醫學中心121位接受Platinum和Docetaxel化學治療之肺癌病人，研究工具包括：照護需求、症狀困擾及日常活動干擾等量表。結果　肺癌病人化學治療後之照護需求包括：緊急問題處置、衛教及問題諮詢和情緒支持。症狀困擾嚴重度前三項依序為：疲憊、食慾不振及睡眠困擾。日常活動干擾主要項目為：保持社交活動、工作及爬樓梯。肺癌病人化學治療後日常活動干擾（r = .30, p ＜ .01）、症狀困擾（r = .23, p ＜ .01）與照護需求呈現顯著正相關。迴歸分析發現，日常活動干擾為照護需求之預測因子，可解釋之變異量為10.7%。結論／實務應用　本研究發現，肺癌病人接受化學治療後的照護需求、症狀困擾及日常活動干擾之相關性，此結果可提供腫瘤護理人員於接受此類治療病人的護理指導參考，進而協助病人日常活動及滿足相關照護需求，以提昇病人之照護品質。

Background: Chemotherapy (CT) is the first priority treatment for advanced stage lung cancer. However, symptom distress, impaired ability to conduct daily activities, and post-CT care needs are potential side effects of CT. Purpose: To explore the factors related to the care needs of post-chemotherapy lung cancer patients. Methods: A cross-sectional study was used. One hundred and twenty-one adult patients who had been diagnosed with advanced-stage lung cancer and who had undergone CT using the Platinum and Docetaxel doublet regimen were recruited from a medical center in southern Taiwan. The instruments used included a nursing care needs survey, symptoms distress scale, daily activity interference scale, and patient characteristics datasheet. Results: Participants self-prioritized their emergency management, health consultation, and emotional support activities based on their perceived care needs. The top three post-CT symptoms in terms of severity were: fatigue, appetite change, and sleep disorder. Primary disruptions in daily activities during the post-CT period related to: holding social activities, work, and stair climbing. Significant and positive correlations were found among daily activity interference (r = .30, p ＜ .01), symptoms distress (r = .23, p ＜ .01), and care needs. The regression model indicated daily activity interference as a predictor of care needs, accounting for 10.7% of the total variance. Conclusions / Implications for Practice: These results highlight the relationships among care needs, symptom distress, and daily activity interference in post-chemotherapy lung-cancer patients. The present study provides a reference for nursing care to reduce the symptom distress, to enhance the performance of daily activities, and to meet the care needs of lung-cancer patients.