婦癌婦女焦慮憂鬱及生活品質之相關因素探討

Correlation Among Anxiety, Depression, and Quality of Life in Women With Gynecologic Cancer

背景：焦慮和憂鬱是婦科癌症婦女在治療過程常有的情緒困擾，常會危及婦女的身心健康而影響生活品質。目的：探討婦科癌症婦女的焦慮、憂鬱、社會支持及生活品質的影響因素。方法：採橫斷式相關性研究，以方便取樣選取中部某醫學中心共111位婦科癌症婦女為研究對象。以「基本資料表」、「臺灣簡明版世界衛生組織生活品質問卷」、「社會支持量表」及「醫院焦慮憂鬱量表」進行資料的收集。結果：本研究樣本具有中等程度的生活品質（3.46；SD＝0.73），41.4％婦癌婦女有焦慮傾向、24.3％有憂鬱傾向，四個範疇的平均分數以生理健康範疇得分最高（14.93；SD＝2.24），依序為環境健康（14.76；SD＝1.97）、社會關係（14.13；SD＝2.33）和心理健康（13.92；SD＝2.44）。焦慮、憂鬱、婚姻狀況和社會支持等變項可有意義的解釋生活品質總變異量之18.5％－37.0％。焦慮為最重要的解釋因子，可預測四個範疇的生活品質。結論／實務應用：建議醫療團隊成員能加強對婦科癌症婦女早期評估其焦慮、憂鬱及社會支持、增加對婦女情緒狀況之敏感度、提供及時的支持性照護，並對其需求提供衛教與適時轉介，以及提供婦女所需之照護措施，以維持其生活品質。

Background: Anxiety and depression are common emotional distresses experienced by women during gynecologic cancer treatment. These often have dangerous effects on physical and mental health and may impact quality of life (QoL). Purpose: To investigate the factors influencing anxiety, depression, social support, and QoL in women with gynecologic cancer. Methods: This was a cross-sectional correlational study. A total of 111 women with gynecologic cancer receiving treatment at a medical center in central Taiwan were selected as subjects using convenience sampling. A demographic characteristics questionnaire, the World Health Organization Quality of Life-Brief-Taiwan version (WHOQOLBREF-Taiwan version) questionnaire, the International Support Evaluation List (ISEL), and the Hospital Anxiety and Depression Scale (HADS) were used for data collection. Results: Of the 111 subjects, 41.4% and 24.3% had tendencies for anxiety and depression, respectively, and a moderate QoL score (mean = 3.46; SD = 0.73). The physical health domain had the highest mean QoL score (14.93; SD = 2.24), followed by environmental health (14.76; SD = 1.97), social relationships (14.13; SD = 2.33), and psychological health (13.92; SD = 2.44). Anxiety, depression, marital status, and social support respectively explained 18.5%–37.0% of the total variation in QoL scores. Of the four QoL domains examined in this study, anxiety was the most significant predictor of QoL . Conclusion/Implications for Practice: It is recommended that healthcare professionals strengthen the early assessment of anxiety, depression, and social support in women with gynecologic cancer. In addition, sensitivity towards emotional status should be increased in these cases. Healthcare professionals should provide care, support, and timely completion of referrals. Finally, psychological and social support and related interventions should be provided based on patient needs in order to maintain QoL.