頭頸部癌症病人溝通與生活品質之探討

Communication and Quality of Life in Head and Neck Cancer Patients

本研究目的為瞭解頭頸部癌症病人的溝通表達及生活品質的現況及相關性。採橫斷式描述性相關研究，以立意取樣共收50位23歲至84歲接受頭頸部癌症治療後病人，以結構式問卷進行資料收集。分別以描述性統計、單因子變異數分析、T檢定、皮爾森積差相關進行資料分析。研究結果顯示1.溝通能力與年齡呈負相關（r=-.45），與職業、復發或轉移、手術方式、溝通方式均達顯著差異。生活品質與治療方式達顯著差異。2.影響溝通能力相關問題包括「改變聲音的音調」、「吵雜環境中別人可以聽到您說話的聲音」、「喉部/頸部/口腔感到不舒服」等項目。3.過去一週影響病人生活品質前三項為「咀嚼」、「講話」、「吞嚥」。4.整體溝通能力與生活品質呈正相關（r=.57）。研究結果建議護理人員需了解病人的溝通問題及生活品質的相關因素，進而指導病人及家屬學習術後溝通的方式及居家自我照護，改善咀嚼能力及食物的準備。因此，在整個治療時期，提供充足的時間及照護計畫，了解病人的需要，以增加對疾病預後的信心，提升生活品質。

The purpose of this study was to understand the relationship between the communication andquality of life in head and neck cancer patients. A cross-sectional design and purposive samplingtechnique were applied, and a total of 50 head and neck cancer surgery patients aged from 23 to 84were sampled. The major findings of this study were as follows: 1.The level of communicationshowed a negative correlation with the age(r=-.45); and the demographic characteristics of thedifferences¡]job, metastasis, treatment, communication approach et al.¡^in the level of communicationwere significant. 2.The first three items influence quality of the were 'chewing', 'speaking',and 'swallowing'. 3.The whole communication ability showed a positive correlation with the qualityof life(r= .57).The results suggested encouraging and teaching patients and family to learn howto communicate well after surgery and in home care, and to enhance the ability of chewing orchange of food preparation. Furthermore, nursing care should be organized in a way that providessufficient time to meet these patients'needs throughout the period of treatment to improve theirquality of life.