支持性關懷對腦腫瘤術後病人之症狀困擾、護理需求與憂鬱成效之前驅性研究

The Effects of Supportive Caring on Symptoms Distress, Nursing Needs, and Depression in Patients With Brain Tumor After Surgery: A Preliminary Study

背景：腦瘤治療以手術為主，然手術後病人仍因疾病與治療因素產生諸多症狀困擾和護理需求，若未及時改善則容易產生憂鬱情緒。
目的：探討支持關懷介入措施對腦腫瘤術後病人之症狀困擾、護理需求與憂鬱之成效。
方法：本研究採雙組前、後測實驗設計，以隨機抽樣將參與者分配到兩組，實驗組接受術後1個月和3個月的支持性關懷，對照組接受常規性出院衛教。成果測量包括支持性護理需求量表、症狀困擾量表和流行病學研究中心憂鬱量表。資料收集時間包括：出院前（T0）、術後1個月（T1）、3個月（T2）和6個月（T3）。
結果：由廣義估計模式分析顯示，支持性關懷介入後，實驗組護理需求在T1（β= -23.61, p < .001）、T2（β= -22.51, p < .001）、T3（β= -22.26, p < .001）顯著低於對照組。症狀困擾在T1（β= -7.03, p = .019）、T2（β= -8.39, p = .003）顯著低於對照組。憂鬱情緒僅在T2（β= -8.55, p = .005）顯著低於對照組。
結論：本研究顯示支持性關懷有助改善腦瘤病人手術後護理需求、症狀困擾和憂鬱情緒，醫護團隊人員應注意腦瘤病人術後護理需求、症狀困擾和憂鬱情緒狀況，必要時提供訊息，以提高護理的照護品質。

Background: Brain tumors are mainly treated with surgery. However, patients still experience many symptoms and nursing needs due to disease and treatment-related factors that, if not improved in a timely manner, may result in depression.
Purpose: The purpose of this study was to examine the effectiveness of supportive caring on symptom distress, nursing needs, and depressive symptoms in patients with brain tumor after surgery.
Methods: This study adopted a two-group, pre- and post-test experimental design. The enrolled participants were randomized into two groups. Those in the experimental group received a phone-based supportive caring intervention twice at 1 and 3 months after surgery. Those in the control group received usual discharge care. The measurement outcomes included a supportive care needs survey, symptom distress scales, and the center for epidemiological studies of depression. Baseline data was collected prior to hospital discharge (T0), with follow-up data collected at one month (T1), three months (T2), and six months (T3) after surgery.
Results: The results of the generalized estimating equation analysis showed that nursing needs in the experimental group at T1 (β= -23.61, p < .001), T2 (β= -22.51, p < .001), and T3 (β= -22.26, p < .001) were significant lower than in the control group. Also, symptom distress in the experimental group at T1 (β= -7.03, p = .019) and T2 (β= -8.39, p = .003) was significantly lower than in the control group. However, depressive symptoms in the experimental group were lower than in the control group only at T2 (β= -8.55, p = .005).
Conclusion: The results of this study confirm that supportive care helps improve nursing needs, symptoms distress, and depressive symptoms in patients with brain tumor after surgery. Medical team members should pay attention to these issues following surgery.