結腸直腸癌存活者癌症治療後的症狀困擾與害怕癌症復發

Post-Cancer Treatment-Related Symptom Distress and Fear of Cancer Recurrence in Colorectal Cancer Survivors

背景：結腸直腸癌仍然是癌症相關死亡的主要原因，治療後的癌症存活者擔心疾病復發容易使健康狀況更加惡化。儘管如此，有關結腸直腸癌存活者的害怕癌症復發與治療相關症狀的研究篇幅有限。
目的：本研究目的探討：(1)結腸直腸癌存活者癌症治療後的症狀困擾、害怕癌症復發現況；(2)其害怕癌症復發的預測因子。
方法：採橫斷式相關性研究設計，方便取樣，於台灣中部地區某醫學中心大腸直腸外科門診收案。以基本資料表、症狀困擾量表、害怕疾病進展量表為監測工具，統計分析方法採用皮爾森積差相關分析、獨立t檢定、one-way ANOVA與逐步線性迴歸分析。
結果：本研究共招募114名結腸直腸癌存活者，平均年齡63.44歲，症狀困擾以麻木感、排便改變、疲倦、失眠及口乾等症狀排名前5名。「害怕癌症復發」（fear of cancer recurrence）平均分數18.09分。性別、教育程度、每月可支配收入及症狀困擾等變項為存活者害怕癌症復發的重要預測因子，整體解釋力41.4%。
結論：結腸直腸癌存活者癌症治療結束後的害怕癌症復發的程度會受到症狀困擾的影響。健康照護提供者及早協助存活者控制或緩解身體的症狀，將有助於避免負面情緒的產生，及改善病人的生活品質。

Background: Colorectal cancer (CRC) is a primary cause of cancer-related mortality, and, after treatment, cancer survivors often worry that disease recurrence may worsen their health. Nevertheless, limited research on fear of cancer recurrence (FCR) and treatment-related symptoms has been conducted on survivors of CRC.
Purpose: This study was designed to explore (1) symptom distress severity and post-treatment FCR in CRC survivors and (2) the predictors of FCR.
Methods: A cross-sectional correlational research design and convenience sampling approach were used to recruit patients at the colorectal surgery outpatient department of a medical center in central Taiwan. Basic demographic data, the Symptom Distress Scale–Chinese Modified Form, and Fear of Progression Questionnaire - Short Form were used as monitoring tools. Pearson’s product-moment correlation analysis, independent t-tests, one-way ANOVA, and stepwise linear regression analysis were used for statistical analysis.
Results: One hundred fourteen survivors of CRC with an average age of 63.44 were enrolled as participants. The top five symptoms of distress were numbness, bowel patterns, fatigue, insomnia, and dry mouth, and the average FCR score was 18.09. Gender, educational level, monthly disposable income, and symptom distress were identified as significant predictors of FCR, with an overall explanatory power of 41.4%.
Conclusions: Level of post-treatment FCR in survivors of CRC is influenced by symptom distress severity. Early intervention by healthcare providers to control or alleviate physical symptoms can help prevent the emergence of negative emotions and improve quality of life in this patient group.