接受乳房重建病人之生活品質相關因素探討

Exploring Factors Associated with Quality of Life in Patients Undergoing Breast Reconstruction

背景：乳癌為台灣女性癌症發生率最高的癌症，乳房切除手術對病人的身心狀態造成顯著影響。乳房重建有助於恢復乳癌病人身體心像完整及提升生活品質。但現況對於乳房重建術後長期生活品質的研究較少進行探究。
目的：探討乳癌病人接受乳房重建手術之生活品質相關影響因素。
方法：採橫斷式相關性研究，以方便取樣選取北部某醫學中心115位乳房重建病人為研究對象。以「基本資料表」及「乳房重建生活品質問卷- Breast Questionnaire（Breast Q）」-術後版進行資料的收集，包括安適感與整體滿意度兩大範疇。
結果：本研究115位乳房重建病人包括62位自體組織重建及53位義乳重建病人。自體組織重建組在安適感範疇以「性安適」得分顯著優於義乳重建組，滿意度各項得分也明顯高於義乳重建婦女。自體重建組在年齡與心理安適及乳房外觀滿意度呈正相關，接受化學治療及放射線治療與乳房外觀滿意度達顯著相關；義乳重建組重建月數與生理安適:胸部及乳房外觀滿意度呈正相關。經由迴歸分析顯示年齡、重建方式-義乳重建可做為預測生活品質的重要因子。
結論/實務應用：乳房重建可以幫助乳癌病人恢復自信心及改善生活品質，而義乳重建病人在生活品質的感受及滿意度都較自體重建病人得分低，特別是年輕的病人，應多關注其生活品質變化，提供適當臨床照護。

Background: Breast cancer is the most common cancer among women in Taiwan, and mastectomy can profoundly affect patients’physical and psychological well-being. Breast reconstruction helps restore bodily integrity and enhances quality of life. However, limited research has examined the long-term quality of life following breast reconstruction.
Purpose: To identify factors associated with quality of life among breast cancer patients who have undergone breast reconstruction.
Methods: A cross-sectional correlational study was conducted using convenience sampling to recruit 115 women who underwent breast reconstruction at a medical center in northern Taiwan. Data were collected using a demographic questionnaire and the postoperative version of the Breast-Q, which assesses two major domains: comfort and overall satisfaction.
Results: Among the 115 participants, 62 underwent autologous reconstruction and 53 received implant-based reconstruction. In the comfort domain, the autologous reconstruction group reported significantly higher“sexual comfort”scores than the implant-based group. Overall satisfaction scores were also significantly higher in the autologous group. In the autologous reconstruction group, age was positively correlated with psychological comfort and breast appearance satisfaction. Receipt of chemotherapy and radiotherapy was also significantly associated with breast appearance satisfaction. Among patients who received implant-based reconstruction, longer reconstruction duration was positively correlated with chest-related physical comfort and breast appearance satisfaction. Regression analysis identified age and reconstruction type as significant predictors of quality of life.
Conclusions / Implications for Practice: Breast reconstruction can help breast cancer survivors regain confidence and improve their quality of life. However, patients who undergo implant-based reconstruction—particularly younger women—tend to report lower comfort and satisfaction scores than those who undergo autologous reconstruction. These findings highlight the need for ongoing assessment and tailored clinical care for patients receiving implant-based procedures. Nurses should consider age, reconstruction type, and treatment history when developing individualized postoperative support plans.