癌症患者的疼痛因應：內外控傾向在因應策略與生活品質關係中的調節效果

Coping with Cancer Pain: The Moderating Effect of Locus of Control on the Relationship between Coping Strategies and Quality of Life

研究目的：本研究主要欲檢驗在癌症患者的疼痛因應歷程中，採取不同疼痛因應策略（問題導向因應策略／情緒導向因應策略）的效果是否會受到患者之內外控傾向的調節。研究方法：參與者為70名報告有疼痛症狀的癌症患者，所有參與者均完成「台灣版簡易疼痛量表－疼痛強度分量尺」、「內外控量表」、「疼痛因應策略檢核表」，以及「臺灣簡明版世界衛生組織生活品質問卷」，資料取得時間為民國95年7至12月間。研究結果：階層迴歸分析結果發現，癌症患者的內外控傾向在兩種疼痛因應策略分別對生活品質的預測中，均具有調節效果。內控的患者採取較多問題導向因應可提升其生活品質；外控的患者採取問題導向因應則對生活品質沒有顯著影響。其次，內控的患者採取較多情緒導向因應會惡化患者的生活品質；外控的患者採取較多情緒導向因應則可促進患者的生活品質。研究結論：癌症患者採取何種疼痛因應策略較為有效，需考量患者的內外控傾向而定。

Purpose: This study investigates the moderating effect of locus of control on the relationship between pain coping strategies (problem-oriented coping/emotion-oriented coping) and quality of life in cancer patients. Methods: Seventy cancer pain patients participated in this study. All participants completed the pain severity subscale of the Taiwanese version of the Brief Pain Inventory (BPI-T), a locus of control scale, a pain coping strategies checklist, and the Brief Version of the World Health Organization Quality of Life Questionnaire-Taiwanese version (WHOQOL-BREF-T). The data were collected from July 2006 to December 2006. Results: The results of hierarchical regression analyses showed that locus of control moderated the relationship between problem-oriented coping and quality of life. More problem-oriented coping strategies predicted better quality of life for the cancer pain patients with an internal locus of control, whereas no such association was found for the cancer pain patients with an external locus of control. Moreover, we also found that a person’s locus of control moderated the relationship between emotion-oriented coping and quality of life. More emotion-oriented coping strategies predicted worse quality of life for the cancer pain patients with an internal locus of control, whereas more emotionoriented coping strategies predicted better quality of life for the cancer pain patients with an external locus of control. Conclusions: In the process of coping with cancer pain, whether the problem-oriented and emotion-oriented coping strategies facilitate a patient’s quality of life depends on that person’s locus of control.