門診接受化學治療病人之症狀困擾及居家護理需求之探討.

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門診接受化學治療病人之症狀困擾及居家護理需求之探討.

Symptom Distress and Home Care Needs in Patients

Receiving Chemotherapy in an Outpatient Setting

賴裕和摘要本研究目的在探討門診接受化學治療之癌症病人，居家期間的症狀困擾、日常生活功能程度、對化學治療的整體感受及其居家護理需求。研究採橫斷式描述性研究法，於台北市某醫學中心門診化學治療室，對於最近一個月內曾於門診接受化學治療的癌症病人，以症狀困擾量表中文修訂版、日常生活功能量表、化學治療整體感受量表、居家護理需求評估表及基本資料表，進行結構式問卷訪談，共徵得 80 位個案。結果顯示，治療後症狀困擾的的前十項依其嚴重度為：食慾改變、疲倦、外觀改變、德心的頻率、噁心的強度、對未來的展望、焦躁不安、性生活改變、失眠及疼痛的強度，化學治療對日常生活功能的主要影響在於無法工作及無法保持正常社交活動，居家護理需要則以衛教諮詢、心理支持及緊急問題的處理為主，症狀困擾程度越高的病人，其居家護理需求越高（r=.38，p<.0005）。研究建議症狀困擾的程度應被重視，且以其為追蹤病人及居家護理的指標，門診護理服務應建立完善電話追蹤及居家照護系統，以協助症狀困擾程度嚴重之癌症病人。 Abstract

The purpose of this study was to explore the symptom distress, performance of daily living, perception of chemotherapy experiences and home care needs in clients

receiving cancer chemotherapy in an outpatient setting. A cross-sectional descriptive design was used for the study. Research instruments included Symptom Distress Scale-Chinese Modified Form (SDS-CMF), Performance of Daily Living Scale, Perception of Chemotherapy Experience Index, Home Care Needs Assessment Form, and Demographic Data Form. Eighty subjects receiving chemotherapy within recent months were recruited from an outpatient chemotherapy center in a university-based teaching hospital in Taipei. In general, subjects did not have severe symptom distress. The ten distressful symptoms in descending order were appetite change, fatigue, appearance change, nausea frequency, nausea intensity, outlook, restless, sexuality change, insomnia, and pain intensity. The major influences of chemotherapy on performance in daily life were on work and social activities. The three major home care needs were health teaching, psychological support and managing emergency

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situations. Subjects with higher symptom distress had higher home care needs (r=.38, p<.0005). The results suggested that the level of symptom distress should be used as a clinical indicator to provide further home care nursing services.