放鬆訓練於改善肝癌病患接受肝動脈栓塞治療期間疲憊及焦慮之成
效
The Effects of Relaxation Training on Fatigue and Anxiety in Patients with Hepatocellular Carcinoma Receiving Transcatheter Hepatic Arterial Embolization
中文摘要
肝癌是國人最常見之癌症之一，而疲憊是病患接受治療時最常經歷的副作用，國 內對於改善疲憊的護理措施仍在發展階段，故本研究在測試放鬆訓練於肝癌病患 接受肝動脈栓塞治療期間疲憊改善成效。採類實驗法及前、後縱貫式研究設計，
以台北市一所醫學中心符合收案條件之肝癌病患 60 人，以隨機分派到實驗組（放
鬆訓練）及對照組（目前病房之常規照護），每組各 30 人，比較二組在栓塞前、
第一天、第二天、第三天、第七天，每日的疲憊及焦慮變化之差異。所得資料以 描述性分析、Fisher’s exact test、獨立 t 檢定、配對 t 檢定及重複測量變異數分 析等統計方法分析。研究結果顯示：(1)二組個案在栓塞期間最累疲憊強度之每 日變化有顯著的差異，實驗組比對照組有顯著的降低（p<0.05）；(2)二組個案在 栓塞期間之整體疲憊干擾、症狀困擾、焦慮、憂鬱之每日的改變量未達統計上的 顯著差異； (3) 介入放鬆訓練後，在疲憊、焦慮、憂鬱、症狀困擾程度及血壓、
心跳和呼吸情形均能明顯的下降，有統計上顯著差異（p<0.001），所產生的立即 效果較長期效果明顯。本研究結果可提供臨床實證，提升護理品質，使病患獲得 更好生活品質。
英文摘要
Hepatocellular carcinoma (HCC) is one of the major cancers in Taiwan. Fatigue is the most commonly found symptom in these patients. The aim of this study was to investigate the effects of relaxation training on the degree of fatigue of HCC patients receiving transcatheter hepatic arterial embolization therapy (TAE). Patients were recruited from one medical center in Taipei and randomly assigned into two groups to receive standard nursing care (n=30) or relaxation training (n=30). Degree of fatigue and anxiety were measured the day before TAE, first, second, third, and seventh day post TAE. Data were analyzed by descriptive statistics, Fisher’s exact test, t test, paired t test and repeated measures ANOVA. The results showed : (1). The significant difference was found in the worst fatigue intensity between the two groups.
Relaxation group showed better reduction in fatigue. (2). The overall fatigue
interfered sensation, symptom distress, anxiety, and depression, those changes did not reach a significant level between the two groups. (3). The immediate effects of
relaxation ( before and after relaxation training ) on fatigue, anxiety, depression, symptom distress, systolic pressure, heart beat, and respiration were significant and improved as observed sequentially (p<0.001). However, immediate effects of
relaxation were more prominent than long-term effects. In conclusion, application of relaxation therapy in nursing care, in general, can decrease patients’ fatigue and anxiety sensation during TAE.
