比較衛教與肌肉放鬆訓練處置乳癌婦女術後疼痛及焦慮改善之成效
中文摘要
本研究目的在於比較衛教方案與肌肉放鬆訓練處置在改善初次診斷為乳癌婦女手術一週 內疼痛及焦慮的成效。研究採縱貫式前、後測類實驗法，針對台北市某兩家醫院一般外 科病房內，初次診斷為第Ⅰ、Ⅱ、Ⅲ期乳癌接受乳房切除手術治療的婦女收案；採方便 取樣隨機分配，分為衛教處置組（實驗組Ⅰ）、衛教加肌肉放鬆訓練組（實驗組Ⅱ）、以及控制組。於手術前一天、術後第一、二、三天及出院前一天，共五個時間點收案。
研究工具為醫院焦慮憂鬱量表、症狀困擾量表、疼痛及焦慮數字量表、血壓值、脈搏次 數及呼吸速率測量。資料以卡方檢定、配對 t 檢定、單因子及重複測量變異數分析。研 究結果顯示：（ 1 ）三組病人皆經歷中度至重度術後疼痛強度，（ 2 ）三組病人手術前 一天皆經歷高程度的焦慮，但隨著時間進展而降低，至出院前一天達低程度的焦慮，
（ 3 ）接受肌肉放鬆訓練之病人，於每次接受該訓練前後之疼痛強度、焦慮程度、血壓 值、脈搏次數及呼吸速率皆有明顯下降，且達統計意義，（ 4 ）衛教處置組與衛教加肌 肉放鬆訓練組之病人其術後疼痛、焦慮及症狀困擾改善的程度皆較控制組多，且達統計 上顯著差異。
本研究結果支持乳癌婦女手術期間的衛教處置及肌肉放鬆訓練方案，對接受手術急性期 間乳癌婦女術後疼痛、焦慮及症狀困擾皆有意義地減輕，因此臨床護理照護中應有系統 地給予衛教處置及肌肉放鬆訓練，以促進病人生活品質。
關鍵詞：乳癌婦女、術後疼痛、焦慮、症狀困擾、衛教、肌肉放鬆訓練。Comparing of the effects of using education and relaxation training in
decreasing postoperative pain and anxiety in early-stage breast cancer women
英文摘要
The purpose of this study was to compare of the effects of using education and relaxation training in decrea sing postoperative pain and anxiety in early-stage breast cancer women. This study was a longitudinal pre/
post test quasi-experimental research design. Thirty-six women with breast cancer, who had received breas t surgery, were randomly assigned to a control group, a treatment group that received education, or a treatm ent group that received education and relaxation training. These breast cancer patients were recruited using purposive sampling from the general surgical inpatient wards at two teaching hospitals in Taipei. The follo wing research instruments were used to measure the variables in this study: Hospital Anxiety and Depressi on Scale, Pain and Anxiety Numerical Rating Scale and a Symptom Distress Scale. Eligible subjects were i nterviewed five times from the day before surgery, postoperative first, second and third days to the day bef ore discharge.
Data were analyzed using Chi-square test, One-Way ANOVA, Repeated Measured ANOVA and Paired-t t est. The results indicated (1) All three groups experienced moderate to severe pain intensity. (2) All three g roups experienced a high level of anxiety on the day pre-operative. (3) Significant differences were found i n that relaxation training could decrease pain, anxiety, blood pressure, pulse rate and respiration rate. (4) Si gnificant differences were found between the education group, education and relaxation training group tha n control group.
The results strongly suggest that health care professionals should assess and decrease postoperative pain an d anxiety in breast cancer patients, and increase the quality of life in this population.
Key words: breast cancer women, postoperative pain, anxiety, symptom distress, education, muscle relaxat ion training
