頭頸部癌症病患溝通表達與生活品
質之探討
頭頸部癌症中口腔癌死亡率佔 5.28% ，為所有癌症死亡原因第七位，喉癌死亡率佔 1.97% ，佔男性
癌症死亡原因第十五位，比女性（ 0.10% ）多。頭頸部癌症病患經手術治療後對於溝通的適應在術
後期間是多變的，喪失溝通的聲音造成情緒及社交的改變，進而導致頭頸部癌症病患的退縮、焦慮
及降低生活品質。國內對於頭頸部癌症病患溝通情形並未有更深入的探討。因此採橫斷性描述相關
性研究設計，探討頭頸部癌症病患的溝通表達及生活品質的變化。
本研究於 94 年 11 月至 95 年 3 月期間，以立意取樣方式共收案 63 位個案，研究對象為台北某醫學
中心之頭頸部癌症病患。以結構式問卷訪談，問卷包括病患基本資料、頭頸部癌症病患溝通能力評
估問卷、頭頸部癌症病患溝通自我評估量表、華盛頓生活品質量表。資料以 SPSS 統計軟體進行描
述性統計（包括次數分配、平均值、標準差、百分比）、皮爾森積差相關（ Pearson’s correlation ）
、單因子變異數分析（ One-WAY ANOVA ）。
研究結果發現，病患平均 56.9 歲，以口腔癌最多。頭頸部癌症病患溝通的能力及溝通經驗自我能
力好。溝通的一般狀況子量表以您是一位主動、較外向、健談的人，得分最高。以與周圍的人說話
時會感到輕鬆自在，得分最低；溝通的環境狀況子量表以在一大群人的環境及在吵鬧或喧嘩的地方
說話最困難；溝通的態度狀況子量表以因為說話方式常常及總是限制社交生活或個人生活。頭頸部
癌症病患生活品質量表以病患咀嚼問題影響生活品質最大。人口學特性及疾病治療特質與溝通方式
的能力評估狀況、溝通經驗自我評估狀況、生活品質量表之相關性，與年齡、職業、疾病分類、手
術方式、腫瘤分期、溝通方式等有顯著相關，並且治療方式、溝通方式、手術治療後時期均受生活
品質的影響。
研究結果顯示，周圍環境及病患對於溝通的態度二項因素會影響溝通的學習。護理人員及家屬應該
更有耐心及愛心，提供安靜的環境及鼓勵病患繼續學習溝通方式，以提高病患的生活品質，達到身
、心、靈的和諧。
Communication and Quality of Life i
n Head and Neck Cancer Patients
Oral cavity cancer and laryngeal cancer are two major head and neck cancers in Taiwan. The i mpacts of surgery and disease on head and neck areas may influence patients’ communication.
However, there is little research to examine this issue in Taiwan. Therefore, the purposes of th e cross-sectional description correlation study are to examine the level of communication and changes of quality of life in head and neck cancer patients receiving surgery.
A total of 63 subjects were recruited from a medical center in Taipei. We interviewed patients to assess patients’ background information, level of communication ability, self-evaluation of experience after laryngeal/ oral cancers (SECEL), and quality of life (measured by University of Washington Quality of Life (UWQOL). The data was analyzed by descriptive statistics, Pea rson’s correlation, Analysis of Variance (ANOVA).
The average age of the patients was 56.9 years. Majority of subjects were oral cavity cancer. I n general, these patients perceived good ability and experience in communication were good.
However, the results showed that patients had relatively difficulties to communicate in crowde
d or noisy places. Disability of chewing is the most important factor to influence patients’ qual
ity of life. Types of surgery, time since treatment, type of communication, level of communica
tion ability and the self-evaluation of experience of communication were found to be significa
ntly associated to patients’ quality of life. The results of this study showed that the environme
nt and patients’ attitudes toward communication can affect learning of communication. Nursin
g staff and family members should help patients to build a quieter environment, encourage pati
ents to learning how to communicate well after surgery, and to enhance the ability of chewing
or change of food preparation to improve their quality of life.
