探討運用伸展運動與癌痛衛教於改善癌症病患疼痛經驗之成效 The Effect of Stretching Exercise and Pain Education on Cancer Patients’ Pain Experience
中文摘要
疼痛為癌症病患最常面臨的症狀，是多層面的複雜經驗，因此疼痛處理需要多方 的處置方式，故本研究目的擬探討及比較癌痛衛教、癌痛衛教加伸展運動訓練與 病房照顧對癌症病患疼痛改善的效果。
本研究從 94 年 2 月至 94 年 6 月，共 4 個月，於北部 2 所醫學中心之腫瘤相關病 房選取研究對象，研究設計採類實驗法，以隨機分派將符案病患分為（1）衛教 組，每天接受 10-15 分鐘的癌痛衛教方案並連續五天（實驗組Ⅰ，12 人），（2）
衛教+伸展組，每天接受 15 分鐘的癌痛衛教及執行 15 分鐘伸展運動連續 5 天（實 驗組Ⅱ，12 人），（3）控制組為接受一般病房常規照顧(12 人)，共 36 人，所有 的個案在研究期間（共 28 天）接受 4 次評量，分別為前測（T0）、第 6 天（第 一次後測，T1）、第 14 天（第二次後測，T2）、第 28 天（第三次後測，T3）。
分別以簡明疼痛量表－臺灣版（Brief Pain Inventory Short Form Taiwanese [BPI - T)]）評估疼痛強度及疼痛干擾，疼痛及麻醉性止痛藥信念（Pain and Opioid Analgesic Beliefs Scale - Cancer [POABS - CA]）評估研究對象之疼痛及麻醉性止 痛藥信念、情緒量表簡明版（Profile of Mood State short Form [POMS-SF]）及以 10 分數字量表（Numeric rating scale [NRS]）評估疲憊、焦慮與憂鬱情緒困擾。
研究結果以描述性統計、單因子變異數分析、重複測試變異數分析等統計方法執 行資料分析。
本研究結果發現，經過一個月的追蹤：（1）經過介入方案後，測量衛教+伸展組 之過去 24 小時的疼痛干擾日常生活、情緒、與他人關係、睡眠及生活樂趣，有
顯著改善；（2）兩組實驗組之研究對象在接受癌痛衛教後，不正確疼痛及麻醉性
止痛藥信念得分減少與控制組得分比較，達到顯著差異。
本研究結果顯示，癌痛衛教可改善癌患不正確的疼痛及麻醉性止痛藥信念，癌痛 衛教配合伸展運動可減少研究對象之疼痛干擾，並增加癌痛病患的活動能力。
英文摘要
Pain is a frequently symptom in cancer patients and needs many different ways to manage its characters with multiple dimensions. The Structured pain education
program has been shown to reduce the severity of this symptom in cancer patients and stretching exercise has been detected to improve other pain experiences. Therefore, this randomized controlled study aimed to assess the effects of two therapies on cancer patients with pain experience. Appropriated cancer patients were assigned to three groups, including (1) pain education group, accepted 10- 15 min per day for 5
days (Experimental group I, n= 12), (2) pain education plus stretching exercise group, 15 min education and 15 min exercise for 5 following day (Experimental groupⅡ, n=
12), (3) standard care control group, accepted usual ward routine care (control group, n= 12). All cases were carried out and evaluated in four times, (Pretest [T0], Day 6 [T1], Day 14 [T2], and Day 28 [T3]) for four weeks ( total 28days).
Pain intensity, Pain interferences with daily life, beliefs about pain and opioids, mood status, and fatigue of all cases were evaluated by the Brief Pain Inventory Short Form Taiwanese (BPI-T), Pain and Opioid Analgesic Beliefs Scale – Cancer (POABS-CA), Profile of Mood State short Form (POMS-SF), and Numeric rating scale (NRS). Data were analyzed by using descriptive statistics, one - way ANOVA, and Repeated measure ANOVA.
The result showed that (1) pain interferences with general activity, mood, relations with other people, sleep, and enjoyment of life were significantly improving in following evaluation in experimental groupⅡ, (2) there were significantly statistic difference between two experimental groups and control group on beliefs about pain and opioids.
In conclusion, the result indicated that, after complete treatment, pain education plus stretching exercise could improve cancer patients’ daily life, and patients who had received structured pain education, had significantly less negative beliefs about pain and opioids than the control group. These interventions should be practiced effetely in clinical nursing care for cancer patients.
