比較背部按摩與放鬆訓練處置對化學治療期間疲憊程度改善之成效 Comparison the Effects of Back Massage and Relaxation Training in Reducing Chemotherapy Induced Fatigue
中文摘要
疲憊是接受化學治療病患最困擾的症狀，為改善化學治療期間病患的疲憊問題，
本研究目的為測試背部按摩與放鬆訓練在改善化學治療病患疲憊問題的效果。研 究設計採類實驗法及前、後測縱貫式收集，以頭頸部及食道癌病患，依隨機分配 方式將符案病患分配至對照組、背部按摩（實驗組Ⅰ）及放鬆訓練（實驗組Ⅱ）
三組人數依序為17、15 與 14 人，三組共 46 人，兩實驗組在化學治療期間，予
連續三天，每天兩次，一次10 分鐘的方案，前後測量生理反應及視覺類比量表
（疲憊、症狀困擾、焦慮及憂鬱），對照組病患則接受目前病房之常規照護，三 組在治療前及第三天，測量情緒量表之疲憊、焦慮、憂鬱次量表、症狀困擾量表 及視覺類比量表，並以視覺類比量表測量每日變化。分析方法有：平均數、成對 t 檢定、單因子變異數分析及重覆測量變異數分析。結果發現：（1）對照組之疲 憊、症狀困擾、焦慮及憂鬱程度在治療第三天皆高於治療前，而每日的變化中，
治療第二天及第三天疲憊的程度高於治療前；（2）接受背部按摩的病患在每次 執行後之疲憊、症狀困擾、焦慮及憂鬱程度與生理反應皆明顯下降，而化療前與 第三天之比較中，只有症狀困擾在第三天顯著高於化療前；（3）接受放鬆訓練 的病患在每次執行後，其疲憊、症狀困擾、焦慮及憂鬱程度與血壓、呼吸次數皆 明顯下降，而化療前與第三天之比較中，只有症狀困擾在第三天高於化療前，
而疲憊、焦慮及憂鬱程度則反而下降，且憂鬱下降程度達到統計上顯著差異；
（4）對照組在化療第三天所測得之疲憊量表增加程度（比較於化療前）顯著高 於按摩組，在憂鬱程度方面，對照組在化療第三天所測得之憂鬱量表增加程度
（比較於化療前）顯著高於放鬆組。研究結果，背部按摩及放鬆訓練可降低化學 治療期間病患之疲憊程度，使病患獲得更好的生活品質。
英文摘要
Fatigue is the most annoyed symptom in the cancer patients receiving chemotherapy.
In this study we aimed to assess the effects of back massage and relaxation training in reducing chemotherapy-induced fatigue. A quasi-experimental design was used for this study. Pre-test and post-test longitudinal method was used for data collection. A total of forty-six eligible patients with head and neck or esophageal cancers were randomized assigned into three groups: control, back massage and relaxation training group. Seventeen, fifteen and fourteen patients were assigned in each group
respectively. The experiment patient groups were all received 10-minute program of either back or relaxation training twice a day for three consecutive days during chemotherapy. The control group patients received daily ward routine care only. We
measured patients’ physiological responses and visual analogue scale including fatigue, anxiety, depression, and symptom distress before and after each program.
Before and on the 3rd day of chemotherapy, sub-scales of Profile of Mood State for fatigue, anxiety, depression, and symptom distress scale, visual analogue scale were measured for all patients. A visual analogue scale was used to measure daily changes.
Data were analyzed by mean, paired t-test, repeated measures ANOVA .We found that (1) fatigue, anxiety, depression, and symptom distress level in the control group increased during chemotherapy. The fatigue level on the 2nd and 3rd day was
significantly higher than pre-chemotherapy. (2) However, in the back massage group, fatigue, anxiety, depression, symptom distress level and physiological responses were reduced significantly immediate after therapy. In the long-term effect, which is comparison between the pre-chemotherapy and the 3rd day, symptom distress significantly higher than pre-chemotherapy. (3) In the relaxation training group, the fatigue, anxiety, depression, symptom distress, and blood pressure and respiration rate were reduced significantly immediate after training. In the long-term effect,
depression was significantly lower than pre-chemotherapy. (4) Compared with pre- chemotherapy, fatigue in the control group was significantly higher than the back massage group on the 3rd day. Depression in the control group was significantly higher than the relaxation group on the third day. The results indicated that back massage and relaxation training programs could reduce chemotherapy-induced fatigue and improve the quality of life of the patients.
