乳房手術患者術後兩週內之症狀困擾、身體心像、生活品質之探討

乳房手術患者術後兩週內之症狀困擾、身體心像、生活品質之探討 Symptom

中文摘要

論文名稱：乳房手術患者術後二週內之症狀困擾、身體心像、生活品質之探討 研究所名稱：台北醫學大學護理學研究所

研究生：王楚君

畢業時間：91 學年度第一學期

指導教授：台北醫學大學護理學研究所 賴裕和 教授

乳癌是婦女常見的惡性腫瘤，面對疾病及治療所帶來的副作用，對患者的生理、心理、社會及靈 性是極大的挑戰，而手術更添加了許多的壓力，為了解患者在乳房手術後兩週內急性期的症狀困 擾、身體心像、手部活動及生活品質之改變程度，本研究利用結構式問卷採縱貫式研究法，以手

術前一天為基本對照值，再收集手術當天至手術後第五天，以及手術後第二週，共8 次的資料，

希望針對乳癌患者在乳房手術後兩週內相關問題深入了解。本研究共完成30 位患者之收案，結 果發現患者於手術前便開始有睡眠障礙、焦慮及憂鬱產生，主要是因為手術及乳癌所產生的心理 問題，手術後主要的問題是疼痛及手部活動障礙，焦慮及憂鬱於術後有明顯的改善。乳房手術雖 影響患者的症狀困擾、身體心像、手部活動及生活品質，但於術後兩週皆能有相當程度之恢復。

研究結果建議醫療人員不只是治療疾病及症狀，也應投注更多的關懷，照顧患者的心理及社會層 面，協助患者釐清對乳癌及治療的疑惑、保有對治療的信心、早日恢復正常生活，以提昇整體的 生活品質。

關鍵字：乳癌患者、生理困擾、心理困擾、身體心像、手部活動、生活品質。

英文摘要

Title of Thesis：Symptom Distress, Body Image and Quality of Life in Breast Cancer Patient Receiving Surgery.

Institution：Graduate Institution of Nursing, Taipei Medical University Author：Chu-Chun Wang

Thesis directed by：Yeur-Hur Lai professor

Breast cancer is the most common cancer among female. The adverse effect of post breast cancer treatment has great impact on patient’s physiological, psychological, social, and spiritual aspect. This study investigates patient’s symptomatic distress, body image, shoulder motion, and quality of life in acute recovery stage (i.e. 2 weeks duration) of post breast surgery. This study is based on longitudinal study where questionnaire were given to patients on pre operation day, operation day to post operation day 5 respectively, and 2 weeks post operation. Thirty patients were enrolled in the study. Overall eight entered data were gathered for each patient.

Pre-operation revealed psycho-physical distress such as anxiety, depression, and

sleep disturbance. The distress was mainly contributed by breast cancer itself and uncertainty of operation. In post operation, patients emphasized on surgical pain and limited upper extremities range of motion. Psychological distress showed decline in post operation. Breast surgery affected patients’ symptomatic distress, body image, shoulder motion, and quality of life. However, patient usually showed significant improvement post two weeks from surgery. Study suggested that medical staff should not only focus on disease management itself but also patient’s psychological and social needs. Clarify patient’s query of disease and treatment plan will improve patient’s compliance to the future treatment, early post operation recovery, and increase in overall quality of life.

Key word： Breast cancer, physical distress, psychological distress, body image, shoulder motion, quality of life.