化學治療後乳癌婦女的性功能影響因素探討

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化學治療後乳癌婦女的性功能影響因素探討

中文摘要

本研究目的在探討化學治療後二年內的乳癌婦女性功能及其相關因素,並與一般婦女的性功能相比較。研究變項包 括:基本屬性及疾病特性、身體症狀困擾、心理困擾與社交狀況。研究設計為病例對照研究法,採方便取樣,乳癌 個案選自於台北地區二所區域醫院之乳房外科門診與其支持團體;一般婦女選自於婦產科門診中接受子宮頸抹片檢 查的個案。 72 位符合收案標準的乳癌婦女與 72 位一般婦女,在獨立隱密的空診間,接受研究者以結構式問卷進行 訪談。重要結果歸納如下:

一、乳癌婦女的性愉悅顯著低於一般婦女,性困擾則臨界顯著高於一般婦女。但經校正二組之年齡、經濟與停經狀 況後,乳癌婦女與一般婦女在性愉悅與性困擾的差異則缺乏統計意義。不過,相當特殊的是,在性生活的頻率上,

乳癌婦女顯著低於一般婦女,而且高達四成三的乳癌婦女明顯改變其原有的性習慣。

二、乳癌婦女性習慣改變者之身體症狀困擾顯著高於未改變者,而身體症狀困擾與心理困擾呈顯著正相關。

三、有宗教信仰、主要收入來源為自己者、經濟狀況較佳及手術治療時間較短者,顯著有較高的性愉悅。

四、乳癌婦女的性困擾與性愉悅呈顯著負相關。年齡小於 50 歲者、停經原因為藥物所導致者、初次診斷至今時間較 長、手術治療時間較長,其性困擾程度顯著較高。

根據研究結果,本研究建議:

一、護理實務方面可應用本研究結果,增強護理人員面對照護化學治療後乳癌婦女性功能議題時的信心與敏感度。

可就常見的身體症狀困擾加強衛教指導,並針對有陰道乾燥症狀困擾的婦女教導以水性潤滑劑緩解不適感。

二、正視醫護人員未能適時提供完整性諮詢的問題,仍有部份乳癌婦女有錯誤的性知識,在護理教育方面,需儘快 培育性諮詢專業護理人才,加強「癌症個案性功能」方面課程,以提升知識與技能。

三、建議延長乳癌婦女出院後門診追蹤之評估時間與設置社區追蹤服務。可於門診設有「女性性諮商中心」,營造 一親善、可信賴之婦女就醫環境,加強治療後的性生活品質。

關鍵字:乳癌婦女、化學治療、性功能

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Factors Associated with Sexual Function in women with Breast Cancer after Chemotherapy

英文摘要

Tital of Thesis : Factors Associated with Sexual Function in Women with Breast Cancer after Chemotherapy Institution : Graduate Institute of Nursing , Taipei Medical University

Author : Li-Yen Lee

Thesis directed by : Ping-Ling Chen , Ph. D., MPH , Associate Professor

The purpose of this study was to explore sexual functions and its related factors with breast cancer women who have their chemotherapy in two years.

The comparisons were also made between them and the healthy women. The items studied include: demographics, disease characteristics, physical sy mptom distress, psychological distress, and social state. Case-control Study and Convenience Sampling were being used. Target patients were chosen f rom two area hospitals in Taipei; both from breast surgical outpatients and from pap’s smear women. A questionnaire was completed by 72 breast can cer patients and 72 healthy women in a private room in hospital. The conclusions were:

1. The sexual pleasure of breast cancer women was much lower than that of healthy women, and sexual distress was much higher. But after the

adjustment of age, economic status, and menopause, this difference was not so meaningful statistically. Nevertheless, the frequency of sexual activity of breast cancer women was much less than that of healthy women, and 43% of the breast cancer women had changed their sexual habits dramatically.

2. There was obvious difference between the sexual habits and physical symptom distress of breast cancer women. And psychological distress and phy sical distress were mutually related.

3. The relationship between demographics and sexual pleasure of breast cancer women: sexual pleasure could be varied from different religious belief, main income resource, economic status, and time of treatment.

4. The relationship between demographics and sexual distress of breast cancer women: sexual distress could be related to age, reason of menopause, ti me period from first diagnosis, and time of treatment.

And some suggestions were made accordingly as follow:

1. In nursing practice: the nursing personnel should be trained to have knee observation, and the ability to do the personal evaluation of the sexual function of the breast cancer patients.

2. In nursing education: more professional consultants should be educated and trained, especially in [sexual function of cancer patient], to take care of the patients more professionally.

3. In medical policy: a [female sexual consult center] should be established and conducted mainly by female nursing personnel in order to make a frien

dly atmosphere. Also, the prolongation of follow-up treatment to the breast cancer patients and community follow-up service were highly recommende

d. Key Words: Breast Cancer Women, Chemotherapy, Sexual Function

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