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Author: 蔡鈊甯
Tsai, Shin Ning
Thesis Title: 肺癌患者於治療時期生活品質及失志相關性探討以北部某地區醫院患者為例
The relationship between quality of life and demoralization in patients of lung cancer treatment (Take patients from a hospital in a northern area as an example )
Advisor: 曾治乾
Tseng, Chie-Chien
Committee: 葉國樑 吳岱穎 周明岳 曾治乾
Approval Date: 2022/01/14
Degree: 碩士
Master
Department: 健康促進與衛生教育學系健康促進與衛生教育碩士在職專班
Department of Health Promotion and Health Education_Continuing Education Master's Program of Health Promotion and Health Education
Thesis Publication Year: 2022
Academic Year: 110
Language: 中文
Number of pages: 77
Keywords (in Chinese): 肺癌生活品質失志症候群困擾溫度計
Keywords (in English): lung cancer, Quality of Life, Demoralization, Distress Thermometer
Research Methods: 現象分析
DOI URL: http://doi.org/10.6345/NTNU202200307
Thesis Type: Academic thesis/ dissertation
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  • 摘 要
    本研究之目的為探討治療中的肺癌患者的生活品質與失志症候群以及心理痛苦溫度計之間的關係。本研究共蒐集45位確診肺癌並在治療中之病人,以北部某地區教學醫院胸腔科、血液腫瘤科門診個案為收案對象,以問卷方式進行資料蒐集,問卷內容包括個人基本資料人口學變項與疾病特性、生活品質量表(肺癌生活品質問卷(QLQ-LC13)/癌症生活品質核心問卷(LQ-C30))、失志量表(Demoralization Scale Mandarin Version, DS-MV)、困擾溫度計(Distress Thermometer, DT),有效問卷經編碼後以SPSS26版統計軟體進行資料建檔及分析。
    整體而言,研究對象生活品質是屬於不佳,研究對象之失志症候群呈現高失志。本研究結果顯示困擾溫度計第二部分計分對生活品質的預測力為48.1%。困擾溫度計第二部分對生活品質量表之β值.379為最大,影響力最大,其次是失志症候群對生活品質β值為.304,最後為困擾溫度計第一部分對生活品質β值為.303。背景因素中除不同年齡於困擾溫度計第二部分計分具有顯著差異外,其餘均無顯著差異。生活品質與失志症候群、困擾溫度計的相關性分析中顯示生活品質與失志症候群有顯著相關。另生活品質分別與困擾溫度計第一部分計分及第二部分計分皆有顯著相關,因此可推論失志症候群、困擾溫度計對生活品質有顯著影響。
    未來研究方向建議可增加腫瘤個案管理師介入後之生活品質、心理層面調適等因素之探討。

    Abstract
    This study purposed to explore the correlations between European Organization for Research and Treatment Quality of Life, Demoralization Scale Mandarin Version, and Distress Thermometer in lung cancer patients. A total of 45 patients diagnosed with lung cancer and under treatment were collected. The subjects were outpatients of the department of thoracic and hematology and oncology in a regional teaching hospital in Taipei. Questionnaire survey was conducted to collect subjects' demographic information, quality of life scale (Lung Cancer Quality of Life Questionnaire, QLQ-LC13); Cancer Quality of Life Core Questionnaire (LQ-C30), Depression Scale (Demoralization Scale Mandarin Version, DS-MV), and Distress Thermometer (Distress Thermometer, DT). Valid questionnaires were coded and SPSS26 statistical software was used for data filing and analysis.
    The results showed subjects' quality of life were poor, and their dementia syndrome in this study showed a high level of dementia. The β value of the second part of the distress thermometer on the quality of life scale is .379, which has the greatest influence of the all and can predict 48% of the variance of quality of life; followed by the β value of the dementia syndrome on the quality of life .304; then β value of the first part of the distress thermometer, .303.
    The subjects in different age groups showed significant difference in the scores of the second part of the distress thermometer, while other demographic parameters showed no significant difference. The subjects' quality of life is significantly correlated with their demoralization syndrome. And their quality of life was also significantly correlated with the scores of the first part and the second part of the distress thermometer respectively. So it can be inferred that the demoralization syndrome and the distress thermometer had a significant impact on the quality of life scale.
    Suggestions for future research should include the discussion on the improvement of quality of life and psychological adjustment after intervention by oncology case managers.

    第一章 緒論1 第一節 研究背景與動機2 第二節 研究目的 6 第三節 研究問題 7 第四節 研究假設 8 第五節 名詞解釋 9 第六節 研究限制 14 第二章 文獻探討 15 第一節 肺癌流行病學及治療準則15 第二節 肺癌患者的失志19 第三節 肺癌患者的生活品質22 第四節 失志症候群與生活品質25 第三章 研究方法 29 第一節 研究對象 29 第二節 研究架構 30 第三節 研究實施與步驟31 第四節 研究工具32 第五節 資料分析方法36 第四章 研究結果與討論37 第一節 研究樣本之描述性統計37 第二節 生活品質、失志症候群及困擾溫度計量表得分情形39 第三節 治療中肺癌患者基本變項之生活品質、失志差異性53 第四節 治療中肺癌患者之生活品質與失志症候群相關性55 第五章 結論與建議58 第一節 結論58 第二節 建議59 中文文獻60 英文文獻62 附錄1-癌症病人生活品質問卷70 附錄2-失志量表 (DS-MV)75 附錄3-困擾溫度計(Distress Thermometer, DT)77

    中文文獻
    1.方俊凱(2013),癌症病人的失志症候群,台灣醫學Formosan J Med 2013;17:149-54。
    2.曲幗敏, 蔡玉鳳, 蘇僅涵, 林聿品, 黃金瑩, & 陳美碧. (2019). 探討護理人員與癌症病人對病人之症狀困擾, 情緒困擾及靈性安適評估之一致性. 源遠護理, 13(1), 29-40。
    3.李玉琪、周汎澔、王秀紅(2015),失志的概念分析,護理雜誌,62(3),83–88。
    4.林家惠, & 王枝燦. (2017). 探討癌症病人疼痛與失志狀態之關聯. 護理雜誌, 64(1), 51-60。
    5.李芸湘, 蔡芸芳, 賴裕和, & 高瑞和. (2002). 肺癌病患在化學治療期間疲憊程度及其相關因素. 台灣醫學, 6(6), 797-804。
    6.季瑋珠, 楊志新, 許駿, 賴佳君(2002). 癌症病人特定疾病EORTC生活品質量表簡介. 台灣醫學, 6(2):220-227。
    7.姚開屏(2000)‧簡介與評論常用的一般性健康相關生活質量表兼談對未來研究的建議 測驗年刊‧41(2),111-138。
    8.姚開屏(2006b)‧健康相關生活品質概念與測量原理之簡介.臺灣醫學,6(2),頁 183-192。
    9.洪曉琪, 陳虹汶, 張義芳, 楊育正, 劉建良, 謝瑞坤, ... & 方俊凱. (2010). 癌症病人失志量表中文版之信效度檢測. 內科學誌, 21(6), 427-435。
    10.張美玉, 徐莞雲, 徐倩儀, & 林麗英. (2016). 新診斷癌症病人生活品質之相關因素探討. 榮總護理, 33(3), 293-302。
    11.張煦婕, 林佳靜, & 黃采薇. (2019). 癌症存活者健康促進之概念分析. 腫瘤護理雜誌, 19(1), 13-21。
    12.曾嶔元(2010). 非小細胞肺癌的回顧與標靶治療現況. 生物醫學, 3(1):332-350。
    13.劉美玲、蕭雅竹(2019),末期病人失志對靈性安適之影響,護理雜誌,66(1),48-59。
    14.羅淑芬、胡文郁(2008)‧癌症病人健康相關生活品質之概念與測量工具之評析‧安寧療護雜誌,13(1),42-57。
    15.萬崇華, 陳明清, 張燦珍, 湯學良, 孟瓊, & 張曉磬. (2005). 癌症患者生命質量測定量表 EORTC QLQ-C30 中文版評介. 實用腫瘤雜誌, 20(4), 353-355。
    16.戴鈺娌, 陳貞秀, 楊政達, 陳綱華, 江明珠, & 唐秀治. (2015). 統合分析晚期非小細胞肺癌病人化學治療期間生活品質變化及其影響因素。 台灣癌症醫學雜誌, 2(3), 224-233.
    17.蘇于婷, 馮博皓, 李岡遠, & 陳喬男. (2017). 晚期非小細胞肺癌患者治療後生活品質之相關影響: 先驅研究. 物理治療, 42(2), 142-143。
    英文文獻
    1.American Cancer Society (n.d.).lung cancer, from http://www.cancer.org/cancer/lungcancer/index
    2.Akin, S., Can, G., Aydiner, A., Ozdilli, K., & Durna, Z. (2010). Quality of life, symptom experience and distress of lung cancer patients undergoing chemotherapy. European Journal of Oncology Nursing, 14(5), 400-409.
    3.Berghmans, T., Lievens, Y., Aapro, M., Baird, A. M., Beishon, M., Calabrese, F., ... & Poortmans, P. (2020). European Cancer Organisation Essential Requirements for Quality Cancer Care: Lung cancer. Lung Cancer.
    4.Bouazza, Y. B., Chiairi, I., El Kharbouchi, O., De Backer, L., Vanhoutte, G., Janssens, A., & Van Meerbeeck, J. P. (2017). Patient-reported outcome measures (PROMs) in the management of lung cancer: a systematic review. Lung Cancer, 113, 140-151.
    5.Banks, E., Byles, J. E., Gibson, R. E., Rodgers, B., Latz, I. K., Robinson, I. A., ... & Jorm, L. R. (2010). Is psychological distress in people living with cancer related to the fact of diagnosis, current treatment or level of disability? Findings from a large Australian study. Medical Journal of Australia, 193, S62-S67.
    6.Choi, S., & Ryu, E. (2018). Effects of symptom clusters and depression on the quality of life in patients with advanced lung cancer. European journal of cancer care, 27(1), e12508.
    7.Chen, H. L., Liu, K., & You, Q. S. (2018). Self‐efficacy, cancer‐related fatigue, and quality of life in patients with resected lung cancer. European journal of cancer care, 27(6), e12934.
    8.Cheng, J., Chen, J., Zhang, Y., Kissane, D., & Yan, J. (2019). Translation and psychometric properties for the Demoralization Scale in Chinese breast cancer patients. European Journal of Oncology Nursing, 42, 134-140.
    9.Ferreira, K. A., Kimura, M., Teixeira, M. J., Mendoza, T. R., da Nóbrega, J. C. M., Graziani, S. R., & Takagaki, T. Y. (2008). Impact of cancer-related symptom synergisms on health-related quality of life and performance status.Journal of pain and symptom management, 35(6), 604-616.
    10.Fitzgerald, K., & Simone, C. B. (2020). Combining immunotherapy with radiation therapy in non–small cell lung cancer. Thoracic surgery clinics, 30(2), 221-239.
    11.Guirimand, F., Buyck, J. F., Lauwers-Allot, E., Revnik, J., Kerguen, T., Aegerter, P., ... Cleeland, C. S. (2010). Cancer-related symptom assessment in France: validation of the French MD Anderson Symptom Inventory. Journal of pain and symptom management, 39(4), 721-733.
    12.Ghiggia, A., Pierotti, V., Tesio, V., & Bovero, A. (2021). Personality matters: relationship between personality characteristics, spirituality, demoralization, and perceived quality of life in a sample of end-of-life cancer patients. Supportive Care in Cancer, 29(12), 7775-7783.
    13.Grande, G. E., Farquhar, M. C., Barclay, S. I., & Todd, C. J. (2009). Quality of life measures (EORTC QLQ-C30 and SF-36) as predictors of survival in palliative colorectal and lung cancer patients. Palliative & supportive care, 7(3), 289-297.
    14.Grassi, L., Costantini, A., Kissane, D., Brunetti, S., Caruso, R., Piazza, G., ... & Nanni, M. G. (2017). The factor structure and use of the Demoralization Scale (DS‐IT) in Italian cancer patients. Psycho‐oncology, 26(11), 1965-1971.
    15.Grassi, L., Spiegel, D., & Riba, M. (2017). Advancing psychosocial care in cancer patients. F1000Research, 6.
    16.Joshy, G., Thandrayen, J., Koczwara, B., Butow, P., Laidsaar-Powell, R., Rankin, N., ... & Banks, E. (2020). Disability, psychological distress and quality of life in relation to cancer diagnosis and cancer type: population-based Australian study of 22,505 cancer survivors and 244,000 people without cancer. BMC medicine, 18(1), 1-15.
    17.Hirsch, F. R., Scagliotti, G. V., Mulshine, J. L., Kwon, R., Curran Jr, W. J., Wu, Y. L., & Paz-Ares, L. (2017). Lung cancer: current therapies and new targeted treatments. The Lancet, 389(10066), 299-311.
    18.Ho, Y. R., Ma, S. P., & Chang, K. Y. (2019). Trends in regional cancer mortality in Taiwan 1992–2014. Cancer epidemiology, 59, 185-192.
    19.Hofmeister, D., Schulte, T., & Hinz, A. (2020). Sleep problems in cancer patients: a comparison between the Jenkins Sleep Scale and the single-item sleep scale of the EORTC QLQ-C30. Sleep Medicine, 71, 59-65.
    20.Huda, N. (2019). Psychological distress among patients with advanced cancer: A concept analysis. Annals of Oncology, 30, v822.
    21.Hsiu-Ling, P. E. N. G., Hsueh, H. W., Chang, Y. H., & Ren-Hau, L. I. (2021). The Mediation and Suppression Effect of Demoralization in Breast Cancer Patients After Primary Therapy: A Structural Equation Model. Journal of Nursing Research, 29(2), e144.
    22.Kim, J. W., Cha, Y., Kim, S. J., Han, S. W., Oh, D. Y., Lee, S. H., ... & Bang, Y. J.(2012). Association of oral mucositis with quality of life and symptom clusters in atients with solid tumors receiving chemotherapy. Supportive Care in Cancer, 20(2), 395-403.
    23.Kim, B. H., Kim, J. S., Kim, K. H., Moon, H. J., & Kim, S. (2021). Clinical significance of radiation dose–volume parameters and functional status on the patient-reported quality of life changes after thoracic radiotherapy for lung cancer: a prospective study. La radiologia medica, 126(3), 466-473.
    24.Kissane, D. W., Wein, S., Love, A., Lee, X. Q., Kee, P. L., & Clarke, D. M. (2004). The demoralization scale: A report of its development and preliminary validation. Journal of Palliative Care, 20(4), 269–276.
    25.Karczmarek-Borowska, B., Pelc, M., Rabiej, E., & Grądalska-Lampart, M. (2014). The quality of life of non-small cell lung cancer patients treated with chemotherapy. Advances in Respiratory Medicine, 82(4), 349-357.
    26.Lee, C. Y., Fang, C. K., Yang, Y. C., Liu, C. L., Leu, Y. S., Wang, T. E., … Chen, H. W. (2012). Demoralization syndrome among cancer outpatients in Taiwan. Supportive Care in Cancer, 20(10), 2259–2267.
    27.Li, Y. C., Ho, C. H., & Wang, H. H. (2017). Demoralization in cancer patients and related factors in Taiwan. Cancer nursing, 40(1), E54-E60.
    28.Li, Y. C., Ho, C. H., & Wang, H. H. (2017). Protective factors of demoralization among cancer patients in Taiwan: an age-matched and gender-matched study. Asian nursing research, 11(3), 174-179.
    29.Lee, C. S., & Lyons, K. S. (2019). Patterns, relevance, and predictors of dyadic mental health over time in lung cancer. Psycho‐oncology, 28(8), 1721-1727.
    30.Mehnert, A., Vehling, S., Höcker, A., Lehmann, C., & Koch, U. (2011). emoralization and depression in patients with advanced cancer: Validation of the German version of the demoralization scale. Journal of Pain and Symptom Management, 42(5), 768–776.
    31.Mierzynska, J., Taye, M., Pe, M., Coens, C., Martinelli, F., Pogoda, K., ... & Bottomley, A. (2020). Reference values for the EORTC QLQ-C30 in early and metastatic breast cancer. European Journal of Cancer, 125, 69-82.
    32.Nanni, M. G., Caruso, R., Travado, L., Ventura, C., Palma, A., Berardi, A. M., ... & Grassi, L. (2018). Relationship of demoralization with anxiety, depression, and quality of life: AS outhern E uropean study of I talian and P ortuguese cancer patients. Psycho‐oncology, 27(11), 2616-2622.
    33.Yang, P., Cheville, A. L., Wampfler, J. A., Garces, Y. I., Jatoi, A., Clark, M. M., ...Okuno, S. H. (2012). Quality of life and symptom burden among long-term lung cancer survivors. Journal of Thoracic Oncology, 7(1), 64-70.
    34.Ostroff, J. S., Krebs, P., Coups, E. J., Burkhalter, J. E., Feinstein, M. B., Steingart, R. M., ... & Park, B. J. (2011). Health-related quality of life among early-stage, non-small cell, lung cancer survivors. Lung Cancer, 71(1), 103-108.
    35.Oizumi, S., Kobayashi, K., Inoue, A., Maemondo, M., Sugawara, S., Yoshizawa, H., ... & Nukiwa, T. (2012). Quality of life with gefitinib in patients with EGFR-mutated non-small cell lung cancer: quality of life analysis of North East Japan Study Group 002 Trial. The oncologist, 17(6), 863.
    36.Ruiz-Cordero, R., & Devine, W. P. (2020). Targeted therapy and checkpoint immunotherapy in lung cancer. Surgical pathology clinics, 13(1), 17-33.
    37.Reb, A., Ruel, N., Fakih, M., Lai, L., Salgia, R., Ferrell, B., ... & Sun, V. (2017). Empowering survivors after colorectal and lung cancer treatment: pilot study of a self-management survivorship care planning intervention. European Journal of Oncology Nursing, 29, 125-134.
    38.Sullivan, D. R., Forsberg, C. W., Ganzini, L., Au, D. H., Gould, M. K., Provenzale, D., ... & Slatore, C. G. (2016). Depression symptom trends and health domains among lung cancer patients in the CanCORS study. Lung cancer, 100, 102-109.
    39.Scherz, N., Bachmann-Mettler, I., Chmiel, C., Senn, O., Boss, N., Bardheci, K., & Rosemann, T. (2017). Case management to increase quality of life after cancer treatment: a randomized controlled trial. BMC cancer, 17(1), 1-8.
    40.Serena, A., Dwyer, A., Peters, S., & Eicher, M. (2017). Feasibility of advanced practice nursing in lung cancer consultations during early treatment: A phase II study. European Journal of Oncology Nursing, 29, 106-114.
    41.Sun, F. K., Hung, C. M., Yao, Y., Fu, C. F., Tsai, P. J., & Chiang, C. Y. (2021). The effects of logotherapy on distress, depression, and demoralization in breast cancer and gynecological cancer patients: a preliminary study. Cancer nursing, 44(1), 53-61.
    42.Thakur, S. K., Singh, D. P., & Choudhary, J. (2020). Lung cancer identification: a review on detection and classification. Cancer and Metastasis Reviews, 39, 989-998.
    43.Tang, P. L., Wang, H. H., & Chou, F. H. (2015). A systematic review and meta-analysis of demoralization and depression in patients with cancer. Psychosomatics, 56(6), 634-643.
    44.Tay, M. R. J., & Wong, C. J. (2021). Cancer Rehabilitation-Improving Cancer Survivorship in Singapore. Asia-Pacific Journal of Oncology Nursing, 8(4), 346.
    45.Vehling, S., Kissane, D. W., Lo, C., Glaesmer, H., Hartung, T. J., Rodin, G., & Mehnert, A. (2017). The association of demoralization with mental disorders and suicidal ideation in patients with cancer. Cancer, 123(17), 3394-3401
    46.Xia, H. Z., Gao, L., Wang, Y., Song, H., & Shi, B. X. (2017). Development of the Chinese version of meaning in life scale for cancer patients and psychometric evaluation. Journal of clinical nursing, 26(21-22), 3298-3304.
    47.Yin, Y. N., Wang, Y., Jiang, N. J., & Long, D. R. (2020). Can case management improve cancer patients quality of life?: A systematic review following PRISMA. Medicine, 99(40).
    48.Wu, Y. C., Tung, H. H., & Wei, J. (2019). Quality of life, demoralization syndrome and health-related lifestyle in cardiac transplant recipients - a longitudinal study in Taiwan. European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology, 18(2), 149–162. https://doi.org/10.1177/1474515118800397
    49.Arts-de Jong, M., DeJong, C., Hermens, R. P., Kissane, D. W., Massuger, L. M., Hoogerbrugge, N., Prins, J. B., & deHullu, J. A. (2018). High demoralization in a minority of oophorectomized BRCA1/2 mutation carriers influences quality of life. Journal of psychosomatic obstetrics and gynaecology, 39(2), 96–104. https://doi.org/10.1080/0167482X.2017.1296429
    50.Dischinger, M. I., Lange, L., & Vehling, S. (2019). Loss of resources and demoralization in the chronically ill. General hospital psychiatry, 61, 10–15. https://doi.org/10.1016/j.genhosppsych.2019.08.002
    51.Zhu, B., Kohn, R., Patel, A., Koo, B. B., Louis, E. D., & de Figueiredo, J. M. (2021). Demoralization and Quality of Life of Patients with Parkinson Disease. Psychotherapy and psychosomatics, 90(6), 415–421. https://doi.org/10.1159/000514270
    52.Nanni, M. G., Caruso, R., Travado, L., Ventura, C., Palma, A., Berardi, A. M., Meggiolaro, E., Ruffilli, F., Martins, C., Kissane, D., & Grassi, L. (2018). Relationship of demoralization with anxiety, depression, and quality of life: A Southern European study of Italian and Portuguese cancer patients. Psycho-oncology, 27(11), 2616–2622. https://doi.org/10.1002/pon.4824
    53.Caruso, R., Nanni, M. G., Riba, M. B., Sabato, S., & Grassi, L. (2017). The burden of psychosocial morbidity related to cancer: patient and family issues. International review of psychiatry (Abingdon, England), 29(5), 389–402.
    54.Nanni, M. G., Caruso, R., Sabato, S., & Grassi, L. (2018). Demoralization and embitterment. Psychological trauma : theory, research, practice and policy, 10(1), 14–21. https://doi.org/10.1037/tra0000326
    55.An, E., Lo, C., Hales, S., Zimmermann, C., & Rodin, G. (2018). Demoralization and death anxiety in advanced cancer. Psycho-oncology, 27(11), 2566–2572. https://doi.org/10.1002/pon.4843
    56.Tang, L., Li, Z., & Pang, Y. (2020). The differences and the relationship between demoralization and depression in Chinese cancer patients. Psycho-oncology, 29(3), 532–538. https://doi.org/10.1002/pon.5296

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