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研究生: 朱怡儒
Yi-Ju Chu
論文名稱: 乳癌病患的社會支持及生活品質之研究-以臺北市某跨院性乳癌病友支持團體為例
A Study of the Association of Social Support and Quality of Life among Breast Cancer Patients- A Case Study of A Supporting Group in Northern Taiwan
指導教授: 姜逸群
Chiang, I-Chyun
學位類別: 碩士
Master
系所名稱: 健康促進與衛生教育學系
Department of Health Promotion and Health Education
論文出版年: 2010
畢業學年度: 98
語文別: 中文
論文頁數: 208
中文關鍵詞: 乳癌社會支持生活品質病友支持團體
英文關鍵詞: breast cancer, social support, life quality, patient support group
論文種類: 學術論文
相關次數: 點閱:194下載:52
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  • 本論文研究目的主要探討乳癌病友之參與病友支持團體、社會支持及生活品質之關係,以北部某乳癌病友支持團體之病友為對象,採橫斷面問卷調查收得154份有效問卷。結果發現:
    (1)乳癌病友的生活品質屬中等程度;感受最好的是生理安適感,而心理安適感受最差。社會支持位居中上程度;感受以自尊支持最多,最少是情緒支持;家人在情緒、自尊、實質等支持功能中均高於病友支持團體及醫護人員,而病友支持團體在訊息支持明顯高於醫護人員及家人。參與病友支持團體之狀況:參與時間平均4.98年,互動頻率介於四至七成左右,以及近四成四成的病友網絡數量在1-5位,自覺互動關係及溝通狀況均在普通以上居多。
    (2)在個人基本屬性及疾病特性與參與病友支持團體之狀況間的關係方面:最初乳癌確診時間愈久、目前接受治療種類數目愈少、有擔任幹部者,則參與團體的時間愈長。有擔任幹部者,在病友間自行聚會次數就愈多、自覺團體中的互動關係也愈佳,另,亦與目前無職業者,同時在參與團體活動次數,以及使用或接受團體電話服務次數等變項也愈多。
    (3)乳癌病友參與病友支持團體程度愈顯頻繁,其得到來自病友支持團體社會支持也愈多。
    (4)研究對象的整體社會支持與整體生活品質兩者之間並無相關。
    (5)本研究發現醫護人員情緒支持是影響靈性安適感的主要因素。而家人的社會支持,以及家人的自尊支持是影響整體生活品質與心理安適感共同的顯著預測因素。
    本研究有助於暸解乳癌病友參與病友支持團體、社會支持,以及生活品質之狀況,提供相關支持系統評估及妥適的支持照護,作為提升乳癌病友社會支持及生活品質之參考依據。

    The main purpose of this study is to discuss the relations between breast cancer patients, fellow patient supporting group, and the social support and life quality of the breast cancer patients. The survey was taken from a group of fellow patients that is working with a supporting group in northern Taiwan, with 154 valid effective questionnaires. Result indicated:
    (1) Breast cancer fellow patient's life quality falls the medium degree; they feel best in the physical comfort, but the psychological peacefulness and comfortable feeling is worst. The patients also feel the social supports are above average. In general, the emotional support mostly comes from the self-respect support, but the emotional support is found lacking. Family members associated with emotional, self-respect and all the actual supports is higher patient support groups and the medical care personnel; the fellow patient support groups have stronger ability in communicating and providing medical information than the family members and medical care personnel. The surveyed result for patients attending the fellow patient support groups as follows: average participation time is 4.98 years, the interactive frequency is between about 40 to 70 %, and about 44% of the fellow patient networks have 1 to 5 patients. The self-motivated interactions and communications between patients and the fellow patient supporting groups are above average.
    (2) In terms of relationship between individual essential attribute, disease characteristics with participate in the fellow patient supporting groups: the initial breast cancer diagnosis time is long, with the least present treatment types. If the patients work as management level in their job, they tend to participate in the group activities longer, and also the patients are more likely to have more frequent and better voluntary interactions between the patients. If the patients are currently without occupation, they prefer to attend group activities, as well as accept the support groups’ service via telephone.
    (3) The more frequent the breast cancer patients participate in the fellow patient supporting program, the more social support the patients can get the support group.
    (4) The surveyed patients’ overall social support and life quality are not related.
    (5) This research discovered that medical care personnel’s emotional support is the primary factor to affect patient’s comfort level. However, family member's social and self-respect supports have significant impact on the patient’s overall life quality and emotional peacefulness.

    Though this research, we’ve gained more knowledge in how the breast cancer patients attend the patient support group, how well they receive social support, and the quality of patients’ life. Further, this research provides evaluations in the patient support system and medical care, which is a valuable reference to improve the breast cancer patients’ social support and life quality.

    【目 錄】 書名頁 ………………………………………………………… i 論文口試委員審定書 ………………………………………… ii 授權書 ………………………………………………………… iii 中文摘要 ……………………………………………………… iv 英文摘要 ……………………………………………………… v 誌謝 …………………………………………………………… vi 目錄 …………………………………………………………… vii 表目錄 ………………………………………………………… x 圖目錄 ………………………………………………………… xii 第一章 緒論 ……………………………………………… 1 第一節 研究動機與重要性 ………………………………… 1 第二節 研究目的 …………………………………………… 4 第三節 研究問題 …………………………………………… 4 第四節 研究假設 …………………………………………… 5 第五節 名詞界定 …………………………………………… 6 第六節 研究限制 …………………………………………… 8 第二章 文獻探討 ………………………………………… 9 第一節 乳癌 ………………………………………………… 9 第二節 生活品質 …………………………………………… 15 第三節 社會支持 …………………………………………… 23 第四節 病友支持團體 ……………………………………… 31 第三章 研究方法 ………………………………………… 38 第一節 研究架構 …………………………………………… 38 第二節 研究對象 …………………………………………… 39 第三節 研究工具 …………………………………………… 40 第四節 研究步驟 …………………………………………… 47 第五節 資料處理與分析 …………………………………… 49 第四章 研究結果 …………………………………………… 51 第一節 研究對象個人基本屬性及疾病特性之分佈 ……… 51 第二節 研究對象參與病友支持團體之狀況、社會支持及生活品質之分佈 ………………………58 第三節 研究對象個人基本屬性及疾病特性與參與團體狀況之關係 ………………………75 第四節 研究對象參與病友支持團體之狀況與社會支持之關係 ………………………83 第五節 研究對象社會支持與生活品質之關係 ……………… 106 第五章 討論 ……………………………………………………116 第一節 研究對象參與病友支持團體之狀況、社會支持及生活品質之分佈情形 …………………116 第二節 研究對象個人基本屬性及疾病特性與參與病友支持團體狀況之探討 …………………122 第三節 研究對象參與病友支持團體狀況與社會支持間之探討 …………………… 128 第四節 研究對象社會支持與生活品質間之探討 ………… 133 第六章 結論與建議 ……………………………………… 139 第一節 結論 ………………………………………………… 139 第二節 建議 ………………………………………………… 140 參考書目 …………………………………………………… 145 附錄一:生活品質量表原作者授權………………………… 154 附錄二:生活品質量表中文版授權………………………… 155 附錄三:問卷專家效度名單及審查說明…………………… 156 附錄四:專家建議修改彙整………………………………… 171 附錄五:預試問卷…………………………………………… 176 附錄六:預試問卷修改彙整………………………………… 186 附錄七:正式問卷…………………………………………… 188 【表 目 錄】 表2-1 國內歷年女性乳癌(C50)發生率…………………………… 11 表2-2 乳癌的追蹤與檢查……………………………………………… 14 表3-1 研究工具之信度考驗…………………………………………… 46 表3-2 研究資料之統計方法…………………………………………… 49 表4-1 研究對象的個人基本屬性之分佈(N=154)………………… 53 表4-2 研究對象的疾病特性之分佈(N=154)……………………… 56 表4-3 研究對象的參與病友支持團體之狀況之分佈(N=154)…… 60 表4-4 研究對象的社會支持量表之得分情形(N=154)…………… 64 表4-5 家人社會支持次量表之各題得分情形(N=154)…………… 65 表4-6 醫護人員社會支持次量表之各題得分情形(N=154)……… 67 表4-7 病友支持團體社會支持次量表之各題得分情形(N=154)… 69 表4-8 研究對象的生活品質之各次量表得分情形(N=154)……… 70 表4-9 生理安適感層面之各題得分情形(N=154)………………… 71 表4-10 心理安適感層面之各題得分情形(N=154)………………… 72 表4-11 社會安適感層面之各題得分情形(N=154)………………… 73 表4-12 靈性安適感層面之各題得分情形(N=154)………………… 74 表4-13 研究對象的個人基本屬性及疾病特性與參與病友支持團體之狀況之相關分析(N=154)………………………………………80 表4-14 研究對象的個人基本屬性及疾病特性與參與病友支持團體之狀況的「參與團體的時間」之單因子變異數分析(N=154)…81 表4-15 研究對象的個人基本屬性及疾病特性與參與病友支持團體之狀況之卡方檢定(N=154)………………………………………82 表4-16 研究對象的參與病友支持團體狀況與整體社會支持之單因子變異數分析(N=154)……………………………………………90 表4-17 研究對象的參與病友支持團體狀況與家人社會支持之單因子變異數分析(N=154)……………………………………………94 表4-18 研究對象的參與病友支持團體狀況與醫護人員社會支持之單因子變異數分析(N=154)………………………………………98 表4-19 研究對象的參與病友支持團體狀況與病友支持團體社會支持之單因子變異數分析(N=154)…………………………………102 表4-20 研究對象的社會支持與生活品質之相關分析(N=154)………108 表4-21 整體社會支持功能與「靈性安適感」層面之簡單及多元迴歸分析………………………………………………………………110 表4-22 整體社會支持來源與「整體生活品質總分」、「心理安適感」及「靈性安適感」等層面之多元迴歸分析……………………112 表4-23 家人社會支持功能與「整體生活品質總分」、「心理安適感」及「靈性安適感」等層面之多元迴歸分析……………………114 表4-24 醫護人員社會支持功能與「靈性安適感」層面之多元迴歸分析………………………………………………………………115 表5-1 研究對象個人基本屬性及疾病特性與參與病友支持團體之狀況間關係彙整表………………………………………………………127 表5-2 研究對象參與病友支持團體之狀況與社會支持間之單因子變異數分析彙整表………………………………………………………132 【圖 目 錄】 圖2-1 生活品質、身體功能狀態與幸福感之關係…………………… 17 圖3-1 研究架構………………………………………………………… 38 圖3-2 研究步驟流程…………………………………………………… 47

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