研究生: |
彭心怡 Peng, Hsin-Yi |
---|---|
論文名稱: |
乳癌術後重建手術對患者身體心像與性生活滿意度之影響 Effects of Breast Reconstruction Surgery on Breast Cancer Patients’ Body Image and Sexuality Satisfaction |
指導教授: |
張鳳琴
Chang, Fong-Ching |
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: | 2017 |
畢業學年度: | 105 |
語文別: | 中文 |
論文頁數: | 77 |
中文關鍵詞: | 乳癌 、患者 、乳房重建手術 、身體心像 、性生活滿意度 |
英文關鍵詞: | Breast cancer, patient, breast reconstruction surgery, body image, sexuality satisfaction |
DOI URL: | https://doi.org/10.6345/NTNU202202960 |
論文種類: | 學術論文 |
相關次數: | 點閱:231 下載:20 |
分享至: |
查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報 |
摘要
本研究採前、後測研究設計,針對乳癌患者探討乳房重建手術對乳癌術後患者身體心像與性生活滿意度之影響。研究對象為北區某醫學中心經醫師診斷為乳癌之患者,實驗組為乳房全切除術後有進行乳房重建手術之患者15位,對照組為乳房全切除術後未進行乳房重建手術患者15位參與研究。資料收集採自填問卷方式,研究對象於術前、術後兩個月進行身體心像與性生活滿意度調查。本研究結果發現乳房重建手術對於乳癌患者身體心像的維持有正面的效果,而乳房重建手術對於乳癌患者的性生活滿意度無顯著的影響。建議臨床治療單位可以將重建手術列入乳癌治療建議的項目,以維持乳癌患者良好的身體心像感受。
Abstract
This study examined the effects of breast reconstruction surgery on body image and sexuality satisfaction of breast cancer patients. Participants included 30 patients with breast cancer from a medical center of the Northern Taiwan. A total of 15 patients enrolled in the experimental group received breast reconstruction surgery after total mastectomy, while 15 patients enrolled in the control group did not received breast reconstruction surgery after total mastectomy. Participant patients completed a self-administered questionnaire before and after the surgery. The results indicated that breast reconstruction surgery had positive effect on maintaining patients’ body image, while breast reconstruction surgery had no significant effect on patients’ sexuality satisfaction. It is suggested that breast reconstruction treatment options should be included in breast cancer patients’ treatment plan to restore their body image.
參考文獻
丁肇鳳、史麗珠 (2006)。乳房切除術後的手臂復健運動方案。腫瘤護理雜誌,6(1),19-27。
王明暘、黃俊升 (2013)。乳癌的手術治療。臺灣醫學,17(4),383-389。
白玉珠、鄒怡真、黃玲雅、雍海鵬 (2001)。肺癌患者生活品質及其相關因素之研究。腫瘤護理雜誌,1(1),1-17。
行政院衛生署食品藥物管理局(2010)。乳癌用藥手冊。
吳琦雯 (2012)。乳癌病患併發心理疾患及其影響。
李逸 (1994)。婦女因應停經之自我照顧行為。高雄醫學大學護理學研究所學位論文。
李嫈絨 (2010)。再見/再建乳房:乳房重建女性情慾與身體之探討。
李麗燕(2002)。化學治療後乳癌婦女的性功能影響因素探討。臺北醫學大學護理學研究所。
沈志陽 (2000)。 台灣乳癌研究:科技發展月刊。
阮芳賦(2010)。性與社會文化:性學和社會中的性愛。台北:巨流。
林怡伶(2011)。探討乳癌婦女接受乳房切除及乳房重建手術前後焦慮、憂鬱與身體心像。長庚大學護理學系。
林雪貴(2000)。更年期婦女成長團體經驗之參與式研究。國立陽明大學國立陽明大學,台北。
林璟宏 (2011)。急速增加的台灣年輕女性乳癌: 臨床病理及腫瘤生物學研究。
侯明鋒、陳芳銘、歐陽賦 (2008)。乳癌手術的沿革。中華民國癌症醫學會雜誌,24(2),102-107。
國家衛生研究院(2004)。 乳癌診斷與治療共識。取自 http://www.nhri.org.tw/NHRI_ADM/userfiles/file/tcog/breast_II.pdf
張珏、陳芬苓 (1993)。女性更年期研究的回顧與展望[An Overview of the Past and the Future of Female Climacteric]。婦女與兩性學刊(4),263-294。 doi: 10.6255/jwgs.1993.4.263
莊岳泉、趙祖怡 (2008)。乳癌的輔助性化療[Trends of Breast Cancer Adjuvant Chemotherapy in Last Decade]。中華民國癌症醫學會雜誌,24(2),112-120。
陳怡琦(2006)。比較乳癌婦女接受乳房切除及乳房重建手術前後生活品質及其相關因素之探討:長庚大學。
陳訓徹(2006)。乳房的診斷。於「九十五年乳癌及子宮頸癌防治研習 」發表之論文,載於桃園縣衛生局主辦(主編),Book 乳房的診斷。桃園縣林口長庚醫院。
陳博明 (2008)。癌症病患的性生活調適。載於 財團法人台灣癌症臨床研究發展基金會 (主編)。
陳惠美、馬鳳歧、郭英調、石宜銘 (1999)。乳癌術後婦女身心社會調適之探討-以羅氏適應模式為基礎。護理研究,7(4),321-332。
福利衛生部(2012)。 門、住診主要手術處置統計。取自 http://www.mohw.gov.tw/cht/DOS/Statistic.aspx?f_list_no=312&fod_list_no=2668
趙莉芬 (2011)。接受乳房重建手術乳癌婦女生活品質長期變化之前瞻縱貫性探討。
劉瑞靈、丘周萍 (2002)。協助一位接受乳癌切除手術婦女心理衝擊之護理經驗。護理雜誌,49(5),96-102。
蔡政璁(2009)。不同種類癌症病患於不同治療狀態之健康相關生活品質。臺灣大學預防醫學研究所。
衛生福利部國民健康署 (2017)。103年癌症登記報告。Taiwan。
衛生福利部統計處(2016)。 民國104年死因統計年報:取自 https://www.hpa.gov.tw/File/Attach/5191/File_6166.pdf。
鄭明輝 (2001)。乳房重建的最新趨勢。長庚醫訊,33(1),14-15。
鄭淑華 (2006)。乳癌存活者身體心像、憂鬱狀態與性生活調適之探討。
蕭淑敏(2004)。比較接受改良式乳房切除及乳房重建乳癌婦女之生活品質及其相關因素。碩士論文。國防醫學院。
簡玉城(1998)。癌症奪取我的愛-淺談癌症患者的性生活問題。癌症新探,第四期。
顔郁晉 (2005)。社區醫院在乳癌防治所扮演的角色。聲洋防癌之聲(109),15-19。
蘇韋如、蔡篤堅、葉恩典、賴允亮 (2010)。台灣癌症疲累之因素探討。台灣癌症醫學會雜誌,26(6),231-239。
Ahlberg, K.、Ekman, T.、Gaston-Johansson, F.、Mock, V. (2003). Assessment and management of cancer-related fatigue in adults[Comparative Study Research Support, Non-U.S. Gov't Review].Lancet, 362(9384),640-650. doi: 10.1016/S0140-6736(03)14186-4
Arora, N. K.、Gustafson, D. H.、Hawkins, R. P.、McTavish, F.、Cella, D. F.、Pingree, et al. (2001). Impact of surgery and chemotherapy on the quality of life of younger women with breast carcinoma.Cancer, 92(5),1288-1298.
Avis, N. E.、Crawford, S.、Manuel, J. (2004). Psychosocial problems among younger women with breast cancer.Psycho‐Oncology, 13(5), 295-308.
. breast stage 7.0 version().http://www.cancerstaging.org/staging/
Burwell, S. R.、Case, L. D.、Kaelin, C.、Avis, N. E. (2006). Sexual problems in younger women after breast cancer surgery. Journal of clinical oncology, 24(18), 2815-2821.
Christian, C. K.、Niland, J.、Edge, S. B.、Ottesen, R. A.、Hughes, M. E.、Theriault, R.et al.(2006). A multi-institutional analysis of the socioeconomic determinants of breast reconstruction: a study of the National Comprehensive Cancer Network. Annals of surgery, 243(2), 241-249.
Clayton, B. J.、Waller, A. L. (1996). The TRAM flap in breast reconstruction. Plastic Surgical Nursing, 16(3), 133-138.
Damen, T. H.、Timman, R.、Kunst, E. H.、Gopie, J. P.、Bresser, P. J.、Seynaeve, C.et al.(2010). High satisfaction rates in women after DIEP flap breast reconstruction.Journal of Plastic, Reconstructive & Aesthetic Surgery, 63(1), 93-100.
Denton, S.(1995). Breast cancer nursing.:Nelson Thornes.
Didier, F.、Radice, D.、Gandini, S.、Bedolis, R.、Rotmensz, N.、Maldifassi, A.et al. (2009).Does nipple preservation in mastectomy improve satisfaction with cosmetic results, psychological adjustment, body image and sexuality? Breast Cancer Res Treat, 118(3), 623-633.
Dorval, M.、Maunsell, E.、Deschênes, L.、Brisson, J. (1998).Type of mastectomy and quality of life for long term breast carcinoma survivors. Cancer, 83(10), 2130-2138.
Elder, E. E.、Brandberg, Y.、Björklund, T.、Rylander, R.、Lagergren, J.、Jurell, G. et al.(2005). Quality of life and patient satisfaction in breast cancer patients after immediate breast reconstruction: a prospective study. The Breast, 14(3), 201-208.
Fisher, B.、Anderson, S.、Bryant, J.、Margolese, R. G.、Deutsch, M.、Fisher, E. R. et al.(2002). Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer[Comparative Study Research Support, U.S. Gov't, P.H.S.].N Engl J Med, 347(16), 1233-1241.doi: 10.1056/NEJMoa022152
Fisher, B.、Bryant, J.、Wolmark, N.、Mamounas, E.、Brown, A.、Fisher, E. R. et al.(1998). Effect of preoperative chemotherapy on the outcome of women with operable breast cancer. Journal of clinical oncology, 16(8), 2672-2685.
Fisher, B.、Jeong, J. H.、Anderson, S.、Bryant, J.、Fisher, E. R.、Wolmark, N. (2002). Twenty-five-year follow-up of a randomized trial comparing radical mastectomy, total mastectomy, and total mastectomy followed by irradiation[Clinical Trial Comparative Study
Randomized Controlled Trial Research Support, U.S. Gov't, P.H.S.].N Engl J Med, 347(8), 567-575. doi: 10.1056/NEJMoa020128
Ghizzani, A.、Pirtoli, L.、Bellezza, A.、Velicogna, F. (1995). The evaluation of some factors influencing the sexual life of women affected by breast cancer. J Sex Marital Ther, 21(1), 57-63. doi: 10.1080/00926239508405972
Giuliano, A. E.、McCall, L.、Beitsch, P.、Whitworth, P. W.、Blumencranz, P.、Leitch, A. M.et al. (2010). Locoregional recurrence after sentinel lymph node dissection with or without axillary dissection in patients with sentinel lymph node metastases: the American College of Surgeons Oncology Group Z0011 randomized trial. Annals of surgery, 252(3), 426-433.
Gopie, J. P.、ter Kuile, M. M.、Timman, R.、Mureau, M. A.、Tibben, A. (2014). Impact of delayed implant and DIEP flap breast reconstruction on body image and sexual satisfaction: a prospective follow-up study[Research Support, Non-U.S. Gov't].Psychooncology, 23(1), 100-107. doi: 10.1002/pon.3377
Haavio-Mannila, E.、Kontula, O. (1997). Correlates of increased sexual satisfaction.Archives of sexual behavior, 26(4), 399-419.
Hart, D. (1996). The psychological outcome of breast reconstruction.Plastic Surgical Nursing, 16(3), 167-171.
Heiman, J. R.、Meston, C. M. (1997). Evaluating sexual dysfunction in women[Comparative Study Review].Clin Obstet Gynecol, 40(3), 616-629.
Helms, R. L.、O'Hea, E. L.、Corso, M. (2008). Body image issues in women with breast cancer. Psychology, Health and medicine, 13(3), 313-325.
Hopwood, P.、Fletcher, I.、Lee, A.、Al Ghazal, S. (2001). A body image scale for use with cancer patients. European Journal of Cancer, 37(2), 189-197.
Hsu, S.-C.、Wang, H.-H.、Chu, S.-Y.、Yen, H.-F. (2010). Effectiveness of informational and emotional consultation on the psychological impact on women with breast cancer who underwent modified radical mastectomy. Journal of Nursing Research, 18(3), 215-226.
Krag, D. N.、Anderson, S. J.、Julian, T. B.、Brown, A. M.、Harlow, S. P.、Ashikaga, T.et al. (2007). Technical outcomes of sentinel-lymph-node resection and conventional axillary-lymph-node dissection in patients with clinically node-negative breast cancer: results from the NSABP B-32 randomised phase III trial[Clinical Trial, Phase III
Randomized Controlled Trial].Lancet Oncol, 8(10), 881-888. doi: 10.1016/S1470-2045(07)70278-4
Krag, D. N.、Anderson, S. J.、Julian, T. B.、Brown, A. M.、Harlow, S. P.、Costantino, J. P.et al. (2010). Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial[Clinical Trial, Phase III Comparative Study Multicenter Study Randomized Controlled Trial Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S.]. Lancet Oncol, 11(10), 927-933. doi: 10.1016/S1470-2045(10)70207-2
Land, S. R.、Kopec, J. A.、Julian, T. B.、Brown, A. M.、Anderson, S. J.、Krag, D. N.et al. (2010). Patient-reported outcomes in sentinel node–negative adjuvant breast cancer patients receiving sentinel-node biopsy or axillary dissection: National Surgical Adjuvant Breast and Bowel Project phase III protocol B-32.Journal of clinical oncology, 28(25), 3929-3936.
Lantz, P. M.、Janz, N. K.、Fagerlin, A.、Schwartz, K.、Liu, L.、Lakhani, I.et al. (2005). Satisfaction with surgery outcomes and the decision process in a population‐based sample of women with breast cancer.Health services research, 40(3), 745-768.
Lawrance, K.-A.、Byers, E. S. (1995). Sexual satisfaction in long‐term heterosexual relationships: The interpersonal exchange model of sexual satisfaction.Personal Relationships, 2(4), 267-285.
Lucci, A.、McCall, L. M.、Beitsch, P. D.、Whitworth, P. W.、Reintgen, D. S.、Blumencranz, P. W.et al. (2007). Surgical complications associated with sentinel lymph node dissection (SLND) plus axillary lymph node dissection compared with SLND alone in the American College of Surgeons Oncology Group Trial Z0011. Journal of clinical oncology, 25(24), 3657-3663.
Lyman, G. H.、Giuliano, A. E.、Somerfield, M. R.、Benson, A. B.、Bodurka, D. C.、Burstein, H. J.et al. (2005). American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in early-stage breast cancer. Journal of clinical oncology, 23(30), 7703-7720.
Malata, C.、McIntosh, S.、Purushotham, A. (2000). Immediate breast reconstruction after mastectomy for cancer. British journal of surgery, 87(11), 1455-1472.
Malinovszky, K. M.、Gould, A.、Foster, E.、Cameron, D.、Humphreys, A.、Crown, J.et al. (2006). Quality of life and sexual function after high-dose or conventional chemotherapy for high-risk breast cancer.Br J Cancer, 95(12), 1626-1631. doi: 10.1038/sj.bjc.6603454
Mock, V. (1993). Body image in women treated for breast cancer. Nursing research, 42(3), 153-157.
Nano, M. T.、Gill, P. G.、Kollias, J.、Bochner, M. A.、Malycha, P.、Winefield, H. R. (2005). Psychological impact and cosmetic outcome of surgical breast cancer strategies. ANZ journal of surgery, 75(11), 940-947.
Nicholson, R.、Leinster, S.、Sassoon, E. (2007). A comparison of the cosmetic and psychological outcome of breast reconstruction, breast conserving surgery and mastectomy without reconstruction. The Breast, 16(4), 396-410.
Nissen, M. J.、Swenson, K. K.、Ritz, L. J.、Farrell, J. B.、Sladek, M. L.、Lally, R. M. (2001). Quality of life after breast carcinoma surgery. Cancer, 91(7), 1238-1246.
Parker, P. A.、Youssef, A.、Walker, S.、Basen-Engquist, K.、Cohen, L.、Gritz, E. R.et al. (2007). Short-term and long-term psychosocial adjustment and quality of life in women undergoing different surgical procedures for breast cancer. Annals of Surgical Oncology, 14(11), 3078-3089.
Pumo, V.、Milone, G.、Iacono, M.、Giuliano, S. R.、Di Mari, A.、Lopiano, C.et al. (2012). Psychological and sexual disorders in long-term breast cancer survivors. Cancer Manag Res, 4, 61-65. doi: 10.2147/CMAR.S28547
Roth, R. S.、Lowery, J. C.、Davis, J.、Wilkins, E. G. (2005). Quality of life and affective distress in women seeking immediate versus delayed breast reconstruction after mastectomy for breast cancer. Plast Reconstr Surg, 116(4), 993-1002.
Rowland, J. H.、Desmond, K. A.、Meyerowitz, B. E.、Belin, T. R.、Wyatt, G. E.、Ganz, P. A. (2000). Role of breast reconstructive surgery in physical and emotional outcomes among breast cancer survivors. Journal of the National Cancer Institute, 92(17), 1422-1429.
Rubino, C.、Figus, A.、Lorettu, L.、Sechi, G. (2007). Post-mastectomy reconstruction: a comparative analysis on psychosocial and psychopathological outcomes. Journal of Plastic, Reconstructive & Aesthetic Surgery, 60(5), 509-518.
Schilder, P. (1968). The image and appearance of the human body. The Self in Social Interaction, 1, 107-114.
Schover, L. R. (1991). The impact of breast cancer on sexuality, body image, and intimate relationships[Comparative Study Review]. CA Cancer J Clin, 41(2), 112-120.
Schover, L. R.、Yetman, R. J.、Tuason, L. J.、Meisler, E.、Esselstyn, C. B.、Hermann, R. E.et al. (1995). Partial mastectomy and breast reconstruction. A comparison of their effects on psychosocial adjustment, body image, and sexuality[Comparative Study]. Cancer, 75(1), 54-64.
Schreier, A. M.、Williams, S. A. (2004). Anxiety and quality of life of women who receive radiation or chemotherapy for breast cancer[Research Support, Non-U.S. Gov't]. Oncol Nurs Forum, 31(1), 127-130. doi: 10.1188/04.ONF.127-130
Timmerman, G. M. (1991). A concept analysis of intimacy. Issues Ment Health Nurs, 12(1), 19-30.
Toth, B. A.、Lappert, P. (1991). Modified skin incisions for mastectomy: the need for plastic surgical input in preoperative planning[Case Reports]. Plast Reconstr Surg, 87(6), 1048-1053.
Ueda, S.、Tamaki, Y.、Yano, K.、Okishiro, N.、Yanagisawa, T.、Imasato, M.et al. (2008). Cosmetic outcome and patient satisfaction after skin-sparing mastectomy for breast cancer with immediate reconstruction of the breast. Surgery, 143(3), 414-425.
Veronesi, U.、Cascinelli, N.、Mariani, L.、Greco, M.、Saccozzi, R.、Luini, A.et al. (2002). Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer[Comparative Study
Research Support, Non-U.S. Gov't]. N Engl J Med, 347(16), 1227-1232. doi: 10.1056/NEJMoa020989
World Health Organization (2012). Cancer fact sheets.
Wright, H. J. (1998). The female perspective: Women's attitudes toward urogenital aging. American journal of obstetrics and gynecology, 178(5), S250-S253.
Yip, S.-K.、Chan, A.、Pang, S.、Leung, P.、Tang, C.、Shek, D.et al. (2003). The impact of urodynamic stress incontinence and detrusor overactivity on marital relationship and sexual function. American journal of obstetrics and gynecology, 188(5), 1244-1248.
Zuckerman, D. (2002). Commentary: are breast implants safe? Plastic Surgical Nursing, 22(2), 66-71.