| 摘要: | 食道癌為消化道惡性腫瘤之ㄧ，發生率在台灣逐年增加，其存活率低且因疾病本身與治療均造成病人生活品質差，相對地影響照護者之需求。本研究目的：在探討居家食道癌病患生活品質與照顧者需求之相關性。研究方法：採橫斷式調查研究，以食道癌病患生活品質量表EORTC QLQ-C30及QLQ-OES18和照顧者需求等問卷，自98年11月1日至100年11月30日，在中部某醫學中心門診，由訪談人員對接受治療完後一個月居家自我照顧之食道癌病人及照顧者進行訪談，病人有182人，主要照顧者108人。
研究結果顯示，在182位食道癌病人QLQ-C30之功能性五項功能構面中，以生理功能之平均分數最高(平均83.75)，社會功能最低(平均71.97)；在症狀項目中，以失眠及缺乏食慾之生活品質最差(平均29.33)；而整體生活品質平均為61.18。食道癌病人在QLQ-OES18之十項徵狀分類中，以吞嚥困難是食道癌病人之生活品質中為最差(平均61.97)，而味覺困難及唾液吞嚥困難是生活品質中最好之兩項(平均17.24，17.71)；影響食道癌病患照顧者之經濟需求的重要因素，有病人70歲以上(P=0.042)，情緒功能層面(P=0.022)、疼痛(P=0.019)、呼吸困難(P=0.023)、便祕(P=0.012)及反逆(P=0.022)等症狀者，達統計上顯著相關；當病人有反逆症狀時，則照顧者在照顧生理支持需求(P=0.039)、醫療人員照顧與溝通病情需求(P=0.043)、醫療復健需求(P=0.004)等構面的照顧需求均較高，且達統計上之顯著相關；當病人有失眠、腹瀉症狀者，則照顧者在照顧社會支持需求較高(P<0.003；P<0.029)。
結論：本研究結果將提供醫療人員了解食道癌病患居家生活品質情況及其照顧者之照護需求，期能適時提供照護措施與指導，以提升食道
癌病患居家生活品質。
Esophageal cancer, one of gastrointestinal cancers, increases gradually in Taiwan. Generally, patients with esophageal cancer have low survival rate and poor quality of life, which resulting from the disease itself and complication of the treatment. The poor quality of the life influences the requirements of the caregivers.
The purpose of this study was to investigate the correlations between the quality of life of esophageal cancer patients and the requirements of their caregivers.
METHODS: The cross-sectional study was performed in outpatient department of the medical central which was located in the central part of Taiwan from November 1, 2009 to November 30, 2011. We designed the scales of life quality for esophageal cancer patients including “EORTC QLQ-C30 and QLQ-OES18 and the questionnaires about requirements of caregivers’. The staff interviewed the caregivers and the patients with esophageal cancer who dialed with one-month self-care at home after the treatment. 182 patients with 108 primary caregivers were included.
RESULTS: In the five functional dimensions of QLQ-C30 in 182 patients with esophageal cancer, the average score is highest in physiological function (average: 83.75), and is lowest in social function (average: 71.97). In the options of the symptoms, Patients with insomnia and poor appetite had the lowest life quality (average score: 29.33). The average score of life quality was 61.18. In the ten symptomatic dimensions of QLQ-OES 18 in patients with esophageal cancer, patients with indigestion had the worst quality of life (average: 61.97), and the patients with difficulties in testes and swallowing had the best quality of life (average: 17.24, 17.71). The factors influencing economic requirements of caregivers included: patients over 70 years of age (P = 0.042), patients with emotional dysfunction (P = 0.022), pain (P = 0.019), dyspnea (P = 0.023), constipation (P = 0.012), and symptoms of indigestion or bile reflux (P = 0.022). These showed significant correlation. Additionally, when patients had symptoms of indigestion or bile reflux, the demands of the caregivers were higher about the physiological support (P = 0.039), rehabilitation (P=0.004), medical staff in the care and communication (P = 0.043), It showed significant correlation. When patients suffered from insomnia or diarrhea, the caregiver demanded a higher requirement of the community support (P <0.003; P <0.029 respectively).
CONCLUSION: The results of this study will help the medical staff to understand the life quality of patients with esophageal cancer at home and the requirments of their caregivers. According to the results, we can provide the measurement of care in time and guidance to improve the life quality of patients with esophageal cancer at home. |
