探討走路方案於乳癌術後疲憊、生活品質與運動耐受力之成效

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Title:	探討走路方案於乳癌術後疲憊、生活品質與運動耐受力之成效 Effects of a Walking Program on Fatigue, Quality of Life and Exercise Capacity in Women with Breast Cancer after Surgery
Authors:	胡曉芳;Hu, Hsiao-Fang
Contributors:	護理學系碩士班
Keywords:	乳癌;走路方案;疲憊;生活品質;運動耐受力;breast cancer;walking program;fatigue;quality of life;exercise capacity
Date:	2012-05-31
Issue Date:	2012-08-31 16:41:04 (UTC+8)
Publisher:	中國醫藥大學
Abstract:	乳癌發生率在女性癌症中佔第一位，隨著早期發現、早期治療的政策推廣，五年整體存活率高達85%。乳癌患者從診斷到治療期間，都有不同程度的身心社會層面的副作用，對生活品質也有潛在的負面影響。研究顯示，運動可有效改善乳癌患者因疾病或治療所導致身心社會層面的副作用，並改善生活品質。本研究的目的在探討走路方案於乳癌術後疲憊、生活品質與運動耐受力之成效。採實驗型設計、兩組隨機分配之研究設計，於五週研究期間重複測量三次。以中部某醫學中心初診斷乳癌病患住院接受乳癌手術後為研究對象，共收案66人，並隨機分配至運動組或對照組。以慢行疾病治?功能性評估-疲憊量表、乳癌治?功能性評估量表及六分鐘走路測試，評估疲憊、生活品質與運動耐受力。統計資料以SPSS 17.0套裝軟體進行建檔及資料分析。統計方法包括描述性統計(平均值、標準差、百分比及次數)及推論性統計(卡方檢定、t檢定和廣義估計方程式分析)。研究結果顯示，走路方案於研究之主要依變項疲憊、生活品質及運動耐受力均改善，但未達統計上之顯著成效。運動週記紀錄的運動量，統計上達顯著之差異。根據事後分析，走路方案能顯著改善無接受化學治療參與者在乳癌問題層面的生活品質，及接受化學治療參與者的體重。於護理實務應用上，護理人員如能與臨床醫師及癌症團隊合作，推廣走路運動於乳癌群體，對乳癌患者是一大助益；對護理之獨特性功能及護理專業角色的拓展亦是一大貢獻。 The incidence rate of breast cancer is the highest in Taiwanese women with cancer. But the overall survival rate is relatively high about 85% due to the policy of early detection and the improvement of treatment. However, women with breast cancer still suffer from side effects such as physical issues and psychosocial burden which negatively impact their quality of life. Evidence indicated exercise improved problems related to cancer itself and its treatment, as well as quality of life. Therefore, the purposes of the study were to explore effects of a walking program on fatigue, quality of life, and exercise capacity in women with breast cancer. This is a two arms, randomized, control trial with three points repeated measurement during a five week period. A total of 66 participants were recruited from a medical center in Taichung, Taiwan and randomized to either the exercise or control group. The instruments used were Functional Assessment for Chronic Treatment- Fatigue, Functional Assessment for Cancer Treatment- Breast, and six minutes walking test. The main outcome variables are fatigue, quality of life, and exercise capacity. SPSS 17 was used for data entry and analysis. Descriptive statistics with mean, standard deviation, frequency, and percentage; in additioninferential statistics including chi-square, t test, and Generalized Estimating Equations were applied in the study. Results indicated that the main outcome variables were not statistically significant between exercise group and control group. However, the amount of exercise from the weekly log was significantly different between the two groups. Also, the results of post hoc analysis indicated the walking program significantly impreoved quality of life in women without chemotherapy and decreased the body weight in those with chemotherapy. The important application of study result for nursing practice is that the nurses can be the kep persons in collaboration with cancer care team and physicians to promote the exercise behavior in women with breast cancer. This definitely will benefit women with breast cancer. Additionally, it will be an important contribution in the nursing independent role and also in the expansion of nursing profession.
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