肝癌患者接受立體定位放射線治療期間疲倦改變及相關因素之探討
The changes of Fatigue and its Correlates in Liver Cancer Patients
Receiving Stereotactic Radiotherapy
中文摘要 疲倦是癌症病患接受放射線治療最常面臨的問題之一，但對於肝癌病患接受放射 治療期間所出現的疲倦問題目前尚未有研究探討，因此本研究主要探討肝癌患者 接受立體定位放射線治療期間疲倦改變及相關因素之探討；採前瞻性縱貫式研究 設計，以方便取樣於北市二所教學醫院收案，問卷內容包括疲倦症狀量表、症狀 困擾量表、生理症狀數字量表、憂鬱量表；收案時間為治療前一週、治療第一至 六週，共收 40 名肝癌病患；以描述性統計、t 檢定、重複測量變異數分析、皮 爾森積差相關等統計方法進行資料分析。結果顯示：治療前即有輕度疲倦，除第 三週略為下降外，疲倦程度隨治療而增加，第五週達高峰，第六週下降。 疲倦 及失眠是治療期間最感困擾的症狀，且症狀困擾、憂鬱與疲倦呈正相關；除第四 週 Hb 及 Ht 與疲倦呈負相關外，其他血液生化數值與疲倦無關；女性、未婚、 低教育程度之肝癌患者其疲倦程度較高。本結果顯示疲倦是病患經歷放射線治療 普遍存在的問題，因此未來研究應進一步發展並驗證減輕癌症疲倦之護理措施。 關鍵字：疲倦、症狀困擾、憂鬱 英文摘要
Fatigue has been recognized as one of the most prevalent problems faced by cancer received radiotherapy. However, little effort has been focused on the changes of fatigue in liver cancer patients received this treatment. The purpose of this study was to explore the fatigue changes and its correlates in liver cancer patients receiving stereotactic radiotherapy. A seven-weeks prospective longitudinal research design was developed to examine the changes of fatigues and its related factors. Data was
collected by a set of questionnaires, including Fatigue Symptom Inventory (FSI), the Symptom Distress Scale - modified (SDS-M), Symptom Severity Numeric Rating Scale (NRS) and Profile of Mood Status - Depression (POMS-Depression). A total of 40 eligible subjects were recruited by convenience sampling from two medical centers in Taipei. Data was analyzed by descriptive statistics, t-test, repeated measures
ANOVA and pearson’s product-moment correlation. The results showed that fatigue scores were mild in the beginning of treatment, but it significantly increased from pre-treatment to the 6th week except the 3rd week. The peak level of fatigue was in the 5th week and it decreased in the 6th week. Fatigue and insomnia were the major concerns and problem interfering patients’ life during the period of treatment. The total symptom distress and depression were significantly positively related to fatigue.
However, Hb and Ht were negatively correlated to fatigue only in week 4. Patients who are female, single and less educated fated higher scores in fatigue, compared those were not. Results of this study supported that fatigue is a common experienced problem in patients received radiotherapy. Nursing intervention on decreasing cancer fatigue should be developed and tested in future study.
