乳癌患者主要照顧者之因應、社會支持與生活品質

Coping, Social Support, and Quality of Life among Primary Caregivers of Patients with Breast Cancer

10.29478/TJP.200703.0006

蔡盈盈(Ying-Ying Tsai)；張巍鐘(Wei-Chung Chang)；陸汝斌(Ru-Band Lu)；曹朝榮(Chao-Jung Tsao)

照顧者 ； 生活品質 ； 因應 ； 社會支持 ； caregivers ； coping ； social support ； quality of life

台灣精神醫學

21卷1期（2007 / 03 / 01）

43 - 52

繁體中文

目的：本研究旨在探討在疾病治療過程中且未經歷復發階段的乳癌患者，其主要照顧者的因應、社會支持與生活品質之相關性。方法：採研究調查法，以結構性問卷於南部兩所醫學中心及一所區域教學醫院之外科門診與化療室收集資料，有效問卷共54份。研究工具包括：家屬因應行為量表、社會支持量表及台灣簡明版世界衛生組織生活品質問卷。結果：情緒取向因應與整體生活品質成顯著負相關；相反地，問題取向因應與之成顯著正相關。乳癌患者家屬照顧者主觀認為所獲得的社會支持程度，與其生活品質成正相關，特別是來自於其親友的部分。逐步迴歸分析發現，對家屬照顧者整體生活品質最具預測力之變項分別為：情緒取向因應、經濟狀況、親友以及患者的社會支持，可解釋其總變異量44.8%。結論：研究結果顯示，當乳癌患者之主要照顧者情緒取向因應越少，問題取向的因應越多，且有來自親友的社會支持較高的時，其整體生活品質會較佳。

Objectives: The purpose of this study was to identify the factors that affect the adjustment of the primary caregivers of breast cancer patients, and to examine what coping strategies and sources of perceived social support are related to a higher quality of life. Methods: This cross-sectional study was designed to determine the relationship between predictor variables (coping strategies, social support) and quality of life. The sample consisted of 54 primary caregivers of women who had been diagnosed with breast cancer, stages 0-3, within an 18-month period. The independent variables were measured with the Family Coping Behaviors Scale and the Social Support Scale. The dependent variable was measured with the WHOQOL-BREF. Results: Bivariate correlational analysis showed that problem-focused coping strategies and social support from family/friends were both significant and positively related to quality of life, whereas emotion-focused coping strategies had detrimental effects. Study variables accounted for a considerable amount of variance in the primary caregivers' quality of life (44.8%). Among these factors, emotion-focused coping strategies and social support from family/friends accounted for the greatest variance in the level of the quality of life of the family caregivers. Conclusion: The findings suggest that coping strategies are very influential in helping primary caregivers deal with the effects of cancer, and the perceived adequacy of support from family members or friends is also important to their psychosocial adjustment.

1. Cohen S,Wills TA(1985).Stress, social support, and the buffering hypothesis.Psychol Bull,98,310-57.
2. Davis JM,Hoshiko BR,Jones S,Gosnell D(1991).The effect of a support group on grieving individuals` levels of perceived support and stress.Arch Paychiatr Nurs,6,35-9.
3. Diane RZ,Cheryl AG,Martha JF(1994).Quality of life and coping in patients with gynecologic cancer and their spouses.Oncol Nurs Forum,21,1699-706.
4. Ell K,Niahimotn R,Mentall J,Hamovitch M(1998).Longitudinal analysis of psychological adaptation among family members of patient with cancer.J Psychosom Res,32,429-38.
5. Given B,Given CW(1992).Patient and family caregiver reaction to new or recurrent breast cancer.J Am Med Womena Assoc,47,201-6.
6. Hinds C(1985).The needs of families who care for cancer patients with cancer at home: are we meeting them?.J Adv Nun,10,575-81.
7. Kathleen D,Carole K(2003).The relation of social support and coping to Positive adaptation to breast cancer.Psychology and health,18,15-29.
8. Keitel MA,Zevon MA,Rounds JB,Petrelli NJ,Karakousis C(1990).Spouse adjustment to cancer surgery: distress and coping responses.J Surg Oncol,43,153-8.
9. Keller M,Heinrich G,Sellschop A,Beutel M,Baider L,Cooper CL,Kaplan De-Nour AK(1996).Between distress and support: spouses of cancer patients.Cancer and the family,187-223.
10. Kershaw T,Northouse L.,Kritprachs C,Schafenackcr A,Mood D(2004).Coping strategies and quality of life in women with advanced breast cancer and their family caregivers.Psychology and Health,19,139-55.
11. Lazarus RS,Folkman S(1984).Stress, appraisal, and coping.New York:Springer Co.
12. Le T,Leis A,Pahws P,Wright K,Ali K,Reeder B(2003).Quality of life issue in patients with ovarian cancer and their caregivers: a review.Obstet Gynecol Surv,58,749-58.
13. Northouae L,Laten D,Reddy P(1995).Res Nurs Health.
14. Northouee L,Templin Y,Mood D,Obcrat M(1998).Couples` adjustment to breast cancer and benign breast disease: a longitudinal analysis.Paychooncology,7,37-48.
15. Olsen AM,Glasdam S(1995).Safety in handling chemotherapy.Eur J Cancer,31,306.
16. Pearlin LI,Mullan JT,Semple SJ(1990).Caregiving and the stress process: an overview of concepts and their measures.Gerontologist,30,583-94.
17. Schumacher KL,Dodd MJ,Paul SM(1993).The stress process in family caregivers of persons receiving chemotherapy.Res Nurs Health,16,395-404.
18. Vess J,Moreland J,Schwebcl A,Kraut E(1988).Psychosocial needs of cancer patients: learning from patients and their spouses.J Psychoaoc Oncol,6,31-51.
19. 衛生統計－癌症發生率統計
20. 林少瑜(2004)。碩士論文(碩士論文)。陽明護理研究所碩士論文。
21. 林梅香、顧乃梅、劉仲冬、陳政友、林立嬋(1996)。肝癌患者家屬主要照顧者的壓力、因應行為、健康狀況相關因素之探討。護理研究，4，171-85。
22. 姚開屏(2002)。台灣版世界衛生組織生活品質問卷之發展與應用。台灣醫學，6，193-200。
23. 姚開屏(2001)。台灣簡明版世界衛生組織生活品質問卷之發展及使用手冊－第一修訂版
24. 徐薇鈞(1997)。碩士論文(碩士論文)。高雄醫學院護理研究所碩士論文。
25. 羅淑芬、黃秀梨、劉雪娥、姚開屏(2002)。燒傷病患主要照顧者生活品質及其相關因素之探討。台灣醫學，6，625-35。

1. 龔庭溱、賴念華、黃傳永、張祐誠、林葳婕(2017)。表達性藝術治療運用於華人文化下乳癌婦女團體方案介入之要素探究。中華輔導與諮商學報，48，107-136。
2. 徐雯娟,徐秀琹,林瑞香,林梅香,石惠美(2019)。肝硬化病人主要照顧者之生活品質及其相關因素。護理雜誌，66(1)，60-69。
3. (2015)。少年生活中的風險與幸福感模型建構之研究：以屏東縣國中生為例。靜宜人文社會學報，9(2)，205-248。
4. (2015)。社區照顧關懷據點老年人社會支持與生活品質之關係研究。靜宜人文社會學報，9(2)，249-286。