義工癌症病人之團體治療效果評估

Evaluation of the Effect of Group Therapy on Cancer Patients Who also Work as Volunteer Cancer Caretakers

周少華(Shaw-Hwa Jou)；黃以文(Yee-Wen Huang)；廖以誠(Yi-Cheng Liao)；黃靜宜(Ching-Yi Huang)；邱南英(Nan-Ying Chiu)

義工癌症病人 ； 支持團體 ； 憂鬱程度 ； 生活品質 ； 團體療效因子 ； volunteer cancer patient ； support group ； depression ； quality of life ； group therapeutic factors

The Changhua Journal of Medicine

9卷s期（2004 / 12 / 01）

261 - 266

繁體中文

背景及目的：多數的對照研究報告均認為癌症病患的團體心理治療，對病人的情緒、疾病的適應、生活品質、身體功能、生命意義的瞭解、獲得醫療資訊和自我效能上均有改善。本研究探討短期支持團體對於兼具「癌症患者義工」與「癌症患者」角色的成員之影響。 方法：由本院社區健康部招募癌症病人，從事院內癌症病患義工，共11人參與團體，團體的目的為提升對疾病的適應。團體共進行8次，過程中收錄BDⅠ-Ⅱ中文版貝氏憂鬱量表，及WHOQOL-BREF生活品質量表台灣簡明版，以探討團體介入的影響。另外並收錄成員自排之Yalom團體療效因素，探討成員認為最有幫助的療效因素。統計方法採用Paired T test及wilcoxon signed Ranks test。 結果：所有成員憂鬱量表前後測量總分差異為不顯著（前測：9.7±5.01，後測：7.5±5.99,P=0.320）。整體生活品質評價，與整體健康滿意度，在團體、後期結果亦無顯著差異（P=1.0與P=0.726）。但就每題平均分數來看，生活品質量表結果，在團體後期生活品質有下降趨勢。唯團體進行至第四週時嚴重急性呼吸道症候群(SARS)疫情漸擴大，至團體結束時疫情仍惡化，對成員的影響並無評估。12類別項目團體療效因素排序結果，以利他性最高，次為普同感。 討論：本研究發現，為期8週的支持團體治療，對義工癌症病人的情緒憂鬱程度，沒有明顯改變；對整體生活品質，與整體健康滿意度的影響，也沒有顯著差異。各項生活品質的評分，在團體後期反而有變差的傾向，推測其可能的原因是評估人數不足，及短期的團體，無法影響生活品質，或真正顯示生活品質的改善；亦或是大環境嚴重流行疾病(SARS)的影響，降低了生活品質。團體過程中呈現高的凝聚力。利他性與普同性是成員認為最重要的團體影響力。

Background and purpose: Most controlled outcome research has indicated that group interventions are effective for cancer patients. Studies have noted improvements in mood, illness-related problems, quality of life, physical functioning, perceived meaning of life, medical information, and self-efficacy. This study reports the effects of short-term support group therapy on cancer patients who also work as volunteer cancer caretakers. Methods: Eleven (11) cancer patients were recruited for hospital volunteer work. The volunteer work was designed to help and to support hospitalized cancer patients. The purpose of the volunteer group was to promote adaptation to having cancer. The group met once per week for 8 weeks. All participants were evaluated by use of the Beck Depression Inventory-IT Chinese version (BDI-II), the World Health Organization Quality of Life Questionnaire-Brief Taiwan version (WHOQOL-BREF), and ranked on a 12-itemYalom group therapeutic factors. Statistical analyses included use of the paired t-test and Wilcoxon Signed Rank test. Results: There was no statistically significant difference in total depression scores between pre- and post-tests for all participants (pre-test=9.7±5.01, post-test 7.5±5.99, P=0.320). All participants reported moderate levels of general life quality and of general health satisfaction in WHOQOL-BREF questionnaires, and there was no statistically significant difference between these two questions in pre-and post-tests. (P=1.0 and P=0.726). However, there was a trend toward decreased quality of life shown in the decrement of the mean of levels in other questions. It is important to mention that at the time of the intervention, there was a gradual expansion of the Severe Acute Respiratory Syndrome (SARS) epidemic in the conmunity by the fourth group session. The epidemic continued to worsen until the final group session. The influence of SARS on depressive mood and quality of life for group members was not assessed during this study. The results of ranking in Yalom therapeutic factors were highest in altruism, followed by universality. Conclusion: This preliminary study found that short-term support group did not significantly affect the depressive mood, the general life quality, and the general physical health satisfaction of our volunteer cancer patient-caretakers. We speculated that the reasons for limited improvements might be due to the small sample size, the short time period of the intervention, and the influence of SARS, which caused mental distress and increased environmental inconvenience.

1. 張心怡(2017)。不同醫病角色對輔助與替代療法認知差異之探討。中山醫學大學健康餐飲暨產業管理學系碩士班學位論文。2017。1-90。