The Symptom Experience of Neobladder Recipients: Characteristics and Related Factors

代用膀胱病患的症狀經驗、個人特質及相關因素之探討

林佑樺(Yu-Hua Lin)；楊美賞(Mei-Sang Yang)

代用膀胱 ； 症狀經驗 ； 控制排尿 ； neobladder ； symptom experience ； urinary continence

The Journal of Nursing Research

18卷1期（2010 / 03 / 01）

26 - 33

英文

背景　代用膀胱是膀胱切除手術病患重建排尿功能常用的手術方式，但術後病患常需經歷因手術所造成的副作用或合併症。 目的　本研究目的在探討接受代用膀胱重建病患之症狀經驗、個人特質及相關因素。 方法　採橫斷式研究，研究對象為南部某醫學中心之53位接受代用膀胱重建病患，研究期間自2004年3月至2005年7月以結構式問卷採電話訪談方式收集資料。 結果　研究結果發現：病患身體症狀出現頻率之前五項依序為：性功能障礙、尿失禁、睡眠型態紊亂、焦慮及疲憊。女性病患在睡眠型態紊亂(p=.03)、焦慮(P=.05)、疲憊(p=.05)和食慾減退(p=.01)等症狀的得分顯著高於男性。病患的症狀經驗與住院天數呈正相關，而與達到完全控制排尿的時間呈負相關。進入迴歸分析發現，有二個因素可解釋病患症狀經驗總變異量之72.0%；分別為性別解釋量為42.7%；達到完全控制排尿的時間解釋量為29.3%。 結論／實務應用　根據研究結果，期望在更了解病患的症狀經驗與影響因素後，能提供臨床護理人員執行代用膀胱病患術後照護及出院指導之參考，以改善病患的症狀並提升其生活品質。

Background: Neobladder implantation has become the preferred means of handling urinary diversion following a cystectomy. However, this surgical procedure frequently results in side effects and complications for the patient. Purpose: The purpose of this study was to examine neobladder recipient symptom experience, characteristics, and related factors. Methods: Using a cross-sectional design, 53 patients who underwent a radical cystectomy and received a neobladder were recruited from a medical center in southern Taiwan. Data were collected from March 2004 to July 2005 by telephone interview using structured questionnaires. Results: The five most frequent symptoms for both genders included decreased sexual function, urinary incontinence, sleep disturbance, anxiety, and fatigue. We found significantly higher scores for women in sleep disturbance (p=.03), anxiety (p=.05), fatigue (p=.05), and decreased appetite (p=.01) variables. Length of hospital stay correlated positively and complete continence duration correlated negatively with symptom experience. Two factors, gender and duration until complete continence, together explained 72.0% of symptom experience variance (42.7% and 29.3% of variance, respectively). Conclusions and Implications for Practice: A better understanding of the symptom experience of neobladder recipients and its related factors can improve the symptom appraisal efforts of physicians, enabling them to provide better quality postsurgical and discharge care and ultimately increase neobladder recipient quality of life.

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