頭頸癌中年期病人身心社會調適之生活經驗

The Life Experience of Bio-Psycho-Social Adaptation among the Middle-Aged Patients with Head and Neck Cancer

10.6880/TJON.202406_24(1).02

張淑芳(Shu-Fang Chang)；林夷真(Yi-Chen Lin)

頭頸癌 ； 中年期 ； 身心社會調適 ； head and neck cancer ； middle age ； bio-psycho-social adaptation

腫瘤護理雜誌

24卷1期（2024 / 06 / 01）

15 - 28

繁體中文;英文

頭頸癌好發於中年期，此時病人正處於負擔家庭經濟、照顧父母及養育兒女的階段，但因罹癌需進行手術、放射線及化學治療，不僅產生生理不適，同時也會造成心理影響，間接降低病人重返社會及職場的意願，對病人而言具有很大的挑戰性。本研究目的在了解頭頸病人經歷重建手術後進行放射線、化學治療之身心社會調適的真實經驗。採現象學取徑之質性研究為基礎，立意取樣至資料飽和為止，自2022年3月至9月，藉由半結構式深度訪談收集資料，共訪談十位病人，訪談過程中，以錄音方式進行資料收集，以Colaizzi（1978）七步驟分析法，進行編碼與意義萃取。研究結果發現二大主軸與八個次要主題：第一主軸是「人生的風雲變色」，包含如影隨形的身體折磨、消失的微笑、打破社交生活原有的平衡、困擾於日常飲食；第二主軸是「尋找復原力」，包含尋求有用的策略、尋覓身心靈平靜、攀出人生的低谷、建立新的飲食風格。本研究結果希望提供醫療團隊在照顧頭頸癌病人上參考，有效提供個別性的照護措施，幫助病人提升生活品質及重新回歸社會。

Head and neck cancer is particularly prevalent in middle age, a life stage marked by familial financial responsibilities, caregiving for parents, and the raising of children. However, the onset of cancer necessitates surgical intervention, radiotherapy, and chemotherapy, resulting in physiological discomfort and concurrent psychological ramifications. These factors not only indirectly diminish the patient's inclination to reintegrate into societal and professional spheres but also present formidable challenges for the afflicted individuals. The objective of this research is to comprehensively explore the authentic experiences of psychosocial adjustment in head and neck cancer patients undergoing reconstructive surgery followed by radiotherapy and chemotherapy. Employing a qualitative research approach rooted in phenomenology, purposive sampling was conducted until data saturation was achieved. Ten participants were engaged in semi-structured in-depth interviews. Data collection occurred from March to September 2022, and the Colaizzi seven-step analysis method was applied for data analysis. Interviews were recorded, and subsequent coding and thematic extraction ensued. The findings of the study delineate two overarching themes and eight subthemes. The primary theme, "Life's Kaleidoscope" encompasses pervasive bodily affliction, the evanescence of smiles, disruption of established social equilibrium, and annoyance during daily meals. The secondary theme, "Quest for Resilience" involves seeking useful strategies, the pursuit of mental and spiritual tranquility, overcoming life's nadirs, and the establishment of novel dietary patterns. This research aspires to furnish healthcare teams with insights for the care of head and neck cancer patients. The provision of effective, personalized care measures is imperative for elevating patients' quality of life and facilitating their reintegration into society.