字級大小SCRIPT，如您的瀏覽器不支援，IE6請利用鍵盤按住ALT鍵 + V → X → (G)最大(L)較大(M)中(S)較小(A)小，來選擇適合您的文字大小，如為IE7或Firefoxy瀏覽器則可利用鍵盤 Ctrl + (+)放大 (-)縮小來改變字型大小。 The purpose of this study was to explore the relationships between postoperative distress and depressive tendency on elderly patients with colorectal cancer. The research subjects of this study were those elderly surgical patients with colorectal cancer who receiving radical surgery and related treatment for 3-6 months. A cross-sectional, correlational study was conducted with a purposive sampling of 86 elderly surgical patients with colorectal cancer from outpatients at a medical center in northern Taiwan. Data were collected with structured questionnaires including the Distress Thermometer (DT) and Geriatric Depression Scale Form (GDS-SF). The results of the study showed that the average postoperative distress score of elderly patients with colorectal cancer was 4.23 points (SD = 2.55), and the average score of depression was 4.40 points (SD = 2.99). There were significant differences in scores of the postoperative distress for colostomy and chemotherapy. And in scores of the depression, there were significant differences in cancer staging, colostomy, and chemotherapy. The most important predictive factors of depressive tendency of elderly patients with colorectal cancer were distress thermometer (DT), memory/concentration, sleep, worry and loss of interest in usual activities. The five predictive factors could be used to explain 67% of the variance. Through this study, expect that medical caregivers can pay attention to postoperative distress and depressive tendency on elderly surgical patients with colorectal cancer, and provide psychological support on their own initiative.
目次
中文摘要 i
英文摘要 ii
目次 iii
表次 vi
圖次 vii
第一章 緒論 1
第一節、研究背景與重要性 1
第二節、研究目的 5
第三節、研究問題 5
第四節、名詞釋義 5
第二章 文獻查證 8
第一節、結腸直腸癌之治療處置 8
第二節、結腸直腸癌術後困擾之相關研究 17
第三節、術後困擾之相關影響 23
第四節、老年憂鬱之涵義及相關研究 25
第五節、研究架構 30
第三章 研究方法 31
第一節、研究設計與研究對象 31
第二節、研究工具 32
第三節、研究步驟 35
第四節、資料分析與處理 35
第五節、研究倫理 38
第四章 研究結果 39
第一節、研究對象之基本屬性與疾病治療特性 39
第二節、研究對象之術後困擾 42
第三節、研究對象之憂鬱傾向 48
第四節、基本屬性、疾病治療特性在困擾程度與憂鬱程度之差異分析 50
第五節、基本屬性、疾病治療特性、術後困擾問題與憂鬱傾向之差異分析 55
第六節、困擾程度與憂鬱程度之相關性 59
第七節、影響結腸直腸癌老年病人憂鬱傾向的預測因子 60
第五章 討論 62
第一節、結腸直腸癌老年病人與術後困擾之相關探討 62
第二節、結腸直腸癌老年病人與憂鬱情緒之相關探討 69
第三節、影響結腸直腸癌老年病人術後憂鬱傾向的預測因素 74
第六章 研究結論與建議 78
第一節、研究結論 78
第二節、研究應用 80
第三節、研究限制及建議 82
參考文獻 84
附件一、美國NCCN困擾溫度計授權使用同意函 112
附件二、困擾溫度計中文版授權使用同意函 113
附件三、老人憂鬱量表授權使用同意函 114
附件四、人口學基本資料表 115
附件五、癌症病人困擾溫度計 116
附件六、老人憂鬱量表簡明版 117
附件七、馬偕紀念醫院人體研究倫理委員會臨床試驗同意書 118
附件八、臨床試驗受試者同意書 120

表次
表一、結腸直腸癌的分期轉換表 13
表二、結腸直腸癌術後困擾相關實證研究 21
表三、術後困擾對癌症病人之相關影響實證研究 24
表四、癌症病人憂鬱之相關實證研究 29
表五、研究變項定義表 35
表六、研究對象之基本屬性 40
表七、研究對象之疾病治療特性 41
表八、研究對象之困擾溫度(DT) 描述性分析 43
表九、研究對象之術後困擾問題描述性分析 44
表十、研究對象術後困擾問題之質性資料 45
表十一、研究對象之憂鬱程度 49
表十二、老人憂鬱量表各題項次數分布 49
表十三、基本屬性、疾病治療特性與困擾溫度(DT)之差異分析 50
表十四、基本屬性、疾病治療特性與憂鬱程度之差異分析 53
表十五、基本屬性、疾病治療特性與憂鬱傾向之差異分析 56
表十六、術後困擾問題與憂鬱傾向之差異分析 58
表十七、困擾溫度(DT)與憂鬱分數之相關分析 59
表十八、憂鬱傾向之重要預測因子(逐步迴歸) 61

圖次
圖一、結腸直腸癌老年病人術後困擾與憂鬱傾向之相關性研究架構圖 30
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