Lai Yeur-Hur, Chang Joseph Tung-Chien, Keefe Francis J, Chiou Chung-Fong, Chen Shu-Ching, Feng Shu-Chin, Dou Su-Jene, Liao Mei-Nan
College of Nursing, Taipei Medical University, Taipei, Taiwan.
Cancer Nurs. 2003 Dec;26(6):485-93. doi: 10.1097/00002820-200312000-00008.
The purposes of this study were to explore symptom distress, catastrophic thinking (catastrophizing) and hope, and factors predicting hope in Taiwanese nasopharyngeal carcinoma (NPC) patients within 3 years of receiving radiation therapy (RT). Instruments used were the modified Symptom Distress Scale, disease catastrophizing scale (modified from Coping Strategies Questionnaire), and Herth's Hope Index. Adult NPC patients (N = 115; 33 undergoing RT, 44 who completed RT within 1 year, and 38 who completed RT more than 1 year but less than 3 years) were recruited from an outpatient RT center in Northern Taiwan. Although participants' overall symptom distress was mild to moderate, they scored moderate level for several distressful symptoms: dry mouth, fatigue, hearing difficulty, loss of appetite, insomnia, and pain. Patients undergoing RT had greater symptom distress than subjects in the other 2 groups. Regression analysis revealed that catastrophizing was the only predictor of hope. Patients who engaged in catastrophizing reported much lower levels of hope. Particular care and attention are recommended to help NPC patients deal with the top distressful symptoms listed. Nursing interventions to reduce catastrophic thinking and enhance hope are discussed.
本研究旨在探讨台湾鼻咽癌（NPC）患者在接受放射治疗（RT）3年内的症状困扰、灾难化思维（灾难化）和希望，以及预测希望的因素。所使用的工具包括改良症状困扰量表、疾病灾难化量表（由应对策略问卷修改而来）和赫思希望指数。从台湾北部一家门诊放疗中心招募了成年NPC患者（N = 115；33例正在接受放疗，44例在1年内完成放疗，38例在1年以上但不到3年完成放疗）。尽管参与者的总体症状困扰为轻度至中度，但他们在几种困扰症状上得分中等：口干、疲劳、听力困难、食欲不振、失眠和疼痛。正在接受放疗的患者比其他两组受试者有更大的症状困扰。回归分析显示，灾难化是希望的唯一预测因素。进行灾难化思维的患者报告的希望水平要低得多。建议给予特别的护理和关注，以帮助NPC患者应对列出的最困扰症状。文中还讨论了减少灾难化思维和增强希望的护理干预措施。
