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題名 初探疾病覺知、因應策略及生活品質之關聯性 —以術後頭頸癌患者為對象之追蹤研究
Exploring the Relationships of Illness Perception, Coping Strategy, and Quality of Life: A Longitudinal Study in Post-surgical Head and Neck Cancer Patients作者 陳品樺
Chen, Pin-Hua貢獻者 吳治勳
Wu, Chih-Hsun
陳品樺
Chen, Pin-Hua關鍵詞 疾病覺知
疾病表述常識模式
生活品質
因應
頭頸癌
illness perception
Common Sense Model
quality of life
coping
head and neck cancer日期 2019 上傳時間 7-Aug-2019 16:34:38 (UTC+8) 摘要 緒論：頭頸癌病人經常面臨吞嚥困難、進食困難、外觀改變與聲音改變等生活中生理、心理、社會等層面的挑戰，對其生活品質產生相當的影響，也需要相當的因應資源。本研究以疾病表述常識模式為理論基礎，將疾病覺知與因應視為動態歷程，進而探討其如何影響頭頸癌病人之生活品質。研究方法：本研究以台灣北部某醫學中心之頭頸癌患者為參與者，以問卷方式搜集其癌症切除手術後一個月與六個月之資料，共有42位參與者（男性36名，女性6名）。研究將利用路徑分析，探討疾病覺知中之疾病結果、時間感、個人控制感、治療控制感、疾病認同、疾病理解程度、疾病在意程度、情緒反應）、與三類因應策略（個人內因應、社會支持、及逃避因應）之相互影響，以及對四個向度的生活品質（生理、心理、社會關係、環境）之預測性。研究結果：結果支持疾病覺知與因應策略有相互影響，術後一個月的治療控制、個人控制可正向預測術後六個月之個人內因應，而術後一個月之疾病結果、時間感、疾病認同、理解程度、情緒程度，可預測術後六個月之逃避因應。術後一個月的個人內因應策略可正向預測術後六個月各範疇的生活品質。討論：本研究可見個人內因應對後續生活品質的重要性，然因樣本與方法上的限制，相關結果有待後續研究繼續探討。
Introduction: Head and Neck Patients confront with challenges of swallowing, eating, and changes in the appearance and voice, which bring about influences on quality of life and the need of coping resources. The present study is based on Common Sense Model, and a ‘dynamic view’ on ‘illness perception’ and ‘coping strategy’ is taken to explore the relationship of illness perception, coping strategy and quality of life among head and neck cancer patients. Method: Path analysis is used for the examination of the relationship of illness perception (including consequence, timeline, personal control, treatment control, identity, understanding, concern, and emotional response), coping strategy and quality of life. Forty-two head and neck cancer patients (thirty-six male and six female) recruited from a medical center in northern Taiwan completed the questionnaire through a month after surgery and the six-month follow up. Result: There are interaction between illness perception and coping strategy. Self-sufficient coping six-months after surgery are predicted by personal control and treatment control a month after surgery, and avoidant coping six-months after surgery are predicted by consequence, timeline, identity, understanding, and emotional response a month after surgery. Quality of life six-months after surgery are predicted by self-sufficient coping a month after surgery. Discussion: The importance of self-sufficient coping on following quality of life is shown in the present study. However, the result have to be examined by further research with suitable sample size.參考文獻 國民健康署（2018）。105年癌症登記報告。上網日期：2019年6月。取自：https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=269&pid=10227。姚開屏（2002）。台灣版世界衛生組織生活品質問卷之發展與應用。台灣醫學，6（2），193-200。鄭逸如，吳治勳（2014）。探討初診慢性病患者之個人建構組型態－「威脅指標-台灣版」之臨床應用。 中華心理衛生學刊，27（4），561-582。Amy E. Richardson, Geraldine Tennant, Randall P. Morton, Elizabeth Broadbent (2017). A Self-Regulatory Intervention for Patients with Head and Neck Cancer: Pilot Randomized Trial. Annals of Behavioral Medicine, Volume 51(5), 629 – 641. DOI: 10.1007/s12160-017-9885-1.Baum, A., Revenson, T. A., & Singer, J. (2012). Handbook of health psychology. Psychology Press.Broadbent, E., Petrie, K. J., Main, J., & Weinman, J. (2006). The brief illness perception questionnaire. Journal of psychosomatic research, 60(6), 631-637.Carver, C. S. (1997). You want to measure coping but your protocol’s too long: Consider the brief cope. International journal of behavioral medicine, 4(1), 92.Carver, C. S., Scheier, M. F., & Weintraub, J. K. (1989). Assessing coping strategies: a theoretically based approach. Journal of personality and social psychology, 56(2), 267.Dempster, M., McCorry, N. K., Brennan, E., Donnelly, M., Murray, L. J., & Johnston, B. T. (2011). Do changes in illness perceptions predict changes in psychological distress among oesophageal cancer survivors?. Journal of health psychology, 16(3), 500-509.Dempster, M., Howell, D., & McCorry, N. K. (2015). Illness perceptions and coping in physical health conditions: A meta-analysis. Journal of psychosomatic research, 79(6), 506-513.Diefenbach, M. A., & Leventhal, H. (1996). The common-sense model of illness representation: Theoretical and practical considerations. Journal of social distress and the homeless, 5(1), 11-38.Donovan, K., Sanson-Fisher, R. W., & Redman, S. (1989). Measuring quality of life in cancer patients. Journal of Clinical Oncology, 7(7), 959-968.Hagger, M. S., & Orbell, S. (2003). A meta-analytic review of the common-sense model of illness representations. Psychology and health, 18(2), 141-184.Hopman, P., & Rijken, M. (2015). Illness perceptions of cancer patients: relationships with illness characteristics and coping. Psycho-Oncology, 24(1), 11-18.Horne, R., & Weinman, J. (2002). Self-regulation and self-management in asthma: exploring the role of illness perceptions and treatment beliefs in explaining non-adherence to preventer medication. Psychology and Health, 17(1), 17-32.Ichikura, K., Yamashita, A., Sugimoto, T., Kishimoto, S., & Matsushima, E. (2018). Patterns of stress coping and depression among patients with head and neck cancer: A Japanese cross‐sectional study. Psycho‐oncology, 27(2), 556-562.Leventhal, H., Meyer, D., & Nerenz, D. (1980). The common sense representation of illness danger. Contributions to medical psychology, 2, 7-30.Meyer, D., Leventhal, H., & Gutmann, M. (1985). Common-sense models of illness: the example of hypertension. Health psychology, 4(2), 115.Llewellyn, C. D., McGurk, M., & Weinman, J. (2007). Illness and treatment beliefs in head and neck cancer: Is Leventhal`s common sense model a useful framework for determining changes in outcomes over time?. Journal of Psychosomatic Research, 63(1), 17-26.Moss-Morris, R., Weinman, J., Petrie, K., Horne, R., Cameron, L., & Buick, D. (2002). The revised illness perception questionnaire (IPQ-R). Psychology and health, 17(1), 1-16.Kline, R. B. (2015). Principles and practice of structural equation modeling. Guilford publications.Rapoport, Y., Kreitler, S., Chaitchik, S., Algor, R., & Weissler, K. (1993). Psychosocial problems in head-and-neck cancer patients and their change with time since diagnosis. Annals of Oncology, 4(1), 69-73.Scharloo, M., Baatenburg de Jong, R. J., Langeveld, T. P., van Velzen‐Verkaik, E., Doorn‐op den Akker, M. M., & Kaptein, A. A. (2005). Quality of life and illness perceptions in patients with recently diagnosed head and neck cancer. Head & Neck: Journal for the Sciences and Specialties of the Head and Neck, 27(10), 857-863.Wang, A. W.-T., Cheng, C.-P., Chang, C.-S., Chen, D.-R., Chen, S.-T., Shieh, V., Hsu, W.-Y. (2018). Does the factor structure of the Brief COPE fit different types of traumatic events? A test of measurement invariance. European Journal of Psychological Assessment, 34(3), 162-173. 描述 碩士
國立政治大學
心理學系
104752022資料來源 http://thesis.lib.nccu.edu.tw/record/#G1047520222 資料類型 thesis dc.contributor.advisor 吳治勳 zh_TW dc.contributor.advisor Wu, Chih-Hsun en_US dc.contributor.author (Authors) 陳品樺 zh_TW dc.contributor.author (Authors) Chen, Pin-Hua en_US dc.creator (作者) 陳品樺 zh_TW dc.creator (作者) Chen, Pin-Hua en_US dc.date (日期) 2019 en_US dc.date.accessioned 7-Aug-2019 16:34:38 (UTC+8) - dc.date.available 7-Aug-2019 16:34:38 (UTC+8) - dc.date.issued (上傳時間) 7-Aug-2019 16:34:38 (UTC+8) - dc.identifier (Other Identifiers) G1047520222 en_US dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/124865 - dc.description (描述) 碩士 zh_TW dc.description (描述) 國立政治大學 zh_TW dc.description (描述) 心理學系 zh_TW dc.description (描述) 104752022 zh_TW dc.description.abstract (摘要) 緒論：頭頸癌病人經常面臨吞嚥困難、進食困難、外觀改變與聲音改變等生活中生理、心理、社會等層面的挑戰，對其生活品質產生相當的影響，也需要相當的因應資源。本研究以疾病表述常識模式為理論基礎，將疾病覺知與因應視為動態歷程，進而探討其如何影響頭頸癌病人之生活品質。研究方法：本研究以台灣北部某醫學中心之頭頸癌患者為參與者，以問卷方式搜集其癌症切除手術後一個月與六個月之資料，共有42位參與者（男性36名，女性6名）。研究將利用路徑分析，探討疾病覺知中之疾病結果、時間感、個人控制感、治療控制感、疾病認同、疾病理解程度、疾病在意程度、情緒反應）、與三類因應策略（個人內因應、社會支持、及逃避因應）之相互影響，以及對四個向度的生活品質（生理、心理、社會關係、環境）之預測性。研究結果：結果支持疾病覺知與因應策略有相互影響，術後一個月的治療控制、個人控制可正向預測術後六個月之個人內因應，而術後一個月之疾病結果、時間感、疾病認同、理解程度、情緒程度，可預測術後六個月之逃避因應。術後一個月的個人內因應策略可正向預測術後六個月各範疇的生活品質。討論：本研究可見個人內因應對後續生活品質的重要性，然因樣本與方法上的限制，相關結果有待後續研究繼續探討。 zh_TW dc.description.abstract (摘要) Introduction: Head and Neck Patients confront with challenges of swallowing, eating, and changes in the appearance and voice, which bring about influences on quality of life and the need of coping resources. The present study is based on Common Sense Model, and a ‘dynamic view’ on ‘illness perception’ and ‘coping strategy’ is taken to explore the relationship of illness perception, coping strategy and quality of life among head and neck cancer patients. Method: Path analysis is used for the examination of the relationship of illness perception (including consequence, timeline, personal control, treatment control, identity, understanding, concern, and emotional response), coping strategy and quality of life. Forty-two head and neck cancer patients (thirty-six male and six female) recruited from a medical center in northern Taiwan completed the questionnaire through a month after surgery and the six-month follow up. Result: There are interaction between illness perception and coping strategy. Self-sufficient coping six-months after surgery are predicted by personal control and treatment control a month after surgery, and avoidant coping six-months after surgery are predicted by consequence, timeline, identity, understanding, and emotional response a month after surgery. Quality of life six-months after surgery are predicted by self-sufficient coping a month after surgery. Discussion: The importance of self-sufficient coping on following quality of life is shown in the present study. However, the result have to be examined by further research with suitable sample size. en_US dc.description.tableofcontents 第一章、 緒論 1第一節、研究背景 1第二節、疾病表述常識模型 2第三節、疾病覺知、因應、與因應結果之關聯性 5第四節、研究目的與假設 13第二章、 研究方法 16第一節、研究對象與研究程序 16第二節、研究工具 16第三節、研究假設與資料分析方法 19第三章、 研究結果 21第一節、樣本資料與各變項之描述統計 21第二節、疾病覺知隨時間之差異 22第三節、疾病覺知與因應策略在時序上之相互影響 23第四節、疾病覺知和因應策略對病人生活品質之預測 32第五節、以疾病覺知和因應預測病人後續之生活品質 52第四章、 綜合討論 76第一節、不同疾病覺知的成分對於因應策略、生活品質的效果不同 76第二節、疾病覺知、因應策略與生活品質的互動 77第三節、研究限制與未來方向 80參考文獻 82附錄一、研究同意書 85附錄二、短版疾病覺知量表 90附錄三、短版因應策略量表 91附錄四、台灣簡明版世界衛生組織生活品質問卷 93附錄五、術後六個月疾病覺知對術後六個月生活品質之影響 95附錄六、術後六個月疾病覺知對術後六個月生活品質之影響 97 zh_TW dc.format.extent 3028822 bytes - dc.format.mimetype application/pdf - dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G1047520222 en_US dc.subject (關鍵詞) 疾病覺知 zh_TW dc.subject (關鍵詞) 疾病表述常識模式 zh_TW dc.subject (關鍵詞) 生活品質 zh_TW dc.subject (關鍵詞) 因應 zh_TW dc.subject (關鍵詞) 頭頸癌 zh_TW dc.subject (關鍵詞) illness perception en_US dc.subject (關鍵詞) Common Sense Model en_US dc.subject (關鍵詞) quality of life en_US dc.subject (關鍵詞) coping en_US dc.subject (關鍵詞) head and neck cancer en_US dc.title (題名) 初探疾病覺知、因應策略及生活品質之關聯性 —以術後頭頸癌患者為對象之追蹤研究 zh_TW dc.title (題名) Exploring the Relationships of Illness Perception, Coping Strategy, and Quality of Life: A Longitudinal Study in Post-surgical Head and Neck Cancer Patients en_US dc.type (資料類型) thesis en_US dc.relation.reference (參考文獻) 國民健康署（2018）。105年癌症登記報告。上網日期：2019年6月。取自：https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=269&pid=10227。姚開屏（2002）。台灣版世界衛生組織生活品質問卷之發展與應用。台灣醫學，6（2），193-200。鄭逸如，吳治勳（2014）。探討初診慢性病患者之個人建構組型態－「威脅指標-台灣版」之臨床應用。 中華心理衛生學刊，27（4），561-582。Amy E. Richardson, Geraldine Tennant, Randall P. Morton, Elizabeth Broadbent (2017). A Self-Regulatory Intervention for Patients with Head and Neck Cancer: Pilot Randomized Trial. Annals of Behavioral Medicine, Volume 51(5), 629 – 641. DOI: 10.1007/s12160-017-9885-1.Baum, A., Revenson, T. A., & Singer, J. (2012). Handbook of health psychology. Psychology Press.Broadbent, E., Petrie, K. J., Main, J., & Weinman, J. (2006). The brief illness perception questionnaire. Journal of psychosomatic research, 60(6), 631-637.Carver, C. S. (1997). You want to measure coping but your protocol’s too long: Consider the brief cope. International journal of behavioral medicine, 4(1), 92.Carver, C. S., Scheier, M. F., & Weintraub, J. K. (1989). Assessing coping strategies: a theoretically based approach. Journal of personality and social psychology, 56(2), 267.Dempster, M., McCorry, N. K., Brennan, E., Donnelly, M., Murray, L. J., & Johnston, B. T. (2011). Do changes in illness perceptions predict changes in psychological distress among oesophageal cancer survivors?. Journal of health psychology, 16(3), 500-509.Dempster, M., Howell, D., & McCorry, N. K. (2015). Illness perceptions and coping in physical health conditions: A meta-analysis. Journal of psychosomatic research, 79(6), 506-513.Diefenbach, M. A., & Leventhal, H. (1996). The common-sense model of illness representation: Theoretical and practical considerations. Journal of social distress and the homeless, 5(1), 11-38.Donovan, K., Sanson-Fisher, R. W., & Redman, S. (1989). Measuring quality of life in cancer patients. Journal of Clinical Oncology, 7(7), 959-968.Hagger, M. S., & Orbell, S. (2003). A meta-analytic review of the common-sense model of illness representations. Psychology and health, 18(2), 141-184.Hopman, P., & Rijken, M. (2015). Illness perceptions of cancer patients: relationships with illness characteristics and coping. Psycho-Oncology, 24(1), 11-18.Horne, R., & Weinman, J. (2002). Self-regulation and self-management in asthma: exploring the role of illness perceptions and treatment beliefs in explaining non-adherence to preventer medication. Psychology and Health, 17(1), 17-32.Ichikura, K., Yamashita, A., Sugimoto, T., Kishimoto, S., & Matsushima, E. (2018). Patterns of stress coping and depression among patients with head and neck cancer: A Japanese cross‐sectional study. Psycho‐oncology, 27(2), 556-562.Leventhal, H., Meyer, D., & Nerenz, D. (1980). The common sense representation of illness danger. Contributions to medical psychology, 2, 7-30.Meyer, D., Leventhal, H., & Gutmann, M. (1985). Common-sense models of illness: the example of hypertension. Health psychology, 4(2), 115.Llewellyn, C. D., McGurk, M., & Weinman, J. (2007). Illness and treatment beliefs in head and neck cancer: Is Leventhal`s common sense model a useful framework for determining changes in outcomes over time?. Journal of Psychosomatic Research, 63(1), 17-26.Moss-Morris, R., Weinman, J., Petrie, K., Horne, R., Cameron, L., & Buick, D. (2002). The revised illness perception questionnaire (IPQ-R). Psychology and health, 17(1), 1-16.Kline, R. B. (2015). Principles and practice of structural equation modeling. Guilford publications.Rapoport, Y., Kreitler, S., Chaitchik, S., Algor, R., & Weissler, K. (1993). Psychosocial problems in head-and-neck cancer patients and their change with time since diagnosis. Annals of Oncology, 4(1), 69-73.Scharloo, M., Baatenburg de Jong, R. J., Langeveld, T. P., van Velzen‐Verkaik, E., Doorn‐op den Akker, M. M., & Kaptein, A. A. (2005). Quality of life and illness perceptions in patients with recently diagnosed head and neck cancer. Head & Neck: Journal for the Sciences and Specialties of the Head and Neck, 27(10), 857-863.Wang, A. W.-T., Cheng, C.-P., Chang, C.-S., Chen, D.-R., Chen, S.-T., Shieh, V., Hsu, W.-Y. (2018). Does the factor structure of the Brief COPE fit different types of traumatic events? A test of measurement invariance. European Journal of Psychological Assessment, 34(3), 162-173. zh_TW dc.identifier.doi (DOI) 10.6814/NCCU201900517 en_US
