癌症，對罹病者而言是具有創傷性質的事件。罹癌患者不僅要面臨痛苦的治療，還得承受內心的抨擊。因此，本研究目的是評估乳癌患者罹癌後之創傷程度，並探討影響創傷程度之顯著因子，建立創傷程度之預測模式，以達到對乳癌患者創傷之有效控制及輔導。本研究使用橫斷性研究，於台中某綜合醫院一般外科乳癌特別門診，經乳癌患者同意後進入此項研究，共計295位研究個案。採用自填式問卷、結構式診斷會談及醫療紀錄等調查方式，透過一般線性模式做逐步?歸，結果發現(1)乳癌患者有失眠狀況、有失眠藥物輔助、曾有精神疾病及最近一年慢性疼痛均對罹癌後創傷程度的顯著較高(2)乳癌患者的罹癌期間(一年以內)對罹癌後創傷程度的顯著較高(3)人格特質愈負向及有重鬱的患者對罹癌後之創傷程度的顯著較高(4)壓力因應因子之疏遠、承擔責任及逃避與罹癌後之創傷程度呈正相關；自我控制及正面評價與罹癌後之創傷程度呈負相關。本研究納入多重指標探討罹癌後創傷程度之影響因子，並建立創傷程度之預測模式，未來可藉由此預測模式提供相關研究領域作為參考依據。研究限制方面，因橫斷式研究僅可判斷乳癌患者在罹癌後創傷程度與關鍵危險因子之間是否影響，建議未來可以追加世代追蹤資料進行，才可進行更為清楚之因果推論。
People suffer from cancer to receive the indisposition painstakingly. Patients with breast cancer not only faced the painful treatment, but also bear the psychological blow. This study adopted the revised version of impact of event scale (IES-R) to evaluate the traumatic degree of breast cancer patients. A cross-sectional study used a sample of 295 cases is from the breast cancer clinic of a general hospital in central Taiwan, by the agreement of patients. Data set consists of IES-R score, socio-demographic characteristics, self-administered, structured clinical interview (SCID) questionnaire, medical records, and scales of Family APGAR index, maudsley personality inventory (MPI), etc.
This study focused on evaluating the traumatic of patients with breast cancer. Using general linear model with backward selection procedure, we have identified key significant factors which influence traumatic extent in breast cancer patient. It results the following: 1) Insomnia, having use insomnia medication assistance, had mental illness and had chronic pain in the past year of are significantly higher traumatic degree; 2) Suffer cancer within one year is significantly higher traumatic degree; 3) The more negative personality traits and major depression are significantly higher traumatic degree; 4) The stress coping factors of distancing, responsibility and escape are positive correlated while self controlling and reappraisal are negative correlated to traumatic degree in breast cancer patients.
This study provided to relative research field as a reference by this predictive regression model. The limitation of the research is that the cross-sectional study could only determine whether the risk factors impact to the traumatic degree in breast cancer patients. Future research could be case-control study and/or repeated measure study to clarify the inference factors accurately.
