| Summary: | 碩士 === 國立陽明大學 === 臨床護理研究所 === 88 === The purpose of this descriptive cross-sectional survey is to understand the correlation of symptom distresses and coping strategies of patients with lung cancer. 73 patients with non-small cell lung cancer obtained from the cancer center or ward in the two medical centers located in northern Taiwan. The instruments used in this study are Symptom Distress Scale and Coping Strategies Scale. The data are analyzed by mean, standard deviation, percentage, rank, independent t-test, one-way ANOVA, post Scheff''s examination, Pearson product-moment correlation, and multiple stepwise regression. The findings are as follows：
1. The degree of symptom distress during therapeutic period was mild to moderate. There was no difference in the degree of symptom distresses in the patients under chemotherapy or radiotherapy but there was difference in the most symptom distress. Generally, the most symptom distresses during therapeutic period were moderate or severe fatigue, bad appetite, weight loss and mild or moderate pain, asleep, dyspnea, cough, constipation, sputum amount increase in the physical dimension. Mild to moderate fatigue-inertia, depression-dejection and confusion-bewilderment were the most distresses in psychological dimension.
2. When patients confront with symptom distresses during therapeutic period, they were always combined with problem- and emotion- focused coping strategies. The most often used were “compliance with the doctor”, “putting symptom distresses to families, nurses or doctors”, “filling with hope”, “acceptance of the true”, “preparing for the worse of disease”, “trying to hold control as far as possible ”, “believing that it was his/her destiny ”, “living as usual”, “preparing something after the therapy is done”.
3. Subjects with higher physical symptom distress had higher psychological distress. Fatigue is the most distress in physical or psychological dimension.
4. Subjects with higher physical symptom distress had higher emotion focused coping strategies frequency and higher psychological distress.
5. According to the discussion, the researcher thinks that The therapeutic regimen (include the dosage of drug or radiation, the site of radiation) is still associated with physical symptom distress. And the psychological symptom distress affected by the physical symptom distress.
6. The frequency of problem focused coping strategies are positive associated with all the patients had longer duration since diagnosed to now, employed chemotherapy, with no smoking habit, had family accompanied and the females. The frequency of emotion focused coping strategies are positive associated with all the patients had religious belief, tumor relapsed and no smoking habit. Patients with income less than 2,000 NT dollars had higher frequency of emotion focused coping strategies than the patients with income more than 100,000 NT dollars. Patients with middle age had higher frequency of emotion focused coping strategies and more coping behaviors than the elders.
7. The distress of tension-anxiety and the age explained 39.4% of variance in the physical symptom distresses.
8. The physical symptom distresses and the frequency of emotion-focused coping strategies used explained 48.8% of variance in the psychological symptom distresses.
The results of this study provide a picture of symptom distresses and coping strategies in patients with non-small cell lung cancer. The physical and psychological symptom distresses are interactional and diversified. The physical and psychological symptom distresses also can be predicted. We recommend that patients during therapeutic period need to be assessed by tool and we predict the degree of symptom distress by the equation. After the process of prediction and systematic assessment, the suitable intervention could to given and the physical and psychological symptom distresses could be released. We also recommend that to make use of problem-focused and positive emotion-focused coping strategies to establish the patient group and it will enhance the efficiency of coping.
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