| Summary: | 碩士 === 國立陽明大學 === 臨床護理研究所 === 104 === Background: Breast cancer is the most frequent female cancer in Taiwan, while its mortality rate is the forth and overall five year survival is 89%. The taxane including paclitaxel and docetaxel is benefitical for breast cancer survivorship demonstrated by numerous randomized trials. However, side effects from taxane because chemotherapy diminished these women’s quality of life. Taxane-induced peripheral neuropathy (TIPN) is a common side effects and negatively influences women’s physical, psychological and social status. There are many studies to survey the phenomenon of TIPN in other countries, but no study to investigate its impact on Taiwanese women with breast cancer up to now.
Purpose: The primary purpose of this study was to investigate the distribution and relationship among peripheral neuropathy, functional status and quality of life in women with breast cancer after taxane treatment. Additionally, it was also to examine the predicting factors of quality of life in this population.
Methods: This study utilized a cross-sectional study design and purposive sampling. A total of 123 women with breast cancer received at least one treatment with taxane were recruited in this study from a medical center in northern Taiwan. Instruments included demographic and clinical characteristic questionnaires, Patient Neurotoxicity Questionnaire, Total Neuropathy Score-clinical version, Peripheral Neuropathy Scale and Functional Assessment for Cancer Treatment-Breast.SPSS 20.0 software was used for data entry and analysis. The data were analyzed utilizing descriptive statistics and inferential analyses.
Results: Majority of the participants received docetaxel therapy. The average age was 51.50 (SD=9.74). The TIPN subjective measure found sensory symptoms and motor symptoms were 71.5% and 66.7%, respectively. Nearly half of the participants were with slight symptoms but only 4.9 to 7.3% of them were with a severe degree. The objective method indicated that 87.0% had peripheral neuropathy. Moreover, two of the most common symptoms were the deterioration of sensation on pinprick and vibration tests. The domain of functional status revealed that the symptoms in feet were more serious than they were in hands; numbness was more severe than tingling. The quality of life in this study was above the moderate level. There was a positive correlation between subjective TIPN and functional status (rho=0.674, p<0.001), a negative correlation between subjective TIPN and quality of life (rho=-0.302, p=0.001), a positive correlation between objective TIPN and functional status (r=0.633, p<0.001), and then a negative correlation between objective TIPN and quality of life (rho=-0.364, p<0.001). In additional, there was a negative correlation between functional status and quality of life (r=-0.490, p<0.001). The hierarchical multiple regression analysis detected that the risk of exposure to chemical materials, quit their job due to illness, with chronic diseases, the severe degree of subjective TIPN motor symptoms and poor functional status were the predictors of negative quality of life. The aforementioned factors explained 37.6% of the variance of quality of life.
Conclusion: Women with breast cancer after taxane treatment induced peripheral neuropathy negatively affected functional status and quality of life. In order to improve patients’ quality of life oncology nurses need to have skills utilizing the TIPN subjective and objective tools to early detect and timely manage the TIPN.
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