The Relationship between symptom-management self-efficacy、Demoralization and Emotional status in Breast Cancer Patients.

• Main Authors: Ya-Chun Chang, 張雅淳
• Other Authors: Shu-Yuan Liang
• Format: Others
• Language: zh-TW
• Published: 2017
• Online Access: http://ndltd.ncl.edu.tw/handle/j8y972

碩士 === 國立臺北護理健康大學 === 護理研究所 === 105 === Malignant tumors rank first in the causes of death of Taiwanese people. When receiving a cancer diagnosis and treatment, most people tend to develop emotional disturbances, such as anxiety and depression, which will have an adverse impact on the cancer treatment, as well as patients' quality of life. According to the research conducted in recent years, demoralization syndrome has a high correlation with anxiety and depression. Self-efficacy is another crucial factor related to patients' healthcare results, as well as their faith and judgment with regard to specific healthcare behaviors. Endeavoring to fulfill a preset healthcare target helps an individual with self-adjustment. As a result, breast cancer patients with relatively high symptom management self-efficacy may develop a positive mental status. This research aims to explore the correlation between the symptom management self-efficacy, demoralization, and mental status of inpatients with breast cancer. This research benefits from a cross-sectional design and a convenience sampling method, with all cases collected from a number of wards located close together in a medical center in northern Taiwan. In total, this study included 71 breast cancer patients undergoing chemotherapy. Structured questionnaire collection, including a basic demographic data sheet, symptom management self-efficacy scale, Demoralization Scale - Mandarin Version (DS-MV), and Hospital Anxiety and Depression Scale (HADS), was used in this research. All research data are analyzed using SPSS 19.0 for Windows. To explore the correlation between the symptom management self-efficacy, demoralization, and mental status of breast cancer patients, the standard statistical significance α under various assumptions shall be 0.05. Descriptive statistics are based on the percentage, mean value, and standard deviation, while inferential statistics are analyzed by means of ANOVA, t-test, Pearson’s correlation, and multiple regression. As shown by the results, there is a significant difference in the anxiety for individual’s "current occupations"(p < .05) and "operations" (p < .05); the correlation coefficients of "dosage" and "depression" result in a significantly positive value (r = .25, p < .05), which means that the higher dosage administered to an individual, the more severe the level of depression. Furthermore, the correlation coefficients of "overall symptom management self-efficacy" (r = -.36, p < .01), "anxiety", and "depression" are significantly negative, which means that a better awareness of symptom management self-efficacy in various respects will help alleviate patients’ anxiety and depression. In contrast, the correlation coefficients of "overall demoralization", "anxiety" (r = .25, p < .05), and "depression" (r = .47, p < .001) are significantly positive, meaning that an individual with a higher level of demoralization will be more anxious and depressed. This research involves exploring patients' symptom management self-efficacy and making predictions about the correlation between demoralization, anxiety, and depression. Based on the results, we found that "symptoms concerning chemotherapy management" (a secondary variable of symptom management self-efficacy), operations (Yes vs. No), and "discouragement" (a secondary variable of demoralization) have an effective influence on the "anxiety level" (a dependent variable), with an explanatory power of 23.0%; while "depression" (a secondary variable of demoralization) and "emotional management and interpersonal disturbance" (a secondary variable of symptom management self-efficacy) have an effective influence on the "depression level" (a dependent variable), with an explanatory power of 34.2%. Cancer patients tend to develop demoralization upon receiving a definite diagnosis and when undergoing medical treatment. Demoralization may be an aura of depression, while self-efficacy can help improve patients’emotional state. These research results can help medical personnel further recognize the symptom management self-care ability of patients with breast cancer when undergoing chemotherapy and better understand the impact of demoralization on the emotions of patients. What's more, it can provide a practical reference for future healthcare and help alleviate unhealthy emotions arising from various diseases.