[[alternative]]The Exploration of Concerns among Gynecology Cancer Women during the Period of Receiving Chemotherapy

[[abstract]]擔憂(Concern)是焦慮、身體、心理、社會等相關的心理窘困，是很重要但不易被了解，婦女罹癌接受治療時，會有身體、心理、社會及其家庭等的擔憂，是與男性患者不同，然而國內研究很少深入了解關於婦女執行治療期間的擔憂。本研究旨在探討1.婦癌婦女接受化學療法期間的擔憂程度，2.不同的基本屬性之婦女擔憂之差異性，3.擔憂之主觀經驗。本研究採質量性混合研究設計，以立意取樣方式，共收集30位有效個案，其中完成21位個案深入訪談，收集其質性資料。量性資料研究工具包含以下量表：一、人口學基本屬性，二、癌症化療擔憂評估量表(Cancer-Chemotherapy Concerns Rating Scale,CCRS)；質性資料以CCRS之15個題項為主，深入訪談婦女接受化學療法期間擔憂。接受化學療法期間的擔憂四個構面，其擔憂程度依序為:1.對病情進展的擔心，2.對社會經濟的關切，3.日常生活的重組，及4.自我的存在。擔憂程度前五名的單題依序是：1.化療使我的腦力和體力都變差了、2.我的腦海中不停擔憂和疾病相關的事項、3.我擔心我會發生疾病的復發或轉移、4.當我接受化療時，我擔心我的家人、5.我無法保持我以往的生活節奏。罹癌第二期以下(p=0.02)婦女對日常生活的重組的擔憂程度較高且達到統計上的顯著差異。已婚(p=0.01)、有子女(p=0.004)的婦女對社會經濟的關切的擔憂程度較高，且達到統計上的顯著差異。主觀經驗描述經內容分析如下:1.罹癌的死亡或復發威脅之省思，治癒或後事安排。2.如何自我處理化療副作用的處理。3.化療使腦力和體力都變差，工作及日常活動需依賴他人。4.化療的不適感，禁錮了生活節奏。5.自覺有負向想法變得易怒。6.擔心家人無法承擔經濟、家事等負荷。本研究可瞭解婦女接受化學療法期間的擔憂，日後可做為臨床醫護人員對於婦女治療期間的擔憂評估之參考，並於執行照護時給予個別性的擔憂照護，有助於減輕婦女在疾病期間害怕擔憂的感受，並提升其生活品質。[[abstract]]Concern is anxiety, physical, psychological, social and other related distress. It is important but not easy to be understood. There are physical, psychological, social and family concerns for cancer women receiving chemotherapy that are different from male patients. However, there were few studies conducted the concerns among cancer women the period of receiving chemotherapy. The purposes of current study are to explore: 1. the degree of concern of cancer women during receiving chemotherapy;2. The differences of concerns degree among different attributes women; 3. The cancer women's subjective experience of concerns. A mixed-method design by Purposive Sampling was used. Thirty women participated in the quantitative questionnaire, and 21 of them were invited to conduct in-depth interviews. Quantitative data applied two questionnaires: Basic attributes of demographic data and Cancer-Chemotherapy Concerns Rating Scale (CCRS) including 15 single item under four dimensions-- the degree of concerns are: disease progress, social and economic concerns, reorganization of daily life, self-existence). Qualitative data was to explore women’s subjective experiences on 15 items of CCRS. The top five concerns are: 1.My physical/mental strength were decreased because of chemotherapy; 2. I cannot get concerns out of my mind; 3. I am concerned that relapse or metastasis will happen; 4. I am concerned about my family while I undergo chemotherapy; 5.I could not maintain my life rhythm. Women under the second stage of cancer (p=0.02), were more concerns about the reorganization of daily life. Women who are married (p=0.01) and having children (p=0.004) are more concerns about socio-economic concerns. The subjective experiences of concerns are as follows: 1. Self reflections about the death or recurrence of cancer, cure or after death arrangement; 2.How to self-care side effects of chemotherapy; 3. Chemotherapy made both mental and physical strength worse resulting work and daily activities needed to depend on others; 4.The discomforts of chemotherapy have impeded the rhythm of life. 5. Negative thoughts made me easily angry; 6. Being Worried that family members can’t afford the load of economy, family affairs, etc. The current study provided the getting insight of the concerns of women during receiving chemotherapy. Health providers should provide caring and supportive care during these women receiving chemotherapy based on their concerns