[[alternative]]The correlation among the spiritual well-being,quality of life and symptoms distress for senior citizens of urinary tract cancer

[[abstract]]本研究的主要目的在探討泌尿系統癌症長者靈性需求，以及生活品質和症狀困擾情形，採橫斷式相關性研究設計，於台北市一家醫學中心進行收案，以有接受癌症治療的泌尿系統癌症長者，年齡滿65歲(含)以上為收案對象。收案期間自106年12月至107年4月止，經醫院IRB通過後開始收案，取得研究個案同意後，進行問卷填寫收集資料，共收到97有效問卷。問卷內容包括人口學資料、疾病資料、靈性安適量表(SWBS)、世界衛生組織生活品質量表台灣簡明版(HOQOL-BREF)、症狀困擾量表-中文版（SDS-CMF)。 研究結果：研究對象的平均年齡為74.99歲，以男性居多，有80人，以佛教最多，有43人。以膀胱癌最多，計53人；平均患有2.09種慢性疾病；癌症治療方式為平均1.81種，其治療方式以化學治療最多。整體靈性安適平均值為3.56(SD = 0.15），屬於中等靈性安適，宗教安適平均值為3.49(SD = 0.16），存在安適平均值為3.63(SD = 0.23）；整體生活品質平均值為3.13，(SD=0.30)，為中等生活品質。各範疇依分數高低排序為得分最高為環境範疇、社會範疇、生理範疇、心理範疇；整體症狀困擾平均值為1.30，(SD=12.37)，為低等症狀困擾，在症狀困擾中，排尿改變、性生活改變、食慾改變、疼痛、疲倦為泌尿系統癌症長者常見前五名的症狀。經皮爾森積差相關分析發現靈性安適與生理範疇、心理範疇、整體生活品質為正相關，與社會範疇與整體症狀困擾為負相關；宗教安適與心理範疇、環境範疇與整體生活品質為負相關；存在安適與生理範疇、心理範疇與整體生活品質為正相關。整體症狀困擾與存在安適、整體靈性安適、生理範疇、心理範疇與整體生活品質為負相關。[[abstract]]This study aimed to investigate the spiritual needs of the elders with urinary tract cancers (UTC), as well as the quality of life (QoL) and their symptom distresses. In a cross-sectional correlation study, we collected the subjects with UTC whose age were ≥65 years in a medical center in Taipei from December of 2017 to April of 2018. The study was approved by the hospital’s Institutional Review Board (IRB). After the informed consent forms were signed by all subjects, the data have been collected, and then questionnaires were completed. A total of 97 valid questionnaires were received. The questionnaires included demographic data, underlying diseases, the Spiritual Well-Being Scale (SWBS), the World Health Organization (WHO) Quality of Life –BREF (WHOQOL-BREF) - Taiwan Version, the Symptom Distress Scale -Chinese Modified Form (SDS-CMF).Results: The mean age of the subjects was 74.99 years old, males were the dominant gender (n=80). The major religious belief was Buddhism (n=43). Bladder cancer was the most common UTC (n=53). On average, there were 2.09 types of chronic diseases; the average treatment method for cancer was 1.81, and chemotherapy was most often used to treat cancer. The mean value of overall spiritual well-being was 3.56 (SD=0.15), which was moderate spiritual well-being. The mean value of religious well-being was 3.49 (SD=0.16), and the mean value of existential well-being was 3.63 (SD=0.23). The mean value of overall QoL was 3.13 (SD=0.30), which belonged to moderate QoL. The major domains ranked by the scores were: environmental domain (with the highest score), social domain, physiological domain, and psychological domain; the mean value of overall symptom distresses was 1.30 (SD=12.37), which was low symptom distresses. In symptom distresses, urination changes, sexual life changes, appetite changes, pain, and fatigue were the top five symptoms among the elders with UTC. The analyses of the Pearson product-moment correlation coefficients revealed that spiritual well-being was positively correlated with physiological domain, psychological domain, and overall QoL, however; negatively correlated with social domain and overall symptom distresses; the religious well-being was negatively correlated with psychological domain, environmental domain, and overall QoL. The existential well-being was positively associated with physiological domain, psychological domain, and overall QoL. The overall symptom distresses were negatively associated with existential well-being, overall spiritual well-being, psychological domain, psychological domain, and overall QoL