[[alternative]]Exploring Relationships among Demoralization,Depression,Hopelessness and Qulity of Life in Women with Breast Cancer.

[[abstract]]本研究基於腫瘤心理學是未來癌症照護所要發展的目標，同時以心理情緒對生活品質影響之理論依據，探討乳癌婦女之失志、憂鬱、無望與生活品質的相關研究。本研究所使用的樣本為台北市某醫學中心門診之乳癌婦女，採方便取樣共110 名，以人口學問卷、失志、憂鬱、無望與生活品質量表進行資料蒐集。研究運用描述統計、卡方檢定、獨立樣本平均數檢定、單因子變異數分析、皮爾遜積差相關、簡單、階層迴歸分析，瞭解乳癌婦女之失志、憂鬱、無望感與生活品質的現況、相關及預測。結果顯示如下:1、 本研究乳癌婦女以中壯年期、已婚婦女居多，9 成和家人同住、且有宗教信仰，教育程度在高中/職、專科/大學者約各佔3 成；以退休/家管為多數，6 成以上收入在2 萬元以下，乳癌分期最多在第二期，多數接受手術併化學治療。2、整體乳癌婦女的憂鬱、無望感為輕微程度、約五成婦女失志得分在平均數以上、生活品質為中上程度。3、最常見的失志表現為意志消沉，其它依序為為煩躁不安、失去生命的意義及目標、無助感、失敗感。4、生理層面的生活品質最差，其它依序為心理、存在安適，支持層面最好。最常見的症狀困擾是疼痛、疲倦、睡眠困擾、手臂淋巴水腫。5、愈失志其感受到的憂鬱、無望感愈高，整體生活品質也愈差，但失志之煩躁不安、失敗感構面和生理層面的生活品質沒有相關性。6、失志和憂鬱對乳癌婦女的整體生活品質具有預測性，其中以失志最具預測力。失志和憂鬱現像在研究樣本的表現是不相同的，二者在某些概念是重疊或相似，但III失志是一種失去生命意義、目標的存在痛苦，還是有不同於憂鬱的面向，對生活品質有其獨特的預測力。根據上述的研究結果，建議往後進行有關存在痛苦的跨文化性研究，更了解台灣癌症病患在失志症候群的樣貌是否和西方樣本有所不同，並提供更多證據確認、擴展失志症候群的理論和內涵。[[abstract]]The purpose of this study is to explore the relationships among demoralization,depression, hopelessness, and quality of life in breast cancer patients. Through questionnairesincluding the Demoralization Scale, Patient Heath Questtionnaire, the Beck HopelessnessScale, and McGill Quality of Life Scale, we took 110 patients recruited from one medicalcenter of major hospital in northern Taiwan as samples for study. The findings of this studyare as following:1. There are 110 women with breast cancer in this study. The majority of the age group liesbetween 51-65 years old; 65% patients with the educational background of senior highschool or higher education, 27% patients are married and more than 90% lives withtheir families and have faith; 66% patients are retired or housewife. The work incomeunder twenty thousands occupied 64% patients. 55% patients are in the breast cancerstage 2-3. And 39% patients are engaging in chemotherapy.2. The degree of depression and hopelessness of most Breast Cancer women are slight. Thedemoralization scores are about half samples higher than the mean value. And overall,the quality of life is good.3. The most common characteristic of demoralization is disheartenment. Others rankedfrom highest to lowest are: dysphoria, lose of meaning and purpose, helplessness, andsense of failure subsequently.4. The mean values of the MQOL ranked from highest to lowest are: support, existentailwellbeing, psychological system and physical system. The most frequent physicalsymtoms are pain, fatigue, insomnia, and lymphotic edema.5. The higher the demoralization score, the higher the depression and hopelessnessre, andthe lower quality of life.6. The depression and demoralization have good explanation ability for the quality of life,Vwhich could explain 51% of the variance, and the demoralization is the most importantexplanator in which.7. The concepts of demoralization and depression are some what overlap, but they aredifferent. Demoralization is an existential pain for losing the meaning of life andobjective. It has some aspects different from depression, has significant effect on thequality of life.According to the results above, we suggest future study can further delineate thedemoralization features in different patient samples and cultures, that will enrich clicicalpractice and increases the quality of life of our patients