[[alternative]]Effects of Progressive Muscle Relaxation Training on Symptom Distress and Anxiety in Colorectal Cancer Patients Undergoing Chemotherapy

[[abstract]]過去研究證實，漸進式肌肉放鬆訓練可有效改善化學治療期間之症狀困擾及其引起之焦慮。本研究目的為探討大腸直腸癌病患於化學治療期間運用漸進式肌肉放鬆訓練對改善症狀困擾與焦慮，及對生命徵象之影響。採類實驗法研究設計，選取北部某醫學中心腫瘤科及大腸直腸外科病房，住院接受化學治療之大腸直腸癌病患，隨機分配至實驗組和對照組，兩組各為34人，共68位。實驗組於化學治療期間，接受漸進式肌肉放鬆訓練，每日兩次、每次20分鐘；對照組則只給予常規護理。兩組於化學治療前及結束後以症狀困擾量表、情境焦慮量表及測量生命徵象，瞭解化學治療期間症狀困擾及焦慮的情形。資料以SPSS 19.0 中文版系統進行統計分析。研究結果顯示：一、化學治療期間執行漸進式肌肉放鬆訓練，可降低整體症狀困擾，達顯著差異（p<.01），包括其中之噁心、嘔吐、食慾影響、失眠、疼痛、疲倦、咳嗽、腹脹、口乾、焦躁不安、精神無法集中、胃灼熱感之症狀。二、化學治療期間執行漸進式肌肉放鬆訓練，可降低焦慮，達顯著差異（p<.01）。三、化學治療期間執行漸進式肌肉放鬆訓練，可降低血壓，達顯著差異（p<.05）。四、影響漸進式肌肉放鬆訓練改善症狀困擾及焦慮之相關因素：特質焦慮與症狀困擾及情境焦慮呈現負相關（r＝-0.59，p<.01；r＝-0.70，p<.01），顯示特質焦慮低者使用漸進式肌肉放鬆訓練對改善其化療之症狀困擾及焦慮的效果佳；教育程度與症狀困擾呈現顯著相關（t＝-2.12，p＝.04），顯示教育程度在高中職/專科以上的病患，使用漸進式肌肉放鬆訓練能有效改善其化療之症狀困擾。由以上說明得知，化學治療期間執行漸進式肌肉放鬆訓練可改善症狀困擾及焦慮，而特質焦慮及教育程度會影響漸進式肌肉放鬆訓練之成效，此研究結果可提供臨床護理實務之參考。[[abstract]]Some studies have proved that progressive muscle relaxation training can help improve symptom distress and anxiety during chemotherapy. The purpose of this study was to investigate the effect of progressive muscle relaxation training on symptom distress, anxiety and vital signs of colorectal cancer patients undergoing chemotherapy. The quasi-experimental design was used in the study. The samples were chosen from the oncology and colorectal surgical ward of a medical center in northern Taiwan. Sixty-eight colorectal cancer patients who received chemotherapy were randomly assigned into experimental or control group. The experimental group received a 20-minute progressive muscle relaxation training twice a day during chemotherapy period. The control group received ward routine care. Symptom Distress Scale, Trait Anxiety Inventory and Vital Signs were used to assess symptom distress and anxiety level during chemotherapy period. We collected statistical analysis by SPSS for Windows 19.0 Chinese version. The results showed that: （1）Progressive muscle relaxation training can significantly reduce symptom distress of the patients who undergo chemotherapy (p < .01), which included the nausea, vomiting, appetite, insomnia, pain, fatigue, cough, bloating, dry mouth , restlessness, inability to concentrate and heartburn. （2）Progressive muscle relaxation training can significantly reduce patients’ anxiety arising from chemotherapy (p < .01). （3）Progressive muscle relaxation training can significantly reduce patients’ blood pressure as the result of chemotherapy (p < .05). （4）The relevant factors of the impact of progressive muscle relaxation training to improve symptom distress and anxiety: Trait anxiety, symptom distress and state anxiety showed negative correlation (r = -0.59, p < .01; r = -0.70, p < .01). This proved that patients with low trait anxiety using progressive muscle relaxation training have better effect to improve symptom distress and anxiety caused by chemotherapy. Education level also showed a significant correlation with symptom distress (t = -2.12, p = .04). Patients with high school, vocational school or higher level education using progressive muscle relaxation training can improve symptom distress during chemotherapy.From the above descriptions we conclude that: progressive muscle relaxation training can improve symptom distress and anxiety during chemotherapy. Trait anxiety and education level will affect the effectiveness of progressive muscle relaxation training. The research result provides the references for clinical nursing practice