[[alternative]]Supportive Care Needs and Associates One Year after Surgery among Breast Cancer Survivors

[[abstract]] 乳癌婦女手術一年後的治療趨近於結束或已治療結束，身心社會的照護需求可能有別於診斷、治療期。依據乳癌婦女個別需求而提升支持性照護為癌症醫護團隊的重要充能。然而國內較少研究著墨於探討治療結束階段的支持性照護需求。本研究乃運用一項於北部某癌症醫院隨機對照臨床試驗研究的乳癌術後6與12個月的追蹤資料進行分析，探討婦女在術後12個月的身心社會支持照護需求，及其與人口社經、乳癌治療、及與術後6至12個月追蹤的症狀困擾、資源運用的相關性。 研究樣本為連續性取樣的148位年滿20歲且經病理診斷為stage 0至IIB之初診斷且完成術後6與12個月追蹤的乳癌婦女。資料包含結構式問卷收集支持性照護需求、症狀困擾、醫療及社區資源運用、病歷資料。 結果顯示，術後12個月的生理、醫療資訊、心理、照顧與支持、性等五面向照護需求的平均分數雖較低，介於8.0 (性) 至23.9分(醫療資訊)。但各項需求仍有多於35%者有需求，其中約70%有資訊需求、74%害怕復發。經多元線性迴歸分析術後一年支持性照護需求之預測因子，其中術後半年的口乾、疲倦、活動和整體生活品質能顯著預測術後12月的生理需求。年齡小於40歲、術後半年食慾不振、口乾、活動、個管師諮詢與整體生活品質能預測12個月的醫療資訊需求。術後12個月的心理需求與年齡小於40歲、和術後半年的手術疤痕、噁心嘔吐、疲倦、健康食品使用、整體生活品質、失眠藥物治療顯著的相關。而照顧與支持需求與術後半年的乳房皮膚、活動、個管師諮詢、女親友討論、整體生活品質、臨床問題與慢性病藥物呈顯著相關。最後，術後半年的手術疤痕、分泌物增加和伴侶討論能預測術後12月的性需求。由研究結果得知，年齡與治療過程中症狀困擾、整體生活品質、資源運用等影響著術後12月的生理、心理、醫療資訊、照護與支持、性需求五大層面。除常見的噁心嘔吐、疲倦的症狀困擾外，仍待加強手術疤痕、乳房皮膚照護、失眠、提升活動的照護，同時鼓勵乳癌婦女對專業諮詢的運用。[[abstract]]Breast cancer (BC) patients’ needs may vary from situation to situation. While most Taiwan studies mainly examined needs at treatment phase, this study secondarily analyzed the one-year follow-up data of a RCT study in northern Taiwan and aimed to explore BC women's physical, psycho-social supportive care needs at 12 months after surgery, and their association with treatment, symptom distress and resource utilization 6 months after the BC surgery. A continuous sampling of 148 women who were aged ≥20 years with newly diagnosed stage 0 to IIB BC and completed the one-year follow-up data were used for this analysis. The results showed that the women reported a relative low mean scores of five support care needs 12 months after surgery, ranging from 8.0 for the sexuality need to 23.9 for health system and information need. But, more than 35% still reported at least one unmet need; especially 70% had unmet information needs and 74% were afraid of recurrence. Multivariate linear regression analysis indicated predictors of dry mouth, fatigue, activity issue and overall QOL six months for physical needs, and the same factors plus age