[[alternative]]The effectiveness of physiological and psychological

Abstract

[[abstract]]術後乳癌病患爲防止癌細胞微小轉移，多數會行輔助性化學治療，然而化學治療之副作用帶給病患之威脅，有時甚至超過疾病本身。因此降低乳癌化療病患之生、心理困擾以及合併症之發生，可說是臨床照護上一個重要的課題。氣功療法為我國傳統醫學的一部份，依中醫理論其調身、調心、調息之吐納方式，有調節臟腑、扶正去邪去邪之療病功效。雖然國內外亦有探討有關氣功療法之相關文獻，但實際應用在臨床之探討則非常有限，尤未見應用於乳癌化療照護方面之研究，故本研究目的旨在探討站樁氣功療法於乳癌化療病患之生、心理指標成效。 本研究採用類實驗設計法（Quasi-experimental design）。研究對象取自台北某醫學中心之乳癌化療病患；研究者以方便取樣方式，將個案分為控制組35名及執行站樁氣功療法之實驗組32名，收案時間自92.04.01至93.03.31止，使用工具（症狀困擾量表、心理困擾量表、BECKMAN 血液自動分析儀）經信、效度測定後進行相關之資料收集。其中化療前第一天所測得之生理指標（白血球、血小板、血色素、症狀困擾程度）及心理指標（心理困擾程度）為前測基準值；後續測得的包括化療後第一週（第八天）、第二週（第十五天）、第三週（第二十二天）資料，進行站樁氣功療法成效之比較分析。 相關資料藉敘述性（次數分配、平均值、標準差、百分比）及推論性（T檢定、配對T檢定、卡方檢定、單因子變數分析、重複測量）統計分析後，研究結果為：接受站樁氣功療法之乳癌化療病患，其生理指標中血球指數之白血球平均上升416立方毫米（p>.05），控制組白血球平均下降810立方毫米（p .05）。此外在血紅素方面，實驗組下降0.27mg/dl（p >.05），控制組下降0.43 mg/dl（p .05）。在生理指標症狀困擾方面，實驗組於第三週時困擾程度低於控制組（p .05）。 整體而言，本研究發現站樁氣功療法在乳癌化療病患有其成效；期盼未來於執行各項臨床護理作業之際，能適時將氣功療法引為發展性照護措施之一部份，以提升臨床護理品質及乳癌化療病患之生活品質。[[abstract]]In order to prevent cancer cell micrometastasis after surgery, most breast cancer patients will do supplementary chemotherapy. However, the threat that aftereffect of chemotherapy bring to patient may exceed the disease itself. Therefore, decreasing the physical and metal disturbance of breast cancer patient in chemotherapy and combination occurrence is an important issue to clinical nursing. Chi therapy is part of our traditional medicine, in which the breath guiding for body, mind and breath harmonization has the therapy effect of internal organs correlation, strength buildup and weakness elimination. Although there are some related domestic and abroad archives discussing chi treatment, there are very few in discussion applying to clinical practice, especially the research applying to chemotherapy of breast cancer. Therefore, the purpose of this research is to explore the physiological and psychological index effect by Chan-Chuang chi therapy in chemotherapy patients with breast cancer . This research adopts Quasi-experimental design, in which the research subjects are chemotherapy patients with breast cancer from certain Taipei medical center. By convenience sampling, researcher divided cases into 35 people in control group and 32 in experimental group excising chi treatment. The tools (Symptom Distress Scale; The Symptom Chechlist-90-Revised; BACKMAN blood automatic analyzer) passed reliability and validity tests were used for related data collection. Among them, the physiological index (leukocyte, platelets, hemoglobin, syndrome distress level) and psychological index (psychological distress level) measured by the day before chemotherapy is the basic value of pre-test; and the consequent data measured at first week (the eighth day) after chemotherapy, second week (the fifteenth day), third week (the twenty-second day) as for comparison analysis of Chan-Chuang chi therapy effect. After descriptive (number allocation, average value, standard variance, percentage) and inferential (T test, pair T test, chi square test, ANOVA, repeating measurement) statistics analysis, the research result of related data is: the leukocyte index of experimental group increases 416 cube mm (p >.05) in average, while the leukocyte index of control group decreases 810 cube mm (p .05). From hemoglobin aspect, experimental group decreases 0.27mg/dl (p >.05), while control decreases 0.43 mg/dl (p .05). Concerning the syndrome distress of physiological index, the distress level of experimental group is lower than control group in the third week (p .05). In overall, this research found the effect of Chan-Chuang chi therapy in chemotherapy patients with breast cancer. About the application in nursing in the future, we hope chi therapy could be introduced as part of nursing intervention to promote clinical nursing care quality and the life quality of breast cancer patients in chemotherapy