某區域醫院卵巢癌病人治療成效的影響因素研究

Chia Nan University of Pharmacy & Science Institutional Repository > 智慧生活學院 > 醫務管理系(所) > 博碩士論文 > Item 310902800/34025

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標題:	某區域醫院卵巢癌病人治療成效的影響因素研究 The Factors Associated with Treatment Effectiveness of Ovarian Cancer Patients in a Regional Hospital 目的：標靶藥物Bevacizumab是一種對抗血管內皮新生因子(anti-VEGF)的重組單株抗體，目前臨床持續研究此藥物用於治療卵巢癌療效。本研究探討卵巢癌婦女治療成效和分析相關風險因素。方法：採回溯性研究方式，蒐集南部某區域教學醫院2009年1月1日至2019年12月31日期間婦癌病人資料，篩出診斷卵巢癌病人共190位。以描述性統計分析病人人口學屬性、醫院因素和卵巢癌病人因素；以質性語幹分類個案管理師評估病人護理問題後介入處置內涵；為探討病人使用標靶藥物治療成效之風險影響因子，用卡方檢定分析各變項相關性；利用Kaplan-Meier進行各變項對效用的影響差異，再以Cox比例風險逐步迴歸模型分析預測病人治療成效之風險影響因子。結果：影響病人治療成效顯著因子為初診斷年齡、共病、臨床分期及標靶藥物使用狀態，死亡風險比在初診斷年齡(≧55歲高於<55歲)、共病(有>無)、臨床分期(III/IV> I/II)、化學治療合併標靶治療>單純化學治療，在整體模式則標靶藥物使用狀態會受到臨床分期中介影響治療成效。另質量性語幹分析探討個案管理師評估病人護理問題後介入處置內涵，共分析出592個語幹，並分類統計衛教項目總數。依據處置內涵語幹發現以心理及生理症狀、治療後問題處置及衛教為主。建議：依據本研究結果建議30歲以上婦女可藉由每年健保提供免費子宮頸抹片檢查，同時合併婦產科超音波檢查以早期發現卵巢癌並早期治療。另建議臨床個案管理師適時介入適當照護、衛教與處置方式，減輕病人治療所產生之心理與生理症狀，增進生活品質，更可監測病人臨床治療指引遵循率及接受治療完治率，藉以降低復發機率與提升存活率。 Purpose: The targeted drug Bevacizumab is a recombinant monoclonal antibody against vascular endothelial growth factor (anti-VEGF). The clinical efficacy of this drug for the treatment of ovarian cancer is currently continuing to be studied. This study explored the effectiveness of treatment for women with ovarian cancer and analyzed related risk factors.Methods: A retrospective research method was adopted to collect the data of women's cancer patients from January 1, 2009 to December 31, 2019 in a regional teaching hospital in the south, and a total of 190 patients with ovarian cancer were screened and diagnosed. Use descriptive statistics to analyze patient demographic attributes, hospital factors, and ovarian cancer patient factors;use qualitative language stemming to classify case managers to assess the patient's nursing problems and intervene in the treatment content;in order to explore the risk factors of the patient’s use of targeted drug treatment, use Chi-square test analyzes the correlation of each variable;Kaplan-Meier is used to analyze the difference in the effect of each variable on the utility, and then the Cox proportional hazard stepwise regression model is used to analyze the risk influencing factors that predict the patient's treatment outcome.Results: The significant factors affecting the patient's treatment effectiveness were the initial diagnosis age, comorbidities, clinical staging and target drug use status. The mortality risk ratio was at the initial diagnosis age (≧55 years, higher than <55 years), and comorbidities (yes>no) , Clinical staging (III/IV> I/II), chemotherapy combined with target therapy> chemotherapy alone, in the overall model, the target drug use status will be affected by the clinical staging intermediary to affect the treatment effect. In addition, qualitative language stem analysis explores the connotation of intervention and treatment by case managers after assessing patient care problems. A total of 592 language stems are analyzed, and the total number of health education items is classified and counted. According to the treatment connotation stemming findings, the main focus is on psychological and physical symptoms, problem management after treatment, and health education.Recommendation: Based on the results of this study, it is recommended that women over 30 years of age can provide free Pap smears through the annual health insurance, and combined with obstetrics and gynecology ultrasound examinations for early detection and early treatment of ovarian cancer. It is also recommended that the clinical case manager intervene in appropriate care, health education, and treatment methods in a timely manner to reduce the psychological and physical symptoms of the patient’s treatment, improve the quality of life, and monitor the patient’s clinical treatment guideline compliance rate and treatment completion rate to reduce recurrence Probability and Improve Survival Rate.
作者:	黃淑惠
貢獻者:	醫務管理系陳惠芳
關鍵字:	卵巢癌化學藥物治療標靶藥物治療存活率護理問題評估處置內涵 Ovarian cancer Chemical drug therapy Targeted drug therapy Survival rate Nursing evaluation problem handling
日期:	2021
上傳時間:	2022-10-21 10:36:01 (UTC+8)
關聯:	學年度：108， 99頁
顯示於類別:	[醫務管理系(所)] 博碩士論文

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