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| Title: | 以壓力模式初探乳癌存活者尋求飲食資訊與健康焦慮之關係
Exploring the relationship between seeking dietary information and Health Anxiety among Breast Cancer Survivors by Stress Model |
| Authors: | 陳怡如
Chen, I-Ju |
| Contributors: | 吳治勳
陳怡如
Chen, I-Ju |
| Keywords: | 乳癌存活者
健康焦慮
壓力模式
飲食資訊
Breast cancer survivor
Dietary information
Stress model
Health anxiety |
| Date: | 2024 |
| Issue Date: | 2024-08-05 14:49:05 (UTC+8) |
| Abstract: | 癌症存活者雖然普遍認為罹癌後可能需要飲食上的調整，不過在獲得飲食相關資訊上常遭遇困難。然而癌症存活者研究多著重於生活品質與工作等面向，較少針對飲食需求進行了解，因此本研究目的為透過壓力模式探討癌症存活者的飲食建議需求，以了解癌症存活者尋求飲食建議行為與健康焦慮的關連。
本研究於北部某醫學中心門診收案，對象為20歲以上曾診斷乳癌且完成首輪治療的乳癌存活者，排除末期與無法對談者。本研究以單次半結構式訪談進行，主要探尋主題為：症狀、飲食、作息、運動、及家庭社會支持等，並蒐集年齡、教育程度、婚姻狀況、同住家人等基本資料，與疾病史、癌症治療狀況與藥物等疾病資料。並以廣泛性焦慮量表、病人健康狀況量表、健康焦慮量表與單題復發恐懼等四份量表作為輔助。以主題分析進行訪談資料的分析，飲食改變與資訊、健康焦慮作為初步編碼，進行資料的整理。
結果以飲食的行為改變歷程、飲食資訊、健康焦慮作為主題，歸納出飲食改變的有無，及整理有飲食改變之乳癌存活者的飲食改變、原因、類型與歷程變化；飲食資訊部分，整理資訊來源與內容；健康焦慮部分則分為認知、行為、情緒、知覺的相關內容與分類，以行為層面有較多樣的表現。
本研究發現乳癌存活者普遍有飲食改變的發生，飲食改變在不同改變歷程可能作為問題解決或情緒焦點因應，且飲食改變的歷程可視為反覆修正的壓力調適歷程。也發現乳癌存活者普遍在飲食改變前有尋求飲食資訊的行為，資訊來源多為醫療人員，然而乳癌存活者偏好的飲食資訊內容與醫療人員給予的飲食資訊存在落差，且社會環境脈絡可能影響其飲食資訊的偏好。研究也發現在健康焦慮的行為裡，回診與檢查對乳癌存活者具有不同的意義內涵，回診的表現可能作為健康焦慮程度的參考。健康焦慮對於壓力模式的壓力源、認知評估、因應都可能產生影響，較難單純視為因應結果。且從飲食改變、尋求飲食資訊的歷程變化可以發現乳癌存活者的健康焦慮狀況與因應，建議適時轉介、提供心理照顧。
Cancer survivors often believe that they may need to make dietary adjustments after cancer. A common barrier they face is the lack of dietary information. However, current research on cancer survivorship in Taiwan mainly focuses on issues such as quality of life and returning to work. This study aims to explore the relationship between the behavior of seeking dietary information and health anxiety using the stress transaction model.
Semi-structured interviews were conducted with adult breast cancer survivors at a hospital in northern Taiwan, excluding those who were unable to communicate or were in the terminal stage of cancer (n = 28). Interview topics included symptoms, diet, lifestyle, exercise, and family and social support. Personal information such as age, education, marital status, residential status, and health status was also collected. General Anxiety Disorder-7 item, Patient Health Questionnaire-9 item, Short Health Anxiety Inventory and the question regarding fear of cancer recurrence were also assessed. Interviews were analyzed using Thematic Analysis.
Themes that emerged included the process of dietary adjustment, seeking dietary information, and health anxiety. The results highlight that dietary adjustment is a common phenomenon, which can serve as problem-focused or emotion-focused coping. The process of dietary adjustment represents a continuous coping process under stress. Most breast cancer survivors reported seeking dietary information before making dietary adjustments, often from healthcare professionals. However, the dietary information provided was generally broad, whereas survivors expressed a preference for more specific advice. The study also found that health anxiety among breast cancer survivors manifests in behaviors such as follow-up visits and medical examinations. These behaviors have different implications and the frequency of follow-up visits could indicate the level of health anxiety. Health anxiety influences various aspects of the stress model, including stressors, cognitive appraisals, and coping mechanisms. Moreover, the process of dietary adjustment and information-seeking can be seen as coping process of health problems, which also reflect the status of health anxiety. |
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| Description: | 碩士
國立政治大學
心理學系
109752005 |
| Source URI: | http://thesis.lib.nccu.edu.tw/record/#G0109752005 |
| Data Type: | thesis |
| Appears in Collections: | [心理學系] 學位論文
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