Predictive Factors of Uncertainty and Hope of the Patients with Advanced Cancer and Their Families

Autor: Ying-Ying Leeliu, 李劉瀅瀅
Rok vydání: 2009
Druh dokumentu: 學位論文 ; thesis
Popis: 97
This research aims to discuss the predictive factors of uncertainty and hope of the patients with advanced cancer and their families. The cases were conducted in a medical center in northern Taiwan from September 9th 2008 to March 31st 2009 by purposive sampling and interviewing. 87 patients and 125 family members participated in the research. The research instruments include background data form, Mishel’s Uncertainty in Illness Scale Chinese Version and Herth Hope Index. As it turned out, 27.6% patients are fully aware of their disease, only 9.2% of them have signed the agreement of DNR, 4.6% have signed the agreement of hospice care, 70.4% family members are fully aware of the patients’ disease, 49.6% of them have signed the agreement of DNR and 23.2% have assisted signing the agreement of hospice care. This showed that the family members know more about the state of illness than the patients and are more likely to sign the agreement of DNR and hospice care. Most medical decisions at the end of life are still made by the families. The average total score of the families’ hope state is 30.61±4.50 (the total score is 10-40, a higher score means a higher level of hope.) and the hope state scores of the patient group labeled as workers and the family group labeled as Folk Religion or Taoism are all lower than their reference groups: the Unemployed and the Irreligious; the average total score of the families’ uncertainty about the disease is 62.92±11.38 (the total score is 23-115, a higher score means a higher level of uncertainty.) and the uncertainty scores of the family group labeled as Poorly Informed about the state of illness, the family group that didn’t sign the agreement of hospice care, the family group that remain single, divorced or widowed and the patient group that didn’t accept hospice shared Care are all higher than their reference ones: the fully informed, the families that signed the agreement of hospice care, the married families and the patient group that accepted hospice shared care. For those patients and their families who have accepted the hospice shared care, it will be easier to make medical decision at the end of life and possibly reduce the family’s uncertainty. This research result is expected to serve as references for medical staff; assist the families to allow the patients to know about their own disease and have equal opportunities for medical decision according to their own wishes; reduce the families’ uncertainty and get better suitable medical care for the patients.
Databáze: Networked Digital Library of Theses & Dissertations