| Summary: | 碩士 === 國立臺灣大學 === 職能治療研究所 === 99 === Background：Occupational therapy can help breast cancer patients to face psychosocial challenges, restore balance lifestyle and improve quality of life. The aims of this study are to examine the change in quality of life and predictors of quality of life in persons with breast cancer from longitudinal perspective. The predictors in this study contain five areas: disease-related, psychological, social, physical & social environment, and contextual areas. The dependent variables are items and domains from World Health Organization Quality of Life-brief version, WHOQOL-BREF)。
Methods：The subjects were 100 outpatients with breast cancer recruited from the chemotherapy treatment room of the medical center in the northern Taiwan. The data collected twice at baseline(T1) and three months later(T2). The mean age of the subjects was 49.6；77% patients were married；55% patients were graduated from colleges。The subjects were tested on the WHOQOL-BREF Taiwan version, occupational self assessment, mastery, Beck Anxiety Inventory , Beck Depression Inventory II, social support and social impact scale, unsupported social interactions, role checklist, occupational questionnaire, and satisfaction with daily occupations. The raw data was transformed for Rasch analysis, then the data were analyzed by mixed effect model using SAS computer program.
Results：The average length of involvement in this study was 3.5 months, and the follow up rate was 76%. The reasons of drop out in this study contain: cannot contact, physical issues, busy, no interests, and far from the hospital. The results showed that the quality of life in persons with breast cancer was similar with healthy populations. The raw score of the social domain decreased from T1to T2. The negative feelings and the opportunities to participate leisure activities increased with time. Depression was the most significant predictors to the psychological domain; occupational competences can improve the social domain of quality of life; environmental affordances have the benefits for environmental domain of quality of life; the predictors in Occupational Patterns domain have the influence on overall quality of life; satisfaction with daily occupations and the predictors of psychological area have the wide influence on quality of life.
Conclusions: According to the study, occupational therapists can provide treatments for persons with breast cancers in the following domains: (1) individual consulting for lifestyle redesign to increase occupational competences (2) providing leisure activities for enhancing occupational competence (3)improving emotional coping skills（4）providing psycho educations for family and communities (5) relocating environmental resources such as attending volunteer works.
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