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系統識別號 U0026-1108201714330200
論文名稱(中文) 印尼癌症晚期病人善終預測因子之探討
論文名稱(英文) Identifying the Significant Predictors of Good Death among Advanced Cancer Patients under Indonesian Culture
校院名稱 成功大學
系所名稱(中) 護理學系
系所名稱(英) Department of Nursing
學年度 105
學期 2
出版年 106
研究生(中文) 林韋汝
研究生(英文) Wahyu Dewi Sulistyarini
學號 T26047051
學位類別 碩士
語文別 英文
論文頁數 115頁
口試委員 指導教授-高綺吟
召集委員-胡文郁
口試委員-范聖育
中文關鍵字 none 
英文關鍵字 palliative care  advanced cancer  good death  diseases awareness 
學科別分類
中文摘要 none
英文摘要 Introduction: Achieving good death is the ultimate goal of palliative care. A good death may also be influenced by personal values, social context, religions and cultural contexts. Indonesia is the most populous Muslim-majority country and palliative care is still at the stage of infancy. Therefore, it is important to understand the components of good death among advanced cancer patients and identify its significant predictors to provide better palliative care for advanced cancer patients under Indonesian culture.
The Purpose of Study: The study aimed to identify the important components of good death and its significant predictors among advanced cancer patients in Central Java, Indonesia
Methods: A cross-sectional survey was conducted with convenience sampling in Central Java, Indonesia. The survey questionnaire included demographic data, clinical information, Components of Good Death questionnaire-Indonesian version, Symptom Distress Scale, the Functional Assessment of Chronic Illness Therapy- Spiritual Well-Being (FACIT-Sp-12) - Indonesian version and Hospital Anxiety and Depression Scale – Indonesian version.
Data Analysis: Data were analyzed with SPSS software. Descriptive statistics were used to present each variable. Exploratory Factor Analysis with principal axis factoring and promax rotation was used to identify the domains of good death. Pearson correlation was used to evaluate the relationship between variables. Multiple Linear regression was applied to determine significance predictors in each domain of good death.
Result: A total of 363 patients with advanced cancer were recruited. After factor analysis of the Components of Good Death questionnaire, 52 items were kept and covered by 5 domains. They were named as comfort, support & faith, dying with dignity, life completion and death awareness & death preparation and explained 51.87% total variance. The most important domain of good death is support & faith (M=6.28), whereas death awareness and death preparation (M=4.42) is the least important domain of good death. Appetite, fatigue and pain were three major distress symptoms among patients. Faith was the significant predictors in all domain of good death.
Conclusion: The findings represent advanced cancer patients’ perspectives regarding good death under Indonesian culture and beliefs. It can be used as a guidance to improve quality of care or end of life care for cancer patients. The results also assist important for healthcare professionals to understand advanced cancer patients’ degrees of symptom distress, the levels of anxiety and depression, and states of spiritual well-being which will provide better care for advanced cancer patients.
Keywords: palliative care, advanced cancer, good death, diseases awareness
論文目次 ABSTRACT I
ACKNOWLEDGEMENTS II
LIST OF TABLES VI
LIST OF FIGURES VII
CHAPTER ONE INTRODUCTION 1
1.1 Background 1
1.2 Study Purpose 3
CHAPTER TWO LITERATURE REVIEW 4
2.1 Advanced Cancer 4
Definition of Cancer 4
Definition of Advanced Cancer 5
Suffering in Patients with Advanced Cancer 5
Advanced Cancer Patients in Indonesia 8
2.2 Palliative Care 9
Definition of Palliative Care 9
The Importance of Palliative Care 9
Palliative Care in Indonesia 9
2.3 Good death 10
Definition 10
Predictors of Good Death 13
CHAPTER THREE METHODS 18
3.1 Research Design and Framework 18
3.2 Sample and Sample Size 19
3.3 Instruments 19
Demographics and Clinical Information 19
Component of Good Death Questionnaire 20
Symptoms Distress Scale 21
Hospital Anxiety and Depression Scale 21
Translation Process 22
3.4 Data Collection 23
3.5 Data Analysis 24
CHAPTER FOUR RESULTS 25
4.1 Demographic data and Clinical Information 25
4.2 Conceptualization of Good Death Dimensionality of the Component of Good Death Questionnaire Indonesian Version 27
Construct Validity Results 27
Component of Good Death from Advanced Cancer Patient’s Perspectives in Indonesia 35
4.3 Patient’s Symptom Distress, Anxiety, Depression and Spiritual Well-being 39
4.4 Correlations between ECOG, SDS, HADS, Facit-Sp 12, and each Domain and subdomain on Component of Good Death 40
4.5 The differences of ECOG, anxiety, depression, Facit Sp-12 and good death domain according to Patients’ Disease Awareness 43
4.6. Significant Predictors in each domain of Good Death 43
4.7 Comparison between Component of Good Death Questionnaire Indonesian-Version and the Original Component of Good Death Questionnaire 46
CHAPTER FIVE DISCUSSION 48
5.1 Domains of Good Death under Indonesian Culture among Advanced Cancer Patients 49
Conceptualization domain of good death by Construct Validity 49
Advanced Cancer Patients’ Perspectives of Good Death in Indonesia 51
5.2 Patient’s Symptom Experiences 54
5.3 Correlation between ECOG Score, Symptom Distress, Anxiety & Depression and Spiritual Well-Being among Advanced Cancer Patients 57
5.4 Influence of Disease Awareness to Advanced Cancer Patients 58
5.5 The Predictors of Good Death 58
5.6 Challenges, Strengths and Limitation of the Current Research 61
5.7 Implications 61
5.8 Further Directions 62
5.9 Conclusions 62
REFERENCES 63
APPENDIXES 77
Appendix 1.Inform Consent Form 77
Appendix 2. Instruments 78
I. Demographic Data &Clinical Information 78
II. Symptom Distress Scale 82
III. Component of Good Death 88
IV. Hospital Anxiety and Depression Scale 96
V. FACIT-Sp-12 100
Appendix 3. IRB Approval 102
Appendix 4. Hospital Permit for Research 103
Appendix 5. Author’s Permission to Translate 104
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