不確定感是癌症病患在疾病過程中一個重要的影響因素，國內這方面的質性研究相當有限，故本研究目的在探討癌症病患疾病不確定感受與其因應策略應用之真實內涵，以半結構式的訪談指引收集主題資料，以立意取樣方式於南部某醫學中心之七位癌症病患進行深度訪談，資料內容以質性研究法之開放性編碼進行分析與歸納。結果顯示：（一）整個患病過程對疾病之不確定感都存有擔心與恐懼的感受。（二）理性層面的因應策略主要是尋求資訊與面對現實，而感性層面的因應策略主要是正向思考與尋求慰藉。（三）醫療支持與身體不適是兩個影響疾病不確定感受的主要因素，醫療支持是具有正向的影響，而身體不適是具有負向的影響。（四）社會支持是因應策略的主要影響因素。本研究結果建議醫護人員在照顧病人時，應該更為主動評估病患對病情瞭解之程度，適時告知疾病的相關訊息，以減輕其擔心或恐懼；腫瘤科病房最好能設置心理諮商師，滿足病患這方面的需求。本研究可提供相關學術之補充，亦可作為建構本土癌症照護模式之參考，提升腫瘤病患照護品質。 Uncertainty is one of an import factor during illness process of cancer patients. There are limited qualitative studies in Taiwan. The purpose of the study is to explore the illness uncertainty and coping strategies of reality feeling in cancer patients. The study involves an exploration on the essence and contents related to patient’s experiences of uncertainty and coping strategies. The data were collected from seven oncology inpatients in a medical oncology unit at a university hospital in southern Taiwan and with deep interviews by a semi-structure guilds. The interviews will be taped and the qualitative data will be analyzed by open coding process. The analyses were show：（1）Patients were worried and faired feeling about illness uncertainty in all illness process.（2）To search information and face to the facts were used in the resonable coping strategies , positive thinking and searching mind support are used in the emotional coping strategies.（3）Medical support and discomfort are the main influence factor to the illness uncertainty. Medical support is the positive influence factor and discomfort is the negative influence factor.（4）Social support is the main influence factor to the coping strategies. It was suggest that care giver ought to assess patients recognize about illness, and talking about information in time in order to reduce worry and fair feeling in this study. The oncology unit should have psychosocial consultants, to match patients need. The essay can be as teaching material of nursing education and useful reference to enhance the quality of a caring and facilitate native nursing.
