本研究之目的旨在探討婦癌存活者之害怕癌症復發、疾病不確定感及生活品質之間的相關性。採橫斷性、方便取樣，藉由結構式問卷調查收集資料，針對台灣地區某醫學中心婦癌門診病人為收案對象。問卷內容包括:基本人口學與疾病相關資料、測量工具採用存活者顧慮評估量表中文版(Assessment of Survivor Concern, ASC)、Mishel疾病不確定感量表中文版、臺灣中文版生活品質核心量表（the European Organization for Research and Treatment of Cancer’s Quality-of-Life Questionnaire-Core 30 items, EORTC QLQ-C30）。運用SPSS 22.0版統計套裝軟體進行資料編碼、建檔與統計與分析。研究結果發現婦癌存活者平均年齡為54.6歲，多數已婚，教育程度大部分為高中職或專科。婦癌診斷以子宮內膜癌最多(48.67%)和第一期佔多數(53.62%)，罹病時間大多數在一年以內(84.40%)；選擇治療的方式以手術+放射治療(含單純放射線)佔一半以上(55.33%)。
研究結果顯示，害怕癌症復發、疾病不確定感與生活品質有顯著相關。身體功能題組的生活品質分數在婦癌期別(F=4.39, p=0.005)、疾病嚴重度(F=4.51, p=0.012)有顯著之差異。角色功能題組的生活品質分數在罹癌前後工作的改變(t=2.56, p=0.011)、宗教信仰(t=-2.17, p=0.031)、身體活動功能(t=2.92, p=0.004)、婦癌期別(F=9.02, p<0.001)、以及治療方式(F=2.81, p=0.041)有顯著之差異。認知功能題組的生活品質分數在目前的工作狀況(t=2.49, p=0.014)、服用抗焦慮/憂鬱藥物(t=2.01, p=0.046)有顯著之差異。整體健康生活品質分數之預測因素有疾病不確定感(β=-0.377)與身體活動功能(β=-0.27)，解釋率為23.7%。

The purpose of the study is to explore the relationships between the fear of cancer recurrence, disease uncertainty, and quality of life in survivors of gynecological cancer patients. The research is a cross-sectional design with a convenience sample. The data are collected through a structured questionnaire. Participants are from a medical center of the gynecological outpatient clinic. The questionnaire included demographic and disease related variables, Assessment of Survivor Concern (ASC), Mishel’s uncertainty questionnaire, and the European Organization for Research and Treatment of Cancer’s Quality-of-Life Questionnaire (EORTC QLQ-C3)。SPSS 22.0 is used for data coding and statistical analysis.
Results revealed that participants with a mean age of 54.6years, married, and high school or higher educational level. Participants are diagnosed mainly with endometrial cancer (48.67%) within one year (84.40%), and cancer stage I (53.62%). Cancer treatment included mainly surgery and radiation therapy (55.33%)。
The results of the correlational analyses indicated that the fear of cancer recurrence, disease uncertainty, and quality of life are significantly related. Physical function of the quality of life is related to cancer stage (F=4.39, p=0.0056), and disease severely (F=4.51, p=0.012). Role function of the quality of life is correlated with job change (t=2.56, p=0.011), religious (t=-2.17, p=0.0316), physical activity function (t=2.92, p=0.004), cancer stage (F=9.02, p<0.0001), and treatment types (F=2.81, p=0.0414). Cognitive function of the quality of life is associated with current working condition (t=2.49, p=0.0140), and taking anxiety or depression medications (t=2.01, p=0.046). The prediction factors for the quality of life are disease uncertainty (β=-0.377) and physical activity function (β=-0.270), and both variables explained 23.7% of the variance in the quality of life.

第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究的重要性與目的 2
第三節 研究問題 3
第四節 名詞定義 4
ㄧ、婦癌存活者 4
二、害怕癌症復發 4
三、疾病不確定感 4
四、生活品質 4
第二章 文獻探討 5
第一節 婦癌病人的治療方式 5
一、婦癌的疾病特性與治療方式 5
第二節 婦癌病人害怕復發之概念與相關研究 8
一、害怕復發的定義與概念 8
二、害怕復發之測量工具 9
三、影響婦癌病人害怕復發之相關研究 10
第三節 婦癌病人不確定感之概念與相關研究 11
一、不確定感的定義與概念 11
二、不確定感之測量工具 12
三、影響婦癌病人不確定感之相關研究 13
第四節 婦癌病人生活品質之概念與相關研究 13
一、生活品質的定義與概念 13
二、生活品質之測量工具 14
三、影響婦癌病人生活品質之相關研究 15
第三章 研究方法 20
第一節 研究設計 20
第二節 研究架構 20
第三節 研究對象與場所 21
第四節 研究工具 22
一、基本資料與疾病特性問卷 22
二、疾病不確定感量表 22
三、台灣中文版生活品質核心量表 23
第五節 資料收集 25
第六節 資料分析方法 25
ㄧ、描述性統計（Descriptive statistics） 25
二、推論性統計(Inferential Statistics) 25
第七節 研究倫理考量 26
第四章 研究結果 27
第一節 研究對象基本屬性以及量表之描述性分析 27
一、研究對象基本屬性 27
二、疾病不確定感、害怕復發、生活品質之描述性分析 29
第二節 人口學變項、疾病相關因素對疾病不確定感、害怕癌症復發及生活品質之影響 34
一、基本人口學、疾病相關因素對疾病不確定感之影響 34
二、基本人口學、疾病相關因素對害怕癌症復發之影響 36
三、基本人口學、疾病相關因素對生活品質之影響 38
第三節 疾病不確定感、害怕癌症復發與生活品質之相關分析 60
第四節 生活品質各領域之預測因素 61
第五章 研究討論 68
第一節 婦癌存活者害怕癌症復發與相關因素之探討 68
一、婦癌存活者之害怕癌症復發 68
二、影響婦癌存活者害怕癌症復發之相關因素 68
第二節 婦癌存活者疾病不確定感與相關因素之探討 70
一、婦癌存活者之疾病不確定感 70
二、影響婦癌存活者疾病不確定感之相關因素 71
第三節 婦癌存活者生活品質表現與相關因素 72
一、婦癌存活者之生活品質 72
二、整體健康生活品質的預測因素 72
三、功能題組的預測因素 73
四、症狀題組的預測因素 75
五、單題問題的預測因素 76
第六章 結論 …… 78
參考文獻 80
 
表目錄
表4-1-1研究對象的基本屬性分佈狀況 28
表4-1-2 疾病不確定感量表得分佈情形 29
表4-1-3害怕癌症復發量表得分情形 30
表4-1-4生活品質量表得分情形 31
表4-1-5、生活品質核心量表單題得分情形 33
表4-2-1基本人口學、疾病相關因素與疾病不確定感分數之差異性分析 34
表4-2-2基本人口學、疾病相關因素與害怕癌症復發分數之差異性分析 36
表4-2-3基本人口學、疾病相關因素與整體健康生活品質分數之差異性分析 39
表4-2-4基本人口學、疾病相關因素與生活品質分數功能題組-身體功能、角色功能、認知功能題組之差異性分析 42
表4-2-5基本人口學、疾病相關因素與生活品質分數功能題組之情緒功能、社會功能與整體健康生活品質之差異性分析 45
表4-2-6基本人口學、疾病相關因素與生活品質分數症狀題組-疲倦、疼痛、噁心嘔吐題組之差異性分析 49
表4-2-7基本人口學、疾病相關因素與生活品質分數單題問題-呼吸困難、失眠、食慾不振之差異性分析 54
表4-2-8基本人口學、疾病相關因素與生活品質分數單題問題-便秘、腹瀉、財務困難之差異性分析 57
表4-3-1 研究對象疾病不確定感、害怕癌症復發與生活品質之相關分析 61
表4-4-1影響研究對象生活品質(整體健康生活品質)之多元迴歸分析 62
表4-4-2 影響研究對象生活品質(身體功能)之多元迴歸分析 63
表4-4-3 影響研究對象生活品質(角色功能)之多元迴歸分析 63
表4-4-4 影響研究對象生活品質(認知功能)之多元迴歸分析 63
表4-4-5 影響研究對象生活品質(情緒功能)之多元迴歸分析 63
表4-4-6 影響研究對象生活品質(社會功能)之多元迴歸分析 64
表4-4-7影響研究對象生活品質(疲倦)之多元迴歸分析 64
表4-4-8 影響研究對象生活品質(疼痛)之多元迴歸分析 65
表4-4-9 影響研究對象生活品質(噁心嘔吐)之多元迴歸分析 65
表4-4-10 影響研究對象生活品質(呼吸困難)之多元迴歸分析 66
表4-4-11 影響研究對象生活品質(失眠)之多元迴歸分析 66
表4-4-12 影響研究對象生活品質(食慾不振)之多元迴歸分析 66
表4-4-13 影響研究對象生活品質(便秘)之多元迴歸分析 67
表4-4-14影響研究對象生活品質(腹瀉)之多元迴歸分析 67
表4-4-15 影響研究對象生活品質(財務困難)之多元迴歸分析 67 

圖目錄
圖3- 1研究架構 21

中文文獻
台灣婦癌醫學會(2018) http://www.tago.org.tw/index.asp
台灣癌症臨床研究合作組織（2011） ‧婦癌臨床診療指引。臺北：國家衛生研究院。取自
https://tcog.nhri.org.tw/wpcontent/uploads/2020/05/100gogpg.pdf
吳淑芬、林佑樺、李來涼、簡婉儀(2014)・婦科癌症病人的疾病不確定感與憂鬱之相關性探討・護理暨健康照護研究，10(2)，83-93。https://doi.org/10.6225/jnhr.10.2.83
李佳玲(2015)‧照護一位子宮內膜癌併卵巢癌復發婦女的護理經驗‧長庚護理，26(2)，232-241。https://doi:10.3966/102673012015062602011
季瑋珠, 楊志新、許駿、 賴佳君 (2002) ‧ 癌症病人特定疾病 EORTC 生活品質量表簡介‧台灣醫學，6(2)，220-227.
許淑蓮、黃秀梨(1966)‧Mishel疾病不確定感量表之中文版測試‧護理研究，4(1)，59-68。
葉月珍、黃曉峰、呂建興(2019)‧婦癌婦女焦慮憂鬱及生活品質之相關因素探討‧護理雜誌，66(6)，43-53。
維基百科（2022）‧害怕 6 月 22日取自 https://zh.wikipedia.org/zh-tw/%E6%81%90%E6%83%A7
行政院衛生福利部國民健康局(2022，4 月)中華民國108 年癌症登記報告取自。
https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=269&pid=14913


英文文獻
Afiyanti, Y., Milanti, A., & Putri, R. H. (2018). Supportive care needs in predicting the quality of life among gynecological cancer patients. Canadian oncology nursing journal = Revue canadienne de nursing oncologique, 28(1), 22–29. https://doi.org/10.5737/236880762812229
Bahadur A., Vdovichenko N., Mundhra R,Chawla L., Yadav A., Kumari P., Kumari S.,Bhattacharya N., Kashibhatla J.,Das D.,Prateek S.,Chaturvedi J .(2019).EP1094 Quality of life assessment in gynae-onco survivors. International Journal of Gynecologic Cancer ,29(4),573.
Budner, S. (1962). Intolerance of ambiguity as a personality variable. Journalof
Personality, 30, 29-50.
Beckjord, E. B., Reynolds, K. A., & Rechis, R. (2022). Psychological Factors and Survivorship: A Focus on Post-treatment Cancer Survivors.Psychological Aspects of Cancer (pp. 21-39). Springer, Cham.
Ben-Arye, E., Samuels, N., Schiff, E., Raz, O. G., Sharabi, I. S., & Lavie, O. (2015). Quality-of-life outcomes in patients with gynecologic cancer referred to integrative oncology treatment during chemotherapy. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 23(12), 3411–3419. https://doi.org/10.1007/s00520-015-2690-0
Baxter, M. F., Newman, R., Longpré, S. M., & Polo, K. M. (2017). Occupational Therapy's Role in Cancer Survivorship as a Chronic Condition. The American journal of occupational therapy : official publication of the American Occupational Therapy Association, 71(3), 7103090010P1–7103090010P7. https://doi.org/10.5014/ajot.2017.713001
Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R. L., Torre, L. A., & Jemal, A. (2018). Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians, 68(6), 394–424. https://doi.org/10.3322/caac.21492
Bottorff, J. L., Katner, P. A., Johnson, J. L., Lovato, C. Y., & Joab, S. A. (1998). Communicating cancer risk information: The challenges of uncertainty. Patient education and counseling, 33(1), 67-81.
Bjordal, K., & Kaasa, S. (1992). Psychometric validation of the EORTC Core Quality of Life Questionnaire, 30-item version and a diagnosis -specific module for head and neck cancer patient. Acta Oncologica, 31, 311-321.
Cerdán Llach, I. (2021). Protocolo asistencial para el manjo de las pacientes con cáncer de endometrio.
Colombo, N., Sessa, C., Bois, A. D., Ledermann, J., McCluggage, W. G., McNeish, I., Morice, P., Pignata, S., Ray-Coquard, I., Vergote, I., Baert, T., Belaroussi, I., Dashora, A., Olbrecht, S., Planchamp, F., Querleu, D., & ESMO–ESGO Ovarian Cancer Consensus Conference Working Group (2019). ESMO-ESGO consensus conference recommendations on ovarian cancer: pathology and molecular biology, early and advanced stages, borderline tumours and recurrent disease. International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, ijgc-2019-000308. Advance online publication. https://doi.org/10.1136/ijgc-2019-000308
Cortez, A. J., Tudrej, P., Kujawa, K. A., & Lisowska, K. M. (2018). Advances in ovarian cancer therapy. Cancer chemotherapy and pharmacology, 81(1), 17–38. https://doi.org/10.1007/s00280-017-3501-8
Chow, K. M., So, W., Choi, K. C., & Chan, C. (2018). Sexual function, psychosocial adjustment to illness, and quality of life among Chinese gynaecological cancer survivors. Psycho-oncology, 27(4), 1257–1263. https://doi.org/10.1002/pon.4663
Chow, K. M., Chan, C. W., Choi, K. C., Siu, K. Y., Fung, H. K., & Sum, W. M. (2020). A theory‐driven psycho‐educational intervention programme for gynaecological cancer patients during treatment trajectory: A randomised controlled trial. Psycho‐Oncology, 29(2), 437-443.
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences. New Jersey: Hillsdale.
Custers, J. A., van den Berg, S. W., van Laarhoven, H. W., Bleiker, E. M., Gielissen, M. F., & Prins, J. B. (2014). The Cancer Worry Scale: detecting fear of recurrence in breast cancer survivors. Cancer Nursing, 37(1), E44-E50.
Crist, J. V., & Grunfeld, E. A. (2013). Factors reported to influence fear of recurrence in cancer patients: a systematic review. Psycho-oncology, 22(5), 978–986. https://doi.org/10.1002/pon.3114
Cohen, J.(1988). Statistical power analysis for the behavioral sciences Academic press.
Clevenger, L., Schrepf, A., Degeest, K., Bender, D., Goodheart, M., Ahmed, A., … Lutgendorf, S. K. (2013). Sleep disturbance, distress, and quality of life in ovarian cancer patients during the first year after diagnosis. Cancer, 119(17),
3234–3241. https://doi.org/10.1002/cncr.28188
De Felice, F., Vertechy, L., Giudice, E., Ergasti, R., Boccia, S., Fagotti, A., Scambia, G., & Marchetti, C. (2021). Evolution of Clinical Trials in Ovarian Cancer Management over the Past 20 Years: Never Settle Down, Always Go Beyond. Journal of oncology, 2021, 1682532. https://doi.org/10.1155/2021/1682532
De Souza, C., Santos, A., Rodrigues, E., & Dos Santos, M. A. (2021). Experience of Sexuality in Women with Gynecological Cancer: Meta-Synthesis of Qualitative Studies. Cancer investigation, 39(8), 607–620. https://doi.org/10.1080/07357907.2021.1912079
Donovan, E., Reade, C. J., Eiriksson, L. R., Pond, G. R., Arora, N., Elit, L., ... & Kong, I. (2018). Outcomes of adjuvant therapy for stage IA serous endometrial cancer. Cureus, 10(9).
Deane, K. A., & Degner, L. F. (1998). Information needs, uncertainty, and anxiety in women who had a breast biopsy with benign outcome. Cancer nursing, 21(2), 117–126. https://doi.org/10.1097/00002820-199804000-00005
Ekdahl, L., Crusensvärd, M., Reynisson, P., Lönnerfors, C., & Persson, J. (2021). Quality of life and long-term clinical outcome following robot-assisted radical trachelectomy. Eur J Obstet Gynecol Reprod Biol, 267, 234-240. https://doi.org/10.1016/j.ejogrb.2021.11.018
Frangou, E., Bertelli, G., Love, S., Mackean, M. J., Glasspool, R. M., Fotopoulou, C.,
& Blagden, S. P. (2021). OVPSYCH2: A randomized controlled trial of
psychological support versus standard of care following chemotherapy for
ovarian cancer. Gynecologic Oncology, 162(2), 431-439.
Frumovitz, M., Obermair, A., Coleman, R. L., Pareja, R., Lopez, A., Ribero, R., Isla, D., Rendon, G., Bernardini, M. Q., Buda, A., Moretti-Marquez, R., Zevallos, A., Vieira, M. A., Zhu, T., Land, R. P., Nicklin, J., Asher, R., Robledo, K. P., Gebski, V., & Ramirez, P. T. (2020). Quality of life in patients with cervical cancer after open versus minimally invasive radical hysterectomy (LACC): a secondary outcome of a multicentre, randomised, open-label, phase 3, non-inferiority trial. The Lancet. Oncology, 21(6), 851–860. https://doi.org/10.1016/S1470-2045(20)30081-4
Ferrans, C. E., & Powers, M. J. (1992). Psychometric assessment of the Quality of Life Index. Research in nursing & health, 15(1), 29–38. https://doi.org/10.1002/nur.4770150106
Gotay, C. C., & Pagano, I. S. (2007). Assessment of Survivor Concerns (ASC): a newly proposed brief questionnaire. Health and quality of life outcomes, 5, 15. https://doi.org/10.1186/1477-7525-5-15
Götze, H., Taubenheim, S., Dietz, A., Lordick, F., & Mehnert, A. (2018). Comorbid conditions and health-related quality of life in long-term cancer survivors-associations with demographic and medical characteristics. Journal of cancer survivorship : research and practice, 12(5), 712–720. https://doi.org/10.1007/s11764-018-0708-6
Hill, E.-M., & Hamm, A. (2019). Intolerance of uncertainty, social support, and loneliness in relation to anxiety and depressive symptoms among women diagnosed with ovarian cancer. Psycho-Oncology, 28(3), 553–560. https://doi.org/10.1002/pon.4975
Hilton, B. A. (1992). Perceptions of uncertainty: Its relevance to life-threatening and chronic illness. Critical Care Nurse, 12(2), 70-73.
Hamama-Raz, Y., Shinan-Altman, S., & Levkovich, I. (2022). The intrapersonal and interpersonal processes of fear of recurrence among cervical cancer survivors: a qualitative study. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 30(3), 2671–2678. https://doi.org/10.1007/s00520-021-06695-8
Herschbach, P., Keller, M., Knight, L., Brandl, T., Huber, B., Henrich, G., &
Marten-Mittag, B. (2004). Psychological problems of cancer patients: a cancer distress screening with a cancer-specific questionnaire. British Journal of Cancer, 91(3), 504-511. doi: 10.1038/sj.bjc.6601986
Hsu, H. C., Tsai, S. Y., Wu, S. L., Jeang, S. R., Ho, M. Y., Liou, W. S., Chiang, A. J., & Chang, T. H. (2017). Longitudinal perceptions of the side effects of chemotherapy in patients with gynecological cancer. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 25(11), 3457–3464. https://doi.org/10.1007/s00520-017-3768-7
Harter, P., Sehouli, J., Vergote, I., Ferron, G., Reuss, A., Meier, W., Greggi, S., Mosgaard, B. J., Selle, F., Guyon, F., Pomel, C., Lécuru, F., Zang, R., Avall-Lundqvist, E., Kim, J. W., Ponce, J., Raspagliesi, F., Kristensen, G., Classe, J. M., Hillemanns, P., … DESKTOP III Investigators (2021). Randomized Trial of Cytoreductive Surgery for Relapsed Ovarian Cancer. The New England journal of medicine, 385(23), 2123–2131. https://doi.org/10.1056/NEJMoa2103294
Ji, J., Zhu, H., Zhao, J. Z., Yang, Y. Q., Xu, X. T., & Qian, K. Y. (2020). Negative
emotions and their management in Chinese convalescent cervical cancer
patients: a qualitative study. Journal of International Medical Research, 48(9),
0300060520948758.
Jiang, X., & He, G. (2012). Effects of an uncertainty management intervention on
uncertainty, anxiety, depression, and quality of life of chronic obstructive
pulmonary disease outpatients. Research in nursing & health, 35(4), 409–418.
https://doi.org/10.1002/nur.21483
Koch, L., Jansen, L., Brenner, H., & Arndt, V. (2013). Fear of recurrence and disease progression in long-term (≥ 5 years) cancer survivors--a systematic review of quantitative studies. Psycho-oncology, 22(1), 1–11. https://doi.org/10.1002/pon.3022
Karawekpanyawong, N., Kaewkitikul, K., Maneeton, B., Maneeton, N., & Siriaree, S. (2021). The prevalence of depressive disorder and its association in Thai cervical cancer patients. PLoS One, 16(6), e0252779. https://doi.org/10.1371/journal.pone.0252779
Kluska, A., Moszynska-Zielinska, M., Zytko, L., Tracz, N., Tomasik, B., Stanislawek, A., Luniewska-Bury, J., Fijuth, J., & Gottwald, L. (2021). The impact of adjuvant treatment with external beam radiotherapy and vaginal brachytherapy on health-related quality of life in patients with early-stage endometrioid endometrial carcinoma - initial results of a prospective study. Ginekol Pol. https://doi.org/10.5603/GP.a2021.0112
Klikovac, T., & Djurdjevic, A. (2010). Psychological aspects of the cancer patients' education: thoughts, feelings, behavior and body reactions of patients faced with diagnosis of cancer. Journal of B.U.ON. : official journal of the Balkan Union of Oncology, 15(1), 153–156.
Logue, C. A., Pugh, J., & Jayson, G. (2020). Psychosexual morbidity in women with ovarian cancer. International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, 30(12), 1983–1989. https://doi.org/10.1136/ijgc-2020-002001
Lebel, S., Maheu, C., Tomei, C., Bernstein, L. J., Courbasson, C., Ferguson, S., Harris, C., Jolicoeur, L., Lefebvre, M., Muraca, L., Ramanakumar, A. V., Singh, M., Parrott, J., & Figueiredo, D. (2018). Towards the validation of a new, blended theoretical model of fear of cancer recurrence. Psycho-oncology, 27(11), 2594–2601. https://doi.org/10.1002/pon.4880
Lim, E., & Humphris, G. (2020). The relationship between fears of cancer recurrence and patient age: A systematic review and meta‐analysis. Cancer Reports, 3(3), e1235.
Llewellyn, C. D., Weinman, J., McGurk, M., & Humphris, G. (2008). Can we predict which head and neck cancer survivors develop fears of recurrence?. Journal of psychosomatic research, 65(6), 525–532. https://doi.org/10.1016/j.jpsychores.2008.03.014
Lin, H., Chan, S. W. c., Ye, M., Wang, Y., Liu, H., Li, M., Liu, S., & Zhu, J. (2021). A multi‐centre randomized controlled trial of mobile gynaecological cancer support program for patients with gynaecological cancer undergoing chemotherapy: Study protocol. Journal of Advanced Nursing, 77(5), 2539-2548.
Lee-Jones, C., Humphris, G., Dixon, R., & Hatcher, M. B. (1997). Fear of cancer recurrence - A literature review and proposed cognitive formulation to explain exacerbation of recurrence fears. Psycho-Oncology, 6(2), 95-105. doi: 10.1002/(sici)1099-1611(199706)6:2<95::aid-pon250>3.0.co;2-b
LaNoue, M. D., Gerolamo, A. M., Powell, R., Nord, G., Doty, A. M., & Rising, K. L. (2020). Development and preliminary validation of a scale to measure patient uncertainty: The "Uncertainty Scale". Journal of health psychology, 25(9), 1248–1258. https://doi.org/10.1177/1359105317752827
Lin C. C. (2017). When Cancer Care Becomes a Long-term Care Issue: Are We Ready?. Cancer nursing, 40(5), 341–342. https://doi.org/10.1097/NCC.0000000000000520
Levesque, J. V., Farnsworth, C., Luckey, R., Hart, R., & Hegarty, S. (2022). Fear, worry and sadness: an exploratory study of psychological wellbeing in men caring for their partner with ovarian cancer. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 30(1), 825–833. https://doi.org/10.1007/s00520-021-06488-z
Medley, N., Robinson, A., Bambury, I., & Rattray, C. (2019). EP1291 What factors
affect quality of life in patients with gynaecoloc cancers? A prospective
cohort study at the University Hospital of the West Indies. International Journal of Gynecological Cancer, 29(Suppl 4), A650-A650.
McCormick, K. M. (2002). A concept analysis of uncertainty in illness. The Journal of Nursing Scholarship, 34(2), 127-131.
Molleman, E., Pruyn, J., & van Knippenberg, A. (1986). Social comparison processes
among cancer patients. British Journal of Social Psychology, 25(1), 1-13.
Myers, S. B., Manne, S. L., Kissane, D. W., Ozga, M., Kashy, D. A., Rubin, S., Heckman, C., Rosenblum, N., Morgan, M., & Graff, J. J. (2013). Social-cognitive processes associated with fear of recurrence among women newly diagnosed with gynecological cancers. Gynecologic oncology, 128(1), 120–127. https://doi.org/10.1016/j.ygyno.2012.10.014
Maheu, C., Singh, M., Tock, W. L., Eyrenci, A., Galica, J., Hébert, M., Frati, F., & Estapé, T. (2021). Fear of Cancer Recurrence, Health Anxiety, Worry, and Uncertainty: A Scoping Review About Their Conceptualization and Measurement Within Breast Cancer Survivorship Research. Frontiers in psychology, 12, 644932. https://doi.org/10.3389/fpsyg.2021.644932
McCluggage W. G. (2021). Progress in the pathological arena of gynecological cancers. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 155 Suppl 1, 107–114. https://doi.org/10.1002/ijgo.13871
Matulonis, U. A., Kornblith, A., Lee, H., Bryan, J., Gibson, C., Wells, C., . . . Penson, R. (2008). Long-term adjustment of early-stage ovarian cancer survivors.
International Journal of Gynecological Cancer 18(6), 1183-1193. doi: 10.1111/j.1525-1438.2007.01167.x
Mishel, M. H. (1981).The measurement of uncertainty in illness.Nursing Research,30(5), 258-263
Mishel, M. H. (1988).Uncertainty in illness. Image the Journal of Nursing Scholarship,20(4), 225-232.
Mishel, M. H. & Braden, C. J. (1988). Finding meaning: antecedents of uncertainty in illness.Nursing Research, 37(2), 98-104.
McCormick K. M. (2002). A concept analysis of uncertainty in illness. Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing, 34(2), 127–131. https://doi.org/10.1111/j.1547-5069.2002.00127.x
Ma, S. G., Deng, X., Xing, L., & Huang, Y. (2021). Postoperative health-related quality of life of patients with gynecological malignancy: a meta-analysis. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 29(8), 4209–4221. https://doi.org/10.1007/s00520-021-06053-8
NCCN Guidelines in Oncology (2018). Ovarian Cancer
http://www.nccn.org/professionals/physician_gls/f_ guidelines.asp
Nursing experience of a female patient with endometrial carcinoma and recurrence of ovarian cancer. Chang Gung Nursing,2015 26(2), 232-241. http://doi.org/10.3966/1026730120 15062602011
National Comprehensive Cancer Network NCCN guidelines for treatment of
cancer by site Retrieved from https://www.nccn.org/professionals/physician_gls/default.aspx (2020)
Omran, S., & Mcmillan, S. (2018). Symptom Severity, Anxiety, Depression, Self- Efficacy and Quality of Life in Patients with Cancer. Asian Pacific journal of cancer prevention : APJCP, 19(2), 365–374. https://doi.org/10.22034/APJCP.2018.19.2.365
Perkowska, E., Terlikowski, S., Terlikowski, R., Moczydłowska, A., Markowska, T., & Marcinowicz, L(2019). Evaluation of the quality of life of ovarian cancer patients in the context of selected quantitative variables such as body mass, number of miscarriages and time from diagnosis. Family Medicine & Primary Care Review, 21(4), 355-359.
Poiseuil, M., Tron, L., Woronoff, A. S., Trétarre, B., Dabakuyo-Yonli, T. S., Fauvernier, M., Roche, L., Dejardin, O., Molinié, F., Launoy, G., & French Network of Cancer Registries (FRANCIM) (2022). How do age and social environment affect the dynamics of death hazard and survival in patients with breast or gynecological cancer in France?. International journal of cancer, 150(2), 253–262. https://doi.org/10.1002/ijc.33803
Philips, D. (2008). Quality of Life and Sustainability. Proceedings of 2008 International Conference. June, 18-19, Pingtung:MIT. Reis N, Beji NK,Coskun A. Quality of life and sexual functioning in gynecological cancer patients: results from quantitative and qualitative data. Eur J Oncol J Oncol Nurs. 2010;14:137–146.
Perkowska, E., Terlikowski, S., Terlikowski, R., Moczydlowska, A., Markowska, T., & Marcinowicz, L. (2019). Evaluation of the quality of life of ovarian cancer patients in the context of selected quantitative variables such as body mass, number of miscarriages and time from diagnosis. Family Medicine & Primary Care Review, 21(4), 355–359. https://doi.org/10.5114/fmpcr.2019.90167
Reb, A. M., & Cope, D. G. (2019). Quality of Life and Supportive Care Needs of Gynecologic Cancer Survivors. Western journal of nursing research, 41(10), 1385–1406. https://doi.org/10.1177/0193945919846901
Rudy, L., Maheu, C., Körner, A., Lebel, S., & Gélinas, C. (2020). The FCR‐1: initial
validation of a single‐item measure of fear of cancer recurrence. Psycho‐
Oncology, 29(4), 788-795.
Rai, S. (2021). Quality of life and sexual dysfunction in cervical cancer
survivors. Nepal Journal of Obstetrics and Gynaecology, 16(1).
Rodriguez-Wallberg, K. A., Hao, X., Marklund, A., Johansen, G., Borgström, B., & Lundberg, F. E. (2021). Hot Topics on Fertility Preservation for Women and Girls-Current Research, Knowledge Gaps, and Future Possibilities. Journal of clinical medicine, 10(8), 1650. https://doi.org/10.3390/jcm10081650
Smith, T. B., Workman, C., Andrews, C., Barton, B., Cook, M., Layton, R., Morrey, A., Petersen, D., & Holt-Lunstad, J. (2021). Effects of psychosocial support interventions on survival in inpatient and outpatient healthcare settings: A meta-analysis of 106 randomized controlled trials. PLoS medicine, 18(5), e1003595. https://doi.org/10.1371/journal.pmed.1003595
Simonelli, L. E., Siegel, S. D., & Duffy, N. M. (2017). Fear of cancer recurrence: a theoretical review and its relevance for clinical presentation and management. Psycho-oncology, 26(10), 1444–1454. https://doi.org/10.1002/pon.4168
Skaali, T., Fossa, S. D., Bremnes, R., Dahl, O., Haaland, C. F., Hauge, E. R., . . . Dahl
A. A. (2009). Fear of recurrence in long-term testicular cancer survivors
Psycho-Oncology, 18(6), 580-588. doi: 10.1002/pon.1437
Sharpe, L., Curran, L., Butow, P., & Thewes, B. (2018). Fear of cancer recurrence and death anxiety. Psycho-oncology, 27(11), 2559–2565. https://doi.org/10.1002/pon.4783
Smith, A., Jones, T. N., Miao, D., & Fader, A. N. (2021). Minimally Invasive Radical Hysterectomy for Cervical Cancer: A Systematic Review and Meta-analysis. Journal of minimally invasive gynecology, 28(3), 544–555.e7. https://doi.org/10.1016/j.jmig.2020.12.023
Small, W., Jr, Bacon, M. A., Bajaj, A., Chuang, L. T., Fisher, B. J., Harkenrider, M. M., Jhingran, A., Kitchener, H. C., Mileshkin, L. R., Viswanathan, A. N., & Gaffney, D. K. (2017). Cervical cancer: A global health crisis. Cancer, 123(13), 2404–2412. https://doi.org/10.1002/cncr.30667
Simard, S., Savard, J., & Ivers, H. (2010). Fear of cancer recurrence: specific profiles and nature of intrusive thoughts. Journal of cancer survivorship : research and practice, 4(4), 361–371. https://doi.org/10.1007/s11764-010-0136-8
Schulman-Green, D., Jaser, S., Martin, F., Alonzo, A., Grey, M., McCorkle, R., Redeker, N. S., Reynolds, N., & Whittemore, R. (2012). Processes of self-management in chronic illness. Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing, 44(2), 136–144. https://doi.org/10.1111/j.1547-5069.2012.01444.x
Suvannasarn, R., Muangmool, T., Wongpakaran, N., & Charoenkwan, K. (2021). Health-related quality of life for early-stage cervical cancer survivors after primary radical surgery followed by radiotherapy versus radical surgery alone. Journal of Obstetrics and Gynaecology, 1-8.
Tarhani, M., Goudarzi, F., Hasanv, S., Ebrahimzadeh, F., & Rassouli, M. (2020). Uncertainty, anxiety, depression and the quality of life in patients with cancer. Onkologia i Radioterapia, 13(4), 124-130.
Tsai, L. Y., Lee, S. C., Wang, K. L., Tsay, S. L., & Tsai, J. M. (2018). A correlation study of fear of cancer recurrence, illness representation, self-regulation, and quality of life among gynecologic cancer survivors in Taiwan. Taiwanese journal of obstetrics & gynecology, 57(6), 846–852. https://doi.org/10.1016/j.tjog.2018.10.014
Tsai, L. Y., Wang, K. L., Liang, S. Y., Tsai, J. M., & Tsay, S. L. (2017). The Lived Experience of Gynecologic Cancer Survivors in Taiwan. The journal of nursing research : JNR, 25(6), 447–454. https://doi.org/10.1097/JNR.0000000000000229
Techata, A., Muangmool, T., Wongpakaran, N., & Charoenkwan, K. (2022). Effect of cancer stage on health-related quality of life of patients with epithelial ovarian cancer. Journal of Obstetrics and Gynaecology, 42(1), 139-145.
Tsai, L. Y., Wang, K. L., Liang, S. Y., Tsai, J. M., & Tsay, S. L. (2017). The Lived Experience of Gynecologic Cancer Survivors in Taiwan. The journal of nursing research : JNR, 25(6), 447–454. https://doi.org/10.1097/JNR.0000000000000229
Trigg, A., Kelly, M., Iadeluca, L., Chang, J., Moreno-Koehler, A., Yaworsky, A., Krohe, M., Rider, A., Cappelleri, J. C., Cella, D., & Cocks, K. (2021). Reliability, validity and important difference estimates for the NCCN-FACT Ovarian Symptom Index-18 (NFOSI-18). Future Oncol, 17(30), 3951-3964. https://doi.org/10.2217/fon-2021-0358
Tsai, L. Y., Wang, K. L., Tsai, J. M., & Tsay, S. L. (2019). Chinese Version of the Assessment of Survivor Concerns Scale for Gynecological Cancer Survivors: A Psychometric Study in Taiwan. The journal of nursing research : JNR, 27(5), e41. https://doi.org/10.1097/jnr.0000000000000323
Tsai, L. Y., Tsai, J. M., & Tsay, S. L. (2020). Life experiences and disease trajectories in women coexisting with ovarian cancer. Taiwanese journal of obstetrics & gynecology, 59(1), 115–119. https://doi.org/10.1016/j.tjog.2019.11.032
Vickberg S. M. (2003). The Concerns About Recurrence Scale (CARS): a systematic measure of women's fears about the possibility of breast cancer recurrence. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 25(1), 16–24. https://doi.org/10.1207/S15324796ABM2501_03
van Meurs, J., Stommel, W., Leget, C., van de Geer, J., Kuip, E., Vissers, K., ... &
Wichmann, A. (2022). Oncologist responses to advanced cancer patients’ lived
illness experiences and effects: an applied conversation analysis study. BMC
palliative care, 21(1), 1-9.
Wiltink, L. M., King, M., Müller, F., Sousa, M. S., Tang, M., Pendlebury, A., Pittman, J., Roberts, N., Mileshkin, L., Mercieca-Bebber, R., Tait, M. A., Campbell, R., & Rutherford, C. (2020). A systematic review of the impact of contemporary treatment modalities for cervical cancer on women's self-reported health-related quality of life. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 28(10), 4627–4644. https://doi.org/10.1007/s00520-020-05554-2
Wright, J. D. (2017). Management of recurrent or metastatic cervical cancer. In J.
AMelin(Ed.),UpToDate.Retrievedfrom https://www.uptodate.com/contents/management-of-recurrent-or-metastatic-cervical-cancer?search=Management%20of%20recurrent%20or%20metastatic%20cervical%20cancer.&source=search_result&selectedTitle=1~150&usage_type=default&di splay_rank=1
Wijayanti, T., Afiyanti, Y., Rahmah, H., & Milanti, A. (2018). Fear of cancer recurrence and social support among Indonesian gynecological cancer survivors. Archive of Oncology, 24(2), 12-19.
Wilmoth, M. C., Hatmaker-Flanigan, E., LaLoggia, V., & Nixon, T. (2011). Ovarian cancer survivors: qualitative analysis of the symptom of sexuality. Oncology nursing forum, 38(6), 699–708. https://doi.org/10.1188/11.ONF.699-708
WHO Classification of Tumours Editorial Board. Female Genital Tumours. WHO
Classification of Tumours, (5th ed.). IARC; 2020.
Wang, H., Ni, C., Xiao, W., Yang, T., & Sun, W. (2021). Comparison of Radical Surgery and Radiotherapy for the Treatment of Early-Stage Cervical Carcinoma: A Meta-Analysis. Oncology research and treatment, 44(4), 176–183. https://doi.org/10.1159/000509149
Yeh Y. C. (2021). Symptom distress, stress, and quality of life in the first year of gynaecological cancers: A longitudinal study of women in Taiwan. European journal of oncology nursing : the official journal of European Oncology Nursing Society, 53, 101984. https://doi.org/10.1016/j.ejon.2021.101984
Zhang, G., Liu, C., Bai, H., Cao, G., Cui, R., & Zhang, Z. (2019). Combinatorial therapy of immune checkpoint and cancer pathways provides a novel perspective on ovarian cancer treatment. Oncology letters, 17(3), 2583–2591. https://doi.org/10.3892/ol.2019.9902
Zhang Y. (2017). Uncertainty in Illness: Theory Review, Application, and Extension. Oncology nursing forum, 44(6), 645–649. https://doi.org/10.1188/17.ONF.645-649
Zandbergen, N., de Rooij, B. H., Vos, M. C., Pijnenborg, J., Boll, D., Kruitwagen, R., van de Poll-Franse, L. V., & Ezendam, N. (2019). Changes in health-related quality of life among gynecologic cancer survivors during the two years after initial treatment: a longitudinal analysis. Acta oncologica (Stockholm, Sweden), 58(5), 790–800. https://doi.org/10.1080/0284186X.2018.1560498
Zhang X, Sun D, Qin N, Liu M, Jiang N, Li X. Factors Correlated With Fear of Cancer Recurrence in Cancer Survivors: A Meta-analysis. Cancer Nurs. 2021 Sep 23. doi: 10.1097/NCC.0000000000001020. Epub ahead of print. PMID: 34560707.