探討擴增實境衛教影片介入對乳癌術後病人焦慮及憂鬱之成效

研究目的：乳癌是台灣十大癌症死因中的第四位，也是女性罹患癌症的首位。乳癌病人在接受部分或全切除手術後，因術前對手術過程不了解及擔憂術後恢復時間等問題，容易引發焦慮和憂鬱情緒，影響其治療順從性及術後復原。本研究旨在探討擴增實境(Augmented Reality, AR)介入對乳癌術後病人焦慮與憂鬱的影響。研究方法：本研究採實驗性設計，於中部某區域教學醫院進行。研究對象為計畫接受乳房部分切除或全切除之女性乳癌病人，透過隨機分派法將受試者分為實驗組與對照組。對照組接受傳統常規衛教，實驗組除接受傳統常規衛教外，另在手術前一天及手術後第一天接受AR體驗介入。所有受試者在介入前進行前測，並在術後第一天和第二天進行後測。研究工具包括中文版情境焦慮量表和貝克憂鬱量表第二版，及生理反應指標（心跳次數、呼吸速率、血壓、血氧濃度），資料以描述性及推論性統計進行分析。研究結果：本研究收案30位受試者，實驗組16名，對照組14名。兩組於介入前之情境焦慮、憂鬱及各項生理指標經檢定均具備良好同質性。研究結果顯示，於術後第一天，實驗組之情境焦慮分數顯著低於對照組，並呈現中至大效果量；焦慮程度分層分析亦顯示，實驗組由中、重度焦慮轉為輕度焦慮之比例較高。惟於術後第一天及第二天，兩組在憂鬱程度及各項生理反應指標，皆未呈現顯著差異。結論與建議：研究結果顯示，AR衛教介入於乳癌手術病人之護理實務具臨床可行性，且可於術後急性期有效緩解情境焦慮，並促進焦慮之正向轉變。然而，研究未發現其對憂鬱程度及客觀生理指標產生顯著影響。受限於樣本數較小及追蹤時間短，研究結果之推論性與外推性仍有限。建議未來研究可擴大樣本數並延長追蹤時間，以評估多次或不同頻率AR介入之長期成效；並可優先將AR衛教導入於術前門診，作為臨床照護之輔助措施。

Objectives：Breast cancer ranks fourth among Taiwan's top ten cancer causes of death and first among cancers in women. Postoperative partial or total mastectomy patients often experience anxiety and depression due to lack of understanding of the surgical process and concerns about recovery time, which can affect treatment adherence and postoperative recovery. This study aimed to investigate the effects of augmented reality (AR) intervention on anxiety and depression in postoperative breast cancer patients.Methods：An experimental design was conducted at a regional teaching hospital in central Taiwan. Female patients with breast cancer scheduled for partial or total mastectomy were randomly assigned to an experimental group or a control group. The control group received routine health education, whereas the experimental group received routine education plus an augmented reality (AR) intervention one day before surgery and on postoperative day 1. Outcomes were measured preoperatively and on postoperative days 1 and 2 using the State Anxiety Inventory, Beck Depression Inventory–II, and physiological indicators (heart rate, respiratory rate, blood pressure, and oxygen saturation). Data were analyzed using descriptive and inferential statistics.Results：Thirty patients were enrolled (experimental group: n = 16; control group: n = 14). Baseline anxiety, depression, and physiological indicators did not differ between groups. On postoperative day 1, the experimental group showed significantly lower state anxiety scores than the control group, with a medium-to-large effect size. A higher proportion of patients in the experimental group shifted from moderate or severe anxiety to mild anxiety. No significant between-group differences were found in depression or physiological indicators on postoperative days 1 and 2.Conclusion and Recommendations：AR-based health education is feasible in clinical nursing practice and effectively reduces state anxiety in the acute postoperative phase after breast cancer surgery. No significant effects were observed on depression or physiological indicators. Larger samples and longer follow-up are needed to evaluate the long-term effects of repeated AR interventions. Implementing AR-based education in preoperative outpatient settings may be a useful adjunct to routine care.