背景：疾病不確定感與憂鬱是癌症患者在漫長治療過程中常出現之困擾，常會導致許多心理調適問題。 目的：探討婦癌患者之疾病不確定感、憂鬱及影響因素。 方法：採橫斷性研究設計，以方便取樣選取南部某區域醫院230位婦癌患者為研究對象，研究工具包括「Mishel疾 病不確定感量表中文版」、「流行病學研究中心憂鬱症狀量表」、「症狀困擾量表」及「個人特質與醫療 相關變項」。 結果：婦癌患者憂鬱盛行率為47.3%，疾病不確定感平均分數58.6分(SD = 12.6)，疾病不確定感與憂鬱間有顯著正 相關。逐步迴歸分析呈現症狀困擾、罹癌時間在一年內、癌症轉移、子宮內膜癌、接受兩種治療、病後工 作受影響情形等六個因子為婦癌患者疾病不確定感之預測因子，可解釋變異量為33.0%。此外，症狀困擾與 疾病不確定感為婦科癌症患者憂鬱之預測因子，可解釋變異量為46.0%。 結論/實務應用：本研究結果確認疾病不確定感與憂鬱存在著正相關，且疾病不確定感為憂鬱的預測因子。臨床照 護上針對婦癌患者，需更深入了解其不確定感之來源及評估心理層面及人格特質，並適當的給予衛教或支 持、關心及協助，協助病患緩解其對疾病之不確定感，亦可加強及培養人員對癌症患者情緒變化之敏感度， 促使其能針對患者的需求提供更多的生理、心理及社會支持。

Background: Uncertainty and depression are psychological‐adjustment problems faced by patients with gynecologic cancer. Purpose: This study examined uncertainty, depression, and related factors among gynecologic‐cancer patients. Methods: Using a cross‐sectional design, 230 patients with gynecologic cancer were recruited from a district hospital in southern Taiwan. Data was collected using the Symptom Distress Scale and structured questionnaires delivered during face‐to‐face interviews. Outcome measurements included the Chinese version of the Mishel Uncertainty in Illness Scale (MUS) and the Center for Epidemiologic Studies Depression Scale (CESD). Results: Nearly half (47.3%) of the participants had depression. The mean score for illness uncertainty was 58.6 (SD = 12.6). A significant positive correlation between CESD and uncertainty was supported. The stepwiseregression model identified symptom distress, one‐year duration of illness, metastatic, concomitant with endometriosis cancer, job status, and receiving two types treatment as predictors of overall uncertainty. These 6 factors accounted for 33.0% of the total variance in overall uncertainty. Symptom distress and uncertainty were two predictors of depression, accounting for 46.0% of the total variance. Conclusions / Implications for Practice: The results of this study may help healthcare professionals better understand the uncertainty and depression related to the psychological aspects and personal characteristics in patients with gynecologic cancer. Appropriate education and psychical and psychological support may help relieve uncertainty and depression in this vulnerable group.