背景：研究結果顯示攝護腺癌病人接受根除性手術，勃起功能障礙是常見症狀易導致情緒困擾，更在存活期影響伴侶親密關係及生活品質。綜觀國內攝護腺癌研究主軸多為評估療效，而勃起功能障礙是否影響情緒變化甚至導致憂鬱文獻較少著墨。
目的：探討攝護腺癌病人行根除性手術後勃起功能障礙與憂鬱之相關性。
方法：採橫斷式研究，於南部某醫學中心以病歷回溯立意取樣方式，選取行根除性攝護腺切除之攝護腺癌病人共79位；研究工具採用國際勃起功能指標問卷簡版量表及中文版貝克憂鬱量表；於手術出院後第一個月返回門診時或電訪函寄問卷，針對確實恢復性生活者收案，並使用SPSS18.0版進行資料統計與分析，描述人口學分析、疾病分期、過去病史、勃起功能與憂鬱分數各變項分佈情形；並以簡單線性迴歸(simple linear regression)及皮爾森積差相關分析(Pearson product moment correlation)探討雙變相的相關。多元迴歸分析(multiple regression)探討在控制個案基本屬性下，攝護腺癌術後病人勃起功能障礙與憂鬱的相關性。
結果：人口學及疾病特性以年齡65歲以上、已婚、高中以下學歷、經濟所得27~99萬、有宗教信仰、有工作、身體質量指數過重以上、有過去病史，以及疾病分期為第二期為多數。根除性攝護腺切除手術後有勃起功能障礙者佔多數，平均分數為7.6分（SD= 7.75）且相較於手術前勃起功能有下降趨勢。根除性攝護腺切除手術後病人無憂鬱者佔多數，但仍有15.2%有憂鬱傾向，輕度、中度、重度分別各有4位（5.1%），甚至有病患出現自殺意念。無工作者（p < .01）其憂鬱指數高，達顯著差異。無工作（p < .001）、疾病分期第二、三期（p < .01）、「疾病分期」（p < .01）此三項可能是攝護腺癌行根除性攝護腺切除術後病人憂鬱之預測因子。
結論：根除性攝護腺切除術後病人勃起功能與憂鬱無顯著相關，然可透過研究結果的工作狀況及疾病分期兩項預測因子介入情緒評估，適當轉介精神科；手術後勃起功能有下降趨勢，故建議針對勃起功能議題發展相關照護指引，並成立網路匿名性功能討論平台提供治療資訊。

SUMMARY
Understanding the patient's Erectile Function after Radical Prostatectomy, the patient's care can be enhanced. The value of this process is to give people an opportunity to state the degree of symptoms, to trigger self-awareness and to pay attention to the intimacy of the partner, and even to reflect on the quality of life. Impact. The main axis of domestic prostate cancer research is to evaluate the efficacy, and whether erectile dysfunction affects mood changes or even leads to less intoxication in the literature. The aim of this study was to investigate the association between erectile dysfunction and depression after radical surgery in patients with prostate cancer. A cross-sectional study was conducted. A convenient sample of 79 patients after prostate cancer surgery was recruited from the Southern Regional Medical Center. Questionnaires using IIEF-5 and BDI-II were used to examine demographics and erectile function and depression. The higher the IIEF-5 score, the better the erectile function, and the higher the BDI-II score, the higher the degree of depression. The results of the study showed that most of the subjects were over 65 years old, married, high school education or below, economic income of 2.7 million to 990,000, religious beliefs, work, over body mass index, past medical history, and disease stage. the second term. The majority of patients with Erectile Dysfunction after radical mastectomy had an average score of 7.6 (SD = 7.75) and a downward trend compared with preoperative erectile function. After Radical Prostatectomy, the majority of patients had no depression, but 15.2% had a tendency to depression. There were 4 (5.1%) mild, moderate, and severe, respectively. No worker (p < .01) has a high depression index, which is a significant difference. No work (p < .001), stage 2, 3 (p < .01), and "stage of disease" (p < .01) may be radical prostatectomy for prostate cancer. Predictors of post-patient depression. There was no significant correlation between erectile function and depression after radical mastectomy. It is recommended to develop relevant care guidelines for erectile function issues and establish a network anonymity function discussion platform to provide treatment information.

衛生福利部國民健康署（2016）．癌症登記線上互動查詢系統．取自
https://cris.hpa.gov.tw/pagepub/Home.aspx [Health Promotion Administration,
Ministry of Health and Welfare. (2016). Cancer registry interactive on-line search
system. Retrieved from https://cris.hpa.gov.tw/pagepub/ Home.aspx
王敏家、鄭哲舟、黃文聰、張書展、李淞維（2014）．攝護腺癌病人勃起功能對生活品質之影響．護理暨健康照護研究，10（1），51-60。DOI：
10.6225/JNHR.10.1.51
成令方（2011）．性、威而剛與男子氣概．台灣醫學，15（3），298-303。DOI：10.6320/FJM.2011.15(3).08
余美嬅、江家貞、謝伶瑜（2011）．尿路結石病人情緒困擾之初探．嘉基護理，11（1），1-8。DOI：10.29936/DMFCCHJN.201106.0001
吳敏倫、鄭英瑋（2010）．亞洲勃起功能障礙流行率統合分析．性學研究，1（2），35-59。DOI：10.6206/SIS.1.2.35
吳淑芬、井慶芸、李燕、董弘一、阮建維、趙東波（2015）．不同時期結直腸癌病人症狀困擾、憂鬱與生活品質關係之探討．護理雜誌，62（6），68-80。DOI：10.6224/JN.62.6.68
李昕宜、許玉娟、陳佳慧（2014）．癌症生存者之困擾症狀．台灣醫學，18（3），355-360。DOI：10.6320/FJM.2014.18(3).12
周繡玲、姚鍾太、楊立華、朱基銘、趙婉青（2010）．肺癌病人化療期間疲憊、睡眠障礙及情緒困擾之探討．腫瘤護理雜誌，10（2），23-38。DOI：10.6880/TJON.2010.10(2).23
林玲華、陳景彥、劉嘉逸、陳美伶（2002）．癌症住院病患憂鬱狀態的盛行率及預測因素．台灣醫學，6（4），535-545。DOI：10.6320/FJM.2002.6(4).08
高家常、林佑樺（2016）．癌症病人之創傷後壓力症狀．護理雜誌，63（5），27-32。DOI：10.6224/JN.63.5.27
張天鈞（2000）．前列腺切除後性功能障礙和尿失禁變化．當代醫學，27（2），27。DOI：10.29941/MT.200006.0009
陳佩英、史麗珠、王正旭、賴裕和、張獻崑、陳美伶（1999）．疼痛對癌症病患焦慮與憂鬱之影響．台灣醫學，3（4），373-382。 DOI：10.6320/FJM.1999.3(4).02
陳雅萍、葉淑惠、龔福財（2007）．子宮頸癌住院病人症狀困擾、憂鬱及生活品質之相關性研究．實證護理，3（2），89-98。DOI：10.6225/JEBN.3.2.89
潘璦琬、許瑋玲（2008）．羅序模式檢定貝氏憂鬱量表第二版之建構效度．台灣醫學，12（3），284-291。DOI：10.6320/FJM.2008.12(3).03
楊榮森（2013）．長存活癌症病患的情緒挑戰．健康世界，331，11。DOI：10.6454/HW.2013.331.11
葉紀妤、謝碧玲、張肇松、吳英璋（2012）．癌症患者情緒調節策略與適應指標相關研究．台灣臨床心理學會年會海報。DOI：10.6550/ACP
詹俊彥、劉建良、陳英貞（2011）．攝護腺癌之診斷與治療．家庭醫學與基層醫療，26（5），201-208。DOI：10.6965/FMPMC.201105.0201
趙慧玲、黃惠如、謝碧晴、蘇慧芳（2013）．癌症病人情緒困擾及其相關因素探討．輔仁醫學期刊，11（3），205-214。
劉美吟、戴研光、洪薇雯、謝明家、王瑞霞（2010）．第二型糖尿病個案情緒困擾、賦權感受、自我照顧行為與生活品質關係探討．護理雜誌，57（2），49-60。DOI：10.6224/JN.57.2.4
蔡欣玲、林小玲、林惠蘭、梁麗麗（2000）．癌症病人疼痛、情緒困擾及睡眠情形之探討．榮總護理，17（1），1-14。DOI：10.6142/VGHN.17.1.1
鄭靜明、張耿嘉、林燕卿（2017）．勃起功能障礙相關因子與介入：文獻回顧報告．性學研究，8（1），33-45。DOI：10.6206/SIS.2017.0801.02
盧孟良、車先蕙、張尚文、沈武典（2002）．中文版貝克憂鬱量表第二版之信度和效度．台灣精神醫學，16（4），301-310。
賴虹均（2008）．癌症患者的憂鬱症腫瘤．護理雜誌，8（1），1-11。DOI：10.6880/TJON.2008.8(1.1)
簡靜慧、莊正鏗、劉冠麟、劉雪娥（2007）．前列腺癌病患接受一個月治療後之決策後悔情形及其相關因素．台灣醫學，11（5），461-469。DOI：10.6320/FJM.2007.11(5).01
簡靜慧、陳全美、簡慧足、劉冠麟、黃宣宜（2015）．系統性文獻回顧方式探討處置介入對前列腺癌病患及其伴侶婚姻調適之成效．護理暨健康照護研究，11（3），242-252。DOI：10.6225/JNHR.11.3.242
謝明達、黃建元（2013）．南部某科學園區勞工憂鬱傾向高風險族群之流行病學及人口學風險分析系統性文獻回顧方式．台灣家醫誌，23，159-167。
顧艷秋、蔣秀容（2012）．第六生命徵象情緒困擾之評估與處置．榮總護理，29（1），104-109。 DOI：10.6142/VGHN.29.1.104

Agarwal M, Hamilton J, Moore C, Crandell J. (2010). Predictors of depression among older African American cancer patients. Cancer Nurse,33, 156-163. doi: 10.1097/NCC.0b013e3181bdef76
Becker, A., Tennstedt, P., Hansen, J., Trinh, Q. D., Kluth, L., Atassi, N., … Steuber, T.
(2013). Functional and oncological outcomes of patients aged < 50 years treated
with radical prostatectomy for localised prostate cancer in a European population.
BJU International, Advanced online publication. doi:10.1111/bju.12407
Hinz A, Krauss O, Hauss JP, M. Hockel, R.D. Kortmann, J.U. Stolzenburg, R. Schwarz. (2010). Anxiety and depression in cancer patients compared with the general population. European Journal of Cancer Care ,19, 522-529. doi:10.1111/j.1365-2354.2009.01088.x
Hou, W. K., Law, C. C., & Fu, Y. T. (2010). Does change in positive affect mediate and/or
moderate the impact of symptom distress on psychological adjustment after cancer
diagnosis? A prospective analysis Psychology & Health, 25(4), 417–431.
doi:10.1080/08870440802559375
Haisfield-Wolfe, M. E., McGuire, D. B., Soeken, K., GeigerBrown, J., De Forge, B., &
Suntharalingam, M. (2012). Prevalence and correlates of symptoms and uncertainty
in illness among head and neck cancer patients receiving definitive radiation with
or without chemotherapy. Supportive Care in Cancer, 20(8), 1885–1893.
doi:10.1007/ s00520-011-1291-9
Jadoon NA, Munir W, Shahzad MA, Choudhry ZS. (2010). Assessment of depression and
anxiety in adult cancer outpatients: a cross-sectional study. BMC Cancer,10, 594-
600. doi:10.1186/1471-2407-10-594
Luppino FS, de Wit LM, Bouvy PF, et al: Overweight, obesity, and depression: a
systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiat
2010; 67: 220-9. doi:10.1001/archgenpsychiatry.2010.2
Lin, Y. H., Yu, T. J., Lin, V. C., Wang, H. P., & Lu, K. (2012). Effects of early pelvic-
floor muscle exercise for sexual dysfunction in radical prostatectomy recipients.
Cancer Nursing, 35(2), 106–114. doi:10.1097/NCC.0b013e3182277425
Merrick, G. S., Butler, W. M., Galbreath, R. W., Stipetich, R. L., Abel, L. J., & Lief, J. H.
(2002). Erectile function after permanent prostate brachytherapy. International
Journal of Radiation Oncology *Biology* Physics, 52(4), 893−902.
doi:10.1016/S0360
Rosen, R. C., Cappelleri, J. C., Smith, M. D., Lipsky, J., & Pena, B. M. (1999).
Development and evaluation of an abridged, 5-item version of the International
Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction.
International Journal of Impotence Research, 11, 319-326.
doi:10.1038/sj.ijir.3900472
Sanda, M. G., Dunn, R. L., Michalski, J., Sandler, H. M., Northouse, L., Hembroff, L., …
Wei, J. T. (2008). Quality of life and satisfaction with outcome among
prostatecancer survivors. The New England Journal of Medicin, 358(12),
1250−1261. doi:10.1056/NEJMoa074311
Sugimori, H., Yoshida, K., Tanaka, T., Baba, K., Nishida, T., Nakazawa, R.,...Iwamoto T.
(2005). Relationships between erectile dysfunction, depression, and anxiety in
Japanese subjects. Journal of Sexual Medicine, 2, 390-396. doi:10.1111/j.1743-6109.2005.20354.x
So, W. K.., Marsh, G., Ling, W. M., Leung, F. Y., Lo, J. C., Yeung, M., & Li, G. K.
(2010). Anxiety, depression and quality of life among Chinese breast cancer
patients during adjuvant therapy. European Journal of Oncology Nursing, 14(1),
17–22. doi:10.1016/j.ejon.2009.07.005
Wang, Y. T., Chen, H. H., Lin, C. H., Lee, S. H., Chan, C. H., & Huang, S. S. (2016).
Newly diagnosed panic disorder and the risk of erectile dysfunction: A
population-based cohort study in Taiwan. Psychiatry Research, 244, 229-234.
doi:10.1016/j.psychres.2016.07.037
Zhang, M., Peng, L., Liu, W., Wen, Y., Wu, X., Zheng, M., … Chan, S. (2015). Physical
and psychological predictors of quality of life in Chinese colorectal cancer
patients during chemotherapy. Cancer Nursing, 38(4), 312–321.
doi:10.1097/NCC.0000000000000190