接受肝臟移植病患身心社會調適及其相關因素之研究

Abstract

本研究目的為瞭解接受肝臟移植病患身心社會調適的現況，並探討病患基本屬性、疾病特性、社會支持、自我照顧與身心社會調適之相關性。採橫斷性描述相關性研究，於2006年2月15日至2006年5月30日，對象為北部某醫學中心器官移植門診，以立意取樣方式收集73位符合選樣條件之個案，經個案同意以結構式問卷訪談收集資料。結構式問卷包括：「病患基本屬性」、「疾病特性」、「生理困擾調適量表」、「心理社會調適量表」、「社會支持量表」、「自我照顧行為量表」。將所收集的資料以SPSS / Window12.0進行描述性和推論性的統計分析。研究結果顯示生理困擾調適為中上程度，心理社會調適平均值為31.3分，各層次調適以非同住家人關係調適最佳，依序為健康照護調適、家庭生活環境調適、心理困擾調適、社會環境調適、性生活調適、工作環境調適。肝臟移植病患之生理困擾調適與移植前有無慢性疾病、社會支持程度、自覺經濟狀況有顯著意義，且移植前有無慢性疾病為主要影響因素，可解釋變異量為34%；而心理社會調適與移植後工作狀況、社會支持程度、自覺經濟狀況有顯著意義，且移植後工作狀況為主要影響因素，可解釋變異量為54%。本研究結果可提供為臨床照護及出院規劃未來介入措施之參考及進一步研究之基礎。

The purpose of this study is to analyze and investigate the biopsychosocial adjustment of liver transplant recipients, and the correlations between patients’ demographic data, characteristic of the disease, social support, self-care, and biopsychosocial adjustment. Between February 15, 2006 and May 30, 2006, 73 qualified participants were recruited for this cross-sectional and correlational study, from an organ transplant outpatient department at a medical center in northern Taiwan, using purposive sampling. With participant consent, data were collected with structured questionnaires assessing demographic data, characteristic of the disease, physical distress adjustment, psychosocial adjustment to illness scale (PAIS), social support scale, and self-care. Data were analyzed with descriptive and inferential statistics using SPSS/Window12.0. Overall patient physical distress adjustment was above average, and the average PAIS score was 31.3. PAIS subscale wise, patients showed best adjustment in Family Relations, followed by Health Care, Domestic Environment, Psychological Distress, Social Environment, Sexual Relations, and Vocational Environment. There was significant correlation between patients’ physical distress adjustment and the presence of chronic diseases before transplant, social support, and self-perceived economic status, with the presence of chronic diseases before transplant being the main factor, accounting for 34% of the total variance. There was also significant correlation between patient’s psychosocial adjustment and the employment status after transplant, social support, and self-perceived economic status, with the employment status after transplant being the main factor, accounting for 54% of the total variance. The result of this study may help caregivers better understand liver transplant recipients’ biopsychosocial adjustment and its affecting factors, and provide as a reference for future intervention.