探討肝硬化病人復原力及生活品質之相關性

背景肝硬化病人常出現腳水腫、腹水及肝昏迷等症狀，其生活品質已受到明顯影響。良好的復原力可促進病人維持健康與心理穩定。然而，國內有關復原力的研究多集中於青少年、創傷者、癌症或中風患者，針對肝硬化病人的復原力研究仍付之闕如，其與生活品質之關聯亦不明確。研究目的本研究旨在探討肝硬化病人之復原力與生活品質之現況及其相關性。研究方法與材料本研究採橫斷式設計與方便取樣法，研究期間自112年3月至113年9月，收案條件為(1)年滿二十歲(2)肝硬化之病患(3)意識清楚，無精神疾患(4)可以語言或文字交談(5)同意接受訪談且有簽署同意書之病患。於中部某醫學中心之肝膽腸胃內科病房、門診及消化系中心收案。研究工具包括台灣簡明版世界衛生組織生活品質問卷(WHOQOL-BREF)及Connor-Davidson復原力量表(CD-RISC)。共回收有效問卷130份。資料以SPSS 25版進行分析，使用描述性統計以瞭解病人人口學特性、復原力與生活品質狀態，並以推論性統計(包含t檢定及相關分析)探討各變項間之關係。結果研究對象以男性為主(69.2%)，平均年齡62.6歲，多數教育程度較低、無工作且收入偏低。整體復原力平均得分為67.9分(中等程度)，其與年齡、教育程度、工作狀況、婚姻狀態及肝硬化分期具顯著關聯。年輕、教育程度高、有工作、已婚及Child A分期者復原力較佳。生活品質方面，「環境範疇」得分最高，「心理範疇」最低。婚姻狀況、就業與收入及肝硬化分期對生活品質具顯著影響。進一步分析顯示，復原力與生活品質四大範疇(生理、心理、社會關係、環境)皆呈顯著正相關(r = .474–.534，p < .01)。結論復原力與生活品質呈正相關，顯示復原力越高，生活品質越佳。復原力在肝硬化病患的疾病調適與生活品質維持上扮演關鍵角色。實務應用臨床照護應重視心理支持與家庭參與，並針對具工作能力的病患提供就業支持、職能重建或社區參與機會，以維持其自我價值與社會角色，提升復原力與生活滿意度。護理教育應納入復原力促進與生活品質評估之內容。未來研究可採縱貫性與介入性設計，以驗證復原力促進及就業支持方案對病患健康成效之影響。

ＢackgroundPatients with liver cirrhosis often experience leg edema, ascites, and hepatic encephalopathy, leading to a decline in their quality of life (QoL). Resilience plays an important role in maintaining psychological and physical well-being. However, most studies on resilience in Taiwan have focused on adolescents, trauma survivors, cancer, or stroke patients. Research on resilience and its relationship with QoL among patients with liver cirrhosis remains limited.PurposeThis study aimed to investigate the relationship between resilience and quality of life among patients with liver cirrhosis.Method amd MaterialsThis study employed a cross-sectional design with convenience sampling. The study period ranged from March 2023 to September 2024. The inclusion criteria were as follows: (1) aged 20 years or older; (2) diagnosed with liver cirrhosis; (3) clear consciousness without psychiatric disorders; (4) able to communicate verbally or in writing; and (5) willing to participate in the interview and having signed informed consent. Participants were recruited from the hepatology and gastroenterology inpatient wards, outpatient clinics, and the digestive disease center of a medical center in central Taiwan.The research instruments included the Taiwan version of the World Health Organization Quality of Life–Brief Version (WHOQOL-BREF) and the Connor–Davidson Resilience Scale (CD-RISC). A total of 130 valid questionnaires were collected. Data were analyzed using SPSS version 25. Descriptive statistics were used to examine demographic characteristics, resilience, and quality of life, while inferential statistics, including t-tests and correlation analyses, were applied to explore the relationships among variables.ResultsThe majority of participants were male (69.2%) with a mean age of 62.6 years. Most had low education levels, were unemployed, and had low income. The mean resilience score was 67.9, indicating a moderate level. Resilience was significantly associated with age, education, employment status, marital status, and cirrhosis stage. Participants who were younger, had higher education, were employed, married, and in Child-Pugh class A showed higher resilience. Regarding QoL, the environmental domain scored highest, while the psychological domain scored lowest, indicating poorer emotional and psychological adjustment. Marital status, employment, income, and cirrhosis stage significantly affected QoL. Further analysis revealed that resilience was positively correlated with all four QoL domains (physical, psychological, social, and environmental) (r = .474–.534, p < .01).ConclusionResilience was positively associated with quality of life, suggesting that patients with higher resilience demonstrated better QoL. Resilience plays a crucial role in disease adaptation and life quality maintenance among patients with liver cirrhosis.Application to Nursing PracticeClinical care should emphasize psychological support and family involvement. Employment support, vocational rehabilitation, and community participation should be encouraged for patients with work capacity to help maintain self-worth and social roles, thereby enhancing resilience and life satisfaction. Nursing education should integrate resilience promotion and QoL assessment into curricula. Future research is recommended to adopt longitudinal or interventional designs to verify the effects of resilience enhancement and employment support programs on overall health outcomes.