[[alternative]]The Relationships among Symptom distress, Uncertainty, Resilience, Social Support and Health-Related Quality of Life of Systemic Lupus Erythematosus Patients

[[abstract]]全身性紅斑性狼瘡易侵犯多種身體器官，常處於疾病活性期或緩解期交替的慢性疾病，本研究目的旨在檢視全身性紅斑性狼瘡患者的身體症狀困擾、疾病不確定感、社會支持、復原力與健康生活品質間的關係。本研究為橫斷性研究，採立意取樣法選取北部某醫學中心醫院之255位符合選樣條件的全身性紅斑性狼瘡患者為對象。研究工具有：身體症狀困擾量表、疾病不確定感量表、社會支持量表、復原力量表、健康生活品質量表及基本人口資料。以自我填答方式收集資料後利用SPSS 17.0及SAS 9.2 套裝軟體進行資料整理。假設檢定使用 Tobit regression model及Sobel test。本研究結果發現： SLE患者在過去30天中身體與心理不健康的天數分別是10.1±9.9天、8.8±8.6天，因上述影響導致妨礙生活的天數6.6±8.3天。部分假設已獲得證實，意即健康生活品質明顯受到身體症狀困擾、疾病不確定感、社會支持或復原力的影響；尤其是復原力在身體症狀困擾或疾病不確定感與健康生活品質間具有中介作用；然而，社會支持的中介作用則不明顯。本研究結果能協助醫護人員了解SLE 患者的健康生活品質，進而提供合適的護理措施，以提升照護品質。[[abstract]]Systemic lupus erythematosus (SLE) is frequent involvement variety of body organs, usually in alternating of disease activity or remission in chronic diseases. The purpose of the present study were to evaluate the relationships among physical symptom distress, uncertainty in illness, social support, resilience and health-related quality of life (HRQOL) for SLE patients. A cross-sectional design was used to guide the study. Two hundred and fifty-five subjects who met the selection criteria were selected from a medical center of Taipei by purposive sampling. The questionnaires included Physical Symptom Distress Scale, Uncertainty in Illness Scale, Social Support Scale, Resilience Scale, HRQOL-4 and demographic data. Data were collected by self-administrated questionnaire. Data was processed by SPSS 17.0 and SAS 9.2. Tobit regression model and Sobel test were used to test the hypothesis. The results of this study showed: SLE participants with physically and mentally unhealthy days were 10.1 ± 9.9 days and 8.8 ± 8.6 days respectively during the previous 30 days; in addition, 6.6 ± 8.3 days of activity limitation due to above poor physical and mental health. Some of hypotheses were supported, that is HRQOL was significantly influenced by the physical symptom distress, uncertainty in illness, resilience, and social support. Especially, resilience mediated the effect of physical symptom distress or uncertainty in illness on HRQOL. However, the mediating effect of social support was not found. The findings of this study could be used as a reference for health providers to better understand the health related quality of life in patients with SLE, to provide suitable nursing intervention, and promote the quality of care