[[alternative]]A Test of Braden's Self-Help Model in Women with Systemic Lupus Erythematosus

[[abstract]]摘要本研究目的是以台灣社區紅斑性狼瘡（Systemic Lupus Erythematosus，SLE）婦女為例來測試Braden的自我幫助模式因果理論。採橫斷性相關研究，以方便取樣方式選取北部某醫學中心「彩虹之友」關懷聯誼會及「思樂醫之友」協會的SLE病患為研究對象，共計231位參與研究。採自填式結構問卷進行資料收集，問卷包括：個人基本資料問卷、疾病病程量表、疾病不確定感量表、限制量表、自我控制量表、成人角色行為量表及安適量表。所得資料以SPSS12.0及SAS sobel統計軟體進行資料整理與分析。研究結果顯示：研究對象平均年齡37.2±10.6歲，平均罹病年數為9.8±7.1年。研究對象疾病嚴重度和限制、不確定感呈正相關（r=.397, p=.001；r=.671, p=.001），限制、不確定感和能力技巧呈負相關（r=-.278, p=.001； r=-.446, p=.001），限制、不確定感和自我幫助呈負相關（r=-.422, p=.001； r=-.674, p=.001），限制、不確定感和生活品質呈負相關（r=-.431, p=.001；r=-.524, p=.001）。能力技巧和自我幫助呈正相關（r=.549, p=.001），自我幫助和生活品質呈正相關（r=.635, p=.001）。路徑分析結果顯示每一路徑之徑路係數都達極顯著水準，經複迴歸分析六條路徑模式，結果顯示自我幫助為中介因子。以SAS Sobel程式進行中介因子統計模式分析，結果顯示在限制方面，其中介變項自我幫助的效益為55.12%（p<.001），在能力技巧方面，其中介變項自我幫助的效益為79.15%（p<.001），在不確定感方面，其中介變項自我幫助的效益為70.95%（p<.001），在疾病嚴重度方面，其中介變項自我幫助的效益為65.20%（p<.001），自我幫助對生活品質的解釋力高達79.15%。本研究結果，有助於了解社區中SLE患者之疾病嚴重度、限制、不確定感、能力技巧、自我幫助和生活品質之相關性，可作為未來擬定合適介入活動之參考依據。關鍵詞：全身性紅斑性狼瘡、Braden自我幫助模式、因徑分析、中介因子測試[[abstract]]AbstractThe purpose of this study was to test the Braden’s Self-Help model on women afflicted with SLE in Taiwan. A cross-sectional study design with convenient sampling was used. A sample of 231 women was recruited from a medical center in the north’s Rainbow Society of Care and Friendship, and the Friends of SLE Society. Data was collected from a questionnaire including: basic demographic information, Disease Course Graphic Scale, Mishel´s Uncertainty in Illness Scale-Community Form (MUIS-C), Limitation Scale, Self Control Schedule, Inventory Adult Role Behavior, and Index of Well Being. Data was analyzed using SPSS12.0 and SAS Sobel statistical software. The results of the research reveal the following: The average ages of the subjects were 37.2±10.6 years, and the average years of contracting the illness were 9.8±7.1. There were a positive relationship to uncertainty in illness with perceived severity of illness (r=.397, p=.001) and disease limitations (r=.671, p=.001), a negative relationship between uncertainty in illness and enabling skill (r=-.278, p=.001) and disease limitations (r=-.446, p=.001), a negative relationship to limitations, uncertainty and self-help (r=-.422, p=.001; r=-.674, p=.001), a negative relationship to limitations, uncertainty and quality of life (r=-.431, p=.001； r=-.524, p=.001). Enabling skill and self-help showed a positive relationship (r=.635, p=.001), self-help and quality of life showed a positive relationship (r=.635, p=.001).The results of path analysis showed that for each path coefficient reached a significant level. The results of a six path model of multiple-regression analysis reveal self help as being a mediating factor. The results of using the SAS Sobel program to carry out a mediating factor statistical model of analysis for limitations show that the benefit of the mediating variables of self help came to 55.12% (p<.001). As far as enabling skill went, the benefit of the mediating variables of self help came to 79.15% (p<.001) ; for uncertainty, 70.95% (p<.001); for perceived severity of illness, 65.20% (p<.001) and lastly, the constructiveness of the self help on their quality of life was as high as 79.15%. The results of this research may contribute towards understanding the perceived severity of illness, limitations, uncertainty, enabling skill, self-help, and quality of life of SLE sufferers in our community. It can be used as a basis to refer to in the future when planning appropriate intervention.Key words: Systemic Lupus Erythematosus, Braden Self-Help model, path analysis, mediating factor