Spiritual well-being in patients with rheumatoid arthritis

[[abstract]]背景 類風濕性關節炎是一慢性長期性的疾病，此疾病雖不會造成立即的生命威脅，但罹病過程卻須面對生活上的種種壓力與挑戰，影響不僅在生理上，同時也帶來心理社會層面的影響，如無助感、依賴他人、自尊受威脅、社交活動受干擾、影響與家人的關係、有困難繼續工作等。病患的靈性安適狀態能反應在生活品質上，可做為病患適應之重要指標。 目的 本研究之目的為描繪類風濕性關節病患之靈性安適狀態。 方法 依Sandelowski與Barroso之建議進行質性資料統合分析。藉完整之系統性資料庫搜尋，尋找探討類風濕性關節病患靈性安適之研究原著。每一篇被搜尋到的文章都經過系統性的評價，如符合下列條件則納入選擇：必須是質性研究，並有清楚之研究目的、收案標準與程序、樣本數與特性、資料分析方式及結果之呈現。 結果 經檢視675篇發表於1995至2009年間之研究文章，十篇符合收案條件。經分析類風濕性關節炎病患之靈性安適可以四個主題呈現，包括與疾病共存、重掌控制、重新架構情況及增長勇氣。 結論／實務應用 在協助病患適應疾病上，投注給予病患靈性力量的支持應考量多層面的來源，除認知為主的教育課程外，應借助病友團體的力量，並規劃家屬教育課程。本研究所呈現之靈性適應面向之內涵，可成為發展評價類風濕性關節炎病患生活品質之重要素材。[[abstract]]Background: Rheumatoid arthritis (RA) is a chronic, long-term, and non-life-threatening disease. Individuals with RA face various daily pressures that include physical symptoms as well as feelings of helplessness, dependency, threats to self-respect, interference with social activities, disruptions of family ties, and difficulties in continuing to work. Quality of life reflects a patient's spiritual well-being and can be used as an important indicator of adaptation to RA. Purpose: The aim of this study was to describe the status of spiritual well-being in RA patients. Methods: This study used meta-synthesis with Sandelowski and Barroso's qualitative meta-summary technique. A comprehensive search of Academic Search Complete, CINAHL, MEDLINE, PsycARTICA LES, and SocINDEX using relevant keywords identified primary research studies that have previously explored spiritual well-being in patients with RA. Each study was systematically evaluated on the basis of the following inclusion criteria: (a) clear descriptions of research purposes and qualitative research, sampling strategies and techniques used; (b) statement of sample size and sample variables; (c) description of data analysis methods used; and (d) quality of research finding presentation. Results: A total of 675 articles, published between 1995 and 2009, were found. Ten met the inclusion criteria. The results revealed four consistent themes related to RA patients' spiritual well-being, namely, living with the disease, reclaiming control, reframing the situation, and bolstering courage. Conclusions/Implications for Practice: Multifaceted resources should be used to give patients spiritual support. These resources should include establishing cognition-based education programs that provide information about the disease and programs that offer strong support for patient groups. Curricula should address how to plan family education courses. Spiritual well-being as presented in this study should be integrated into quality-of-life evaluations of RA patients and provide an evaluation tool able to assess the effectiveness of various interventions