[[alternative]]Relationship between Social Support, Resilience, and Quality of Life of Community Cancer Patient

[[abstract]]目的：對癌症存活者而言，經歷癌症儼然是一種壓力，因此，瞭解影響癌症存活者健康危險因子以利改善生活品質。過去研究發現不同社會支持來源及復原力為影響生活品質的因素，然而較少研究針對社區癌症病友探討三者之間關聯。本研究以「壓力與因應互動模式」、「壓力資源理論」及「青少年復原力模式」為基礎，探討北臺灣某社區協會癌症病友整體及不同支持來源、復原力及生活品質之間關聯。方法：本研究採橫斷式調查研究設計。於2015年4月至5月以zh-TW版多項度感受社會支持量表、康納－戴維森心理復原力量表-10題版及歐盟生活品質健康問卷，針對305位社區協會癌症病友進行問卷調查。採用結構方程式（SEM）進行研究架構驗證，分析復原力對社會支持與生活品質的中介作用。結果：統計證實研究架構具良好配適模式。復原力對社會支持與生活品質之間具中介作用；家人、朋友及特殊他人社會支持對生活品質的直接、間接及整體效果為0.14、0.19 及0.17；0.07、0.07 及0.07，以及0.21、0.26 及0.23，復原力的中介效應比為32.5%、26.8%及29.4%。比較三種支持來源，朋友社會支持對生活品質影響較強，此時復原力中介效應較弱；家人社會支持對生活品質影響較弱，此時復原力中介效應較弱強。結論：本研究發現不同支持來源對復原力及生活品質的影響存在差異。建議社區協會結合醫院管道宣導社區服務，建立使病友及親友願意參與社區機構的對策，營造良好社區平台增加病友與他人互動機會，落實社區機構功能對病友的幫助。[[abstract]]Objectives: Experience of cancer is a stress for cancer survivors. For cancer survivors, it is important to understand the risk factors of health for improving quality of life for cancer survivors. Previous studies had examined the relationship between social support, resilience, and quality of life. However, there is no research to investigate this relationship on community cancer patient. Based on “Transactional Model of Stress and Coping,” “Resource Theories of Stress,” and “Adolescent Resilience Model,” the aim of the study is to examine the relationship between social support, resilience, and quality of life for cancer survivors in community foundation in northern part of Taiwan.Methods: This study was used a cross-sectional survey. For these cancer survivors, Self-report questionnaires, the Multidimensional Scale of Perceived Social Support, the Connor & Davidson resilience scale-10 item, and the scale of The EuroQol Group Association were used to interview 305 community cancer survivors from April to May 2015. Structural Equation Modeling was conducted to evaluate the mediating effect of resilience between social support and quality of life.Results: Goodness of fit statistics confirmed our model where resilience mediates between social support and quality of life. The direct effects, indirect effects, and total effects of families, friends, and significant-other supports to quality of life were 0.14, 0.19 and 0.17, 0.07, 0.07 and 0.07, and 0.21, 0.26 and 0.23, respectively. At the same time, the mediation effect ratios were 32.5%, 26.8%, and 29.4%. Compared to these three support resources, friend social support to quality of life was strongest and mediation effect was weakest. However, the result of family social support was obviously different situation.Conclusions: This study highlighted the difference of support resources had impacted on resilience and quality of life. These results indicate that community could be through hospital advocated community service to cancer survivors. In conclusion, to establish strategies that enable patients and his/her relatives who would be willing to participate in community foundation. For cancer survivors, not only a good platform of community could increase opportunities of interaction with other patients but also could be helpful to implement community institutions in the future