肝移植手術後病人生活品質之初探

A Preliminary Study of Quality of Life in Post Liver Transplantation Patients

本研究目的乃在探討肝臟移植術後患者出院後生活品質之現況，及其基本屬性、性關係、症狀困擾程度、對移植自我照顧認知度與生活品質的相關性。採相關性敘述性研究，以北部某醫學中心接受肝臟移植手術出院返家之病患為研究對象，經個案同意以結構式問卷收集資料，共收得29位個案。結果發現個案整體的生活品質指標為23.99分，各次量表得分高低依序為：家庭因素(25.66)、健康與功能因素(24.24)、社會經濟因素(23.93)、心理靈性因素(22.16)，顯示家庭因素是患者感到最重要與最滿意的層面。移植後造成困擾的主要症狀為體力減退。而移植術後自我照顧認知度平均19.21(總分20分)。肝臟移植術後患者生活品質指標與年齡、性別、婚姻狀況、宗教信仰、就業狀況、移植後月數無顯著相關，接受教育的年數與「家庭」因素呈負相關，已恢復性關係者其整體生活品質指標、健康與功能因素及心理靈性因素較未恢復者高。而整體生活品質指標與症狀出現頻率及嚴重度呈顯著負相關，且主要影響因素為症狀出現頻率，解釋力為14.1%。本研究發現可為臨床照護計畫之參考及進一步研究之基礎。

The purposes of this study were to describe the quality of life of patients discharged after liver transplantation and to examine the relationships between quality of life and patient characteristics, sexual relationship, symptom disturbance, and self-care. The design was descriptive-correlation. Twenty-nine (29) patients who received liver transplantation at a medical center in northern Taiwan were recruited. Data were collected through structured questionnaires. Results indicated the following. The overall mean quality of life index (QLI) was 23.99. The QLI scores from highest to lowest were family factors (mean score=25.66), health and functioning factors (mean score=24.24), socioeconomic factors (mean score=23.93), and psychological/spiritual factors (mean score=22.16). The major symptom disturbance was decreased physical energy. The mean score on knowledge of self-care was 19.21 (the highest scores were 20). The QLI was not associated with patient's age, gender, marital status, type of religion, occupational status, or post liver transplantation duration. However, a negative correlation between the education level and family factors was found. Patients who regained sexual activities post transplantation had higher scores on overall QLI, health and functioning factors, and psychological/spiritual factors than those who did not. The QLI was negatively correlated with frequency and severity of symptoms after transplantation and accounted for 14.1% of the variance. The findings would be helpful as a reference in planning clinical care standard to improve the quality of care and as a baseline data for future research.