慢性肝病患者之生活品質相關因素探討

Factors Associated with the Quality of Life of Patients with Chronic Liver Disease

背景：肝病是台灣的國病，一旦罹患肝病，病患的生活品質大受影響，無論在生理、心理與社會各層面皆出現負面的衝擊。目的：在探討慢性肝病患者，其生活品質現況及其相關因素。方法：樣本選自中部某區域教學醫院，經診斷確定為慢性肝病患者，且同意接受會談，填寫SF-36及CLDQ生活品質量表共120人。以SPSS 12版統計軟體，進行資料分析。結果：(1)研究對象多數為男性有79位(65.8％)，以已婚者、低教育程度和無工作者居多。主要診斷最多為病毒性肝硬化有63位(52.5％)，且65位(54.2％)有現存的慢性病。疾病分級以Child A級有83人(69.2％)居多，主要治療方式以保守藥物治療居多，共78位(65.0％)。(2)研究對象之生活品質為中等程度，SF-36量表得分為64.43(SD=18.92)，次量表中以「身體疼痛」之得分(76.12, SD=25.19)最高，「身體功能對角色扮演之限制」得分最低為46.46(SD=45.52)。而CLDQ量表得分為5.67(SD=1.02)，其中得分最高為「腹部症狀」(6.00, SD=1.43)，最低分為「活動力」(5.27, SD=1.55)。(3)人口學變項和疾病特性，以年齡、主要收入來源、治療方式及Child分級與生活品質有顯著性的相關。結論／實務應用：個案生活品質確實因肝病而有負面衝擊，了解相關因素，可做為護理人員設計合適的諮詢內容與衛教方案，及尋求能增進患者生活品質的護理措施。

The impact of the chronic liver disease (CLD) on patient’s well-being has become an important research topic. The objectives of this study are to investigate the health-related quality of life (HRQOL) experienced by patients following CLD and to analyze the factors associated with its variations. One hundred and twenty patients were recruited from one regional teaching hospital. HRQOL was measured with a generic (Short Form 36) and a liver disease-specific questionnaire (Chronic Liver Disease Questionnaire, CLDQ). We used descriptive statistics and one-way ANOVA to analyze the data. Seventy nine out of 120 patients were male (65.8%). Most patients were married, low educational status, and jobless. Sixty three patients (52.5%) were diagnosed to be viral hepatitis-related liver cirrhosis, and 65 patients (54.2%) had co-morbid illnesses. Eighty three patients (69.2%) were in Child’s A status and 78 of them (65.0%) received conservative treatment as the main therapeutic modality. The quality of life was fair in our study patients with a mean score of SF-36 (64.43). The highest mean score was 76.12 for ‘body pain’, and the lowest was 46.46 for ‘role disability: physical’ in domain analysis. The mean CLDQ was 5.67 with the highest 6.00 for ‘abdominal symptoms’ and the lowest 5.27 for ‘activity’. The age, major income source, therapeutic modalities and Child’s classifications were significantly associated with HRQOL. The study provides guidance for nursing personnel in developing nursing instruction to improve quality of life in patients with chronic liver disease.