探索頸椎脊髓損傷後復原力與社區融入之關聯：障礙適應的中介效應

脊髓損傷會嚴重影響身體功能，並帶來顯著的心理壓力，尤其是頸椎脊髓損傷導致的四肢癱瘓，更影響上半身的活動能力。由於上肢功能損失、軀幹肌肉無力和坐姿控制困難，頸椎脊髓損傷者的日常活動受到嚴重限制。本研究欲初步探究頸椎脊髓損傷者心理復原力、障礙適應和社區融入的動態關聯性，進而檢視障礙適應的中介效果，有助於認識頸椎脊髓損傷者的復原力，增強他們有效地重返社區生活。本研究採用橫斷面研究方法，參與者為18歲以上、已重返社區生活的頸椎脊髓損傷者，需理解國語並能操作電腦或手機等3C設備。本研究採用滾雪球抽樣的方式，於2023年10月至12月，共有65名頸椎脊髓損傷者填寫網路問卷。在統計方法上，本研究以相關分析與迴歸分析，檢視心理復原力與障礙適應對社區融入是否具有解釋力，進而驗證障礙適應的中介效果。結果發現，對於頸椎脊髓損傷者而言，心理復原力、障礙適應與社區融入度兩兩之間呈中度正相關。在心理復原力對社區融入的中介模式中，亦驗證心理復原力對適應障礙有正面影響，且心理復原力透過障礙適應，間接影響社區融入。對此，研究者建議脊髓損傷後重建過程，應提供復原力及障礙適應的訓練介入方案，以利重返社區融合提高社會參與。

Spinal cord injury can disrupt functionality, leading to psychological stress and physical challenges, particularly in cases of cervical spine injury that results in tetraplegia. Cervical spinal cord injury affects the upper body, resulting in trunk muscle weakness, impaired sitting posture, and reduced trunk function, thereby limiting overall functional activities. This study aims to preliminarily explore the correlations among brief resilience, acceptance of disability, and community reintegration among individuals with cervical spinal cord injury. Additionally, it will examine the mediating effects of disability acceptance, which will contribute to our understanding regarding the resilience of cervical spinal cord injury patients and enhance their effective reintegration into community life. A cross-sectional research design was employed, with participants being individuals aged 18 and above who have returned to community living following cervical spinal cord injury. The participants were required to understand Mandarin and possess the ability to operate computers or smartphones. Using the snowball sampling method, a total of 65 individuals with cervical spinal cord injuries completed an online survey between October and December 2023. This study utilizes Pearson correlation and regression analysis to determine whether brief resilience and disability acceptance can predict community reintegration, while also examining the mediating effect of disability acceptance. The results showed that brief resilience, disability acceptance, and community reintegration were all moderately and positively correlated. In the mediation model of brief resilience on community reintegration, brief resilience was found to positively impact disability acceptance for patients with cervical spinal cord injury, and brief resilience indirectly influenced their reintegration into the community through disability acceptance. In this regard, researchers recommend that the rehabilitation process following a spinal cord injury should incorporate training interventions aimed at enhancing brief resilience and disability acceptance. These interventions are essential for facilitating community reintegration and improving social participation.