腦損傷病人之復原力

Resilience in Patients With Brain Injury

腦損傷病人罹病後，須適應生活改變及接受長期復健，對於身心、家庭及社會造成沉重負擔，然而面對人生逆境，透過良好的復原力（resilience）則可獲得支持與適應新生活。本文透過文獻查證，探討腦損傷病人之定義與面臨的困境，並以概念分析（concept analysis）客觀角度系統性地分析復原力的機轉，包含前置因素之逆境、定義性特徵之內在因子、外在因子、保護因子與危險因子，以及後果之疾病推展；並介紹國內外常用之復原力評估工具，最後彙整近年來對於腦損傷病人之復原力相關實證策略及其成效。期許能幫助醫療人員瞭解腦損傷病人復原力的內涵，增進病人的保護因子並削弱危險因子，進而提升其復原力與生活品質。

After brain injury, patients must adapt to their altered lives and undergo long-term rehabilitation, which is a process that imposes increasing burdens on personal health, families, and society. In facing adversities in life, having a relatively high level of self-resilience can help patients secure critical support and successfully adapt to life changes. In this article, a literature review is used to discuss the challenges faced by patients with brain injuries and resilience in these patients is systematically and objectively analyzed using concept analysis. The significant mechanisms identified include the difficulties associated with having predisposing factors, internal and external risk factors, protective factors of attributes, and disease progression of the outcome. Furthermore, commonly used assessment tools in Taiwan and elsewhere are introduced, and empirical strategies that have been deployed in recent years to enhance scholarly understanding of resilience in patients with brain injuries and its progressive improvement are discussed. The objective of this study was to help medical professionals better understand the nature of resilience in patients with brain injury, strengthen protective factors, reduce risk factors, and ultimately improve resilience and quality of life.