個人及健康照護體系復原力之理論與應用

Resilience of Individual and Health Care System: Theory and Application

近年來復原力的觀念逐漸受到重視，去年全球嚴重特殊傳染性肺炎疫情盛行，此議題再度被廣泛討論，本文旨在回顧國內外文獻，闡述復原力的定義、理論及學術與臨床上的運用。

個人復原力定義為「面對重大壓力、創傷和逆境，協調、處理以及適應的過程」，健康照護體系復原力定義為「體系面臨危機時，應變與維持功能，汲取經驗並重新整頓的能力」。建構個人復原力的內在因子包括自尊心、自我感覺、個人競爭力、社會競爭力、外向性和開放性，外在因子包括天然環境、人為環境、社會網絡及教育，目前已有各式評估量表可應用於臨床研究。健康照護系統復原力則應具備資訊處理、解決問題、建構組織和適應轉型的能力。我們可由復原力矩陣觀察體系適應事件的階段及面向，評估其復原力。持續性的心理諮商、教育訓練、自我學習及團體活動可增強個人復原力，而健康照護體系復原力則須完善整體規劃。

復原力可應用於家庭醫學各項臨床業務中，以提升照護品質，在經營及管理上亦可應用復原力觀念，提高單位的應變能力。學術研究方面，未來可發展更適當的評估工具，或對特定對象進行復原力分析或介入成效評估，亦可發展資訊系統建構。

總結以上，擁有良好復原力可提升個人心理衛生狀態、促進社區健康並完善健康照護體系，在臨床與學術上也能有良好發展，個人或體系面對未來的各種重大事件衝擊上，也能有更充足的準備。

 

Individual and health system resilience has been an issue drawing increasing attention in recent years, especially after the outbreak of the COVID-19 pandemic. This article reviews studies on resilience, including its definition, theory and applications.

Individual resilience is generally defined as “a process of negotiating, managing, and adapting to significant sources of stress or trauma.” Health system resilience, on the other hand, refers to “the ability to adjust, adapt, learn, and transform to maintain essential functions when health care institutes, their members and people are facing serious events.” Individual resilience is constructed and related to acceptance, optimism, self-esteem, competence, extroversion, and openness. Extrinsic factors are related to environment, society and education. Several evaluation scales have been developed. We can improve individual resilience by continuous counseling, education, and group activities. Health system and institutes resilience can also be improved by detailed planning.

The concept of resilience can apply to family physicians’ daily clinical practice to help enhance primary care quality. It can also be used to manage a subspecialty, local clinic, or hospital. There are also plenty of developments in the field of research, including intervention, evaluation, and system construction.

In summary, resilience contributes not only to personal physical and mental wellbeing but also to the ongoing improvement of social support and health systems, helping individuals, communities, and institutions better prepare for future events.