Relationships between Stress, Coping Strategies and Quality of Life in Adult Asthma Patients

Abstract

本研究目的在探討成人氣喘患者壓力、因應策略與生活品質的現況及關係。以台北市 某醫學中心胸腔內科及氣喘過敏科門診的成人氣喘患者爲對象，經立意取樣（ purposive sampling），共選取132位患者爲研究樣本，使用結構式問卷，進 行資料收集。結果發現成人氣喘患者的平均生活品質得分居中等程度，且在生活品質 所涵蓋的五個層面中以「親密因素」的生活品質最佳，「環境因素」最差；而患者因 氣喘疾病所感受到的壓力程度總分高低差異相當大，其中以生理壓力帶給患者的壓力 程度最大。患者在面對疾病相關壓力時，最常使用「保持樂觀」的因應策略，而最少 使用「情緒發洩」。經迴歸分析發現，成人氣喘患者的整體壓力程度愈低，自覺健康 狀況愈好，保持樂觀的因應策略使用頻率愈高，順其自然的因應策略使用頻率愈低時 ，生活品質愈佳。依本研究結果建議促進患者疾病控制，減少氣喘發作及惡化，引導 患者使用正向思考、積極面對問題的因應策略是護理人員在提昇氣喘病人生活品質的 重點。 This study explored the relationships between stress, coping strategies and quality of life in adult asthmatic patients. One hundred and thirty-two patients with asthma were recruited from the Chest division and Asthma & Allergy division of the out-patient department of a medical center by purposive sampling. A structured questionnaire was used to collect data from subjects via structured interviews or self- administration. Statistical analysis of data was performed using the SPSS/ PC program. Results of this study showed: (1) Mean score of quality of life was in the middle level. Among the five dimensions of quality of life , “intimacy”ranked the highest, and “environment” the lowest. (2) There was a wide range of levels of stress among adult asthmatic patients. Physical stress was the greatest contributing factor, and social stress the least. (3) ”Staying optimistic” was the most frequently employed coping strategy, and “emotional venting” the least. (4) Multiple regression analysis indicated that subjects with lower scores for total stress and better self-perceived health, and who more frequently used the strategy of “staying optimistic”, and less frequently used “letting nature take its course” to cope with stress, had a better quality of life . These results explained 38.9% of the variance in quality of life. In conclusion, the findings of this study may help nursing professionals to better understand stress, coping strategies and quality of life in adult asthmatic patients. Thus, it would advance nurses competence in helping patients to manage stress and coping effectively.