The series of research for exploring the association among health literacy, resilience, and quality of life for patients with cancer
Ministry of Science and Technology
National Taipei University of Nursing and Health Sciences
National Taipei University of Nursing and Health Sciences-Department of Health Care Management
breast cancer;cancer health literacy;resilience;quality of life
背景 癌症是一項嚴重且複雜的疾病，同時，癌症病患也面臨隨疾病而來 的各種困境，包含疾病與治療所衍生的生理影響，以及心理層面感 受到的生命威脅。雖然過去在醫療上已經有很多努力與成果，但多 數卻都集中照護提供者的部分，社會心理層面並未被適當的討論。 近年來，社會心理因素在癌症治療的角色已經有許多討論，其中健 康識能與復原力是最常被討論的議題，且其與治療品質的關係已有 許多文獻所確認。然而，健康識能、復原力與生活品質之間的關係 仍不清楚。因此，本研究之目的為: 探討健康識能、復原力與生活 品質之關係，並驗證復原力是否中介健康識能與生活品質之關係。 方法 本研究採橫斷式調查，為使資料收集方便，本研究與台灣癌症病友 協會合作，並以乳癌病患作為本研究之研究對象。乳癌識能評估工 具(Breast Cancer Literacy Assessment Tool), EORTC 乳癌生活 品質量表( EORTC QLQ - BR23)和復原力量表(Resilience Scale)作 為本研究之研究工具，並透過台灣癌症病友協會臉書專頁每月活動 發放問卷。 結果 這項研究共招募了114名患者。平均復原力得分為 134.55（24.83），平均健康識能得分為23.94（2.36），平均生活 品質得分為69.36（10.36）。結果顯示工作狀態，癌症分期，治療 狀態，罹患乳癌前的健康狀況以及對健康的關注程度與復原力相關 。工作狀態和對他們健康的關注程度與癌症健康識能相關；受教育 程度，是否有宗教信仰以及工作狀態是影響生活品量的重要因素。 我們還發現，更好的癌症健康識能和復原力可以帶來更好的生活品 質，我們還發現，透過增強復原力，可以將癌症健康識能與生活品 質之間的關係提高10％ 結論 癌症治療有其自身的壓力源，包括治療挑戰，不良事件和生活變化 。在癌症治療期間提高健康識能和復原力可能會促進在治療期間和 之後更好地適應和取得其他積極的社會心理成果。這項研究的發現 發現，癌症健康識能和復原力與生活品質呈正相關，而通過增強復 原力可以稍微改善癌症健康素養與生活品質之間的關聯。
Background Cancer is a critical and complex illness as well, and cancer patients face multiple adversities within their illness, including both the physical impact of the disease (i.e., pain and discomfort) and treatment, as well as the psychological aspects of the knowledge of having a potentially life-threatening illness. Although much effort has been expended, this has mostly concentrated on the healthcare provider and does not adequately address the psychosocial aspects. In recent years, the role of psychosocial aspects in cancer treatment has been given increased attention, where health literacy and resilience are the most commonly discussed issues, and these factors associated with better quality of treatment have been validated. However, the association among health literacy, resilience and quality of life is unclear. Therefore, the purpose of this study is to explore the relationships among cancer literacy and resilience, and quality of life, and discussing whether resilience mediates the relationship between cancer literacy and health-related quality of life. Methods A cross-sectional questionnaire survey was conducted. For the convenience of data collection, we collaborated with Taiwan Association of Cancer Patients, and selected breast cancer as our study population. Breast Cancer Literacy Assessment Tool, EORTC QLQ - BR23 and Resilience Scale were used as measurement tools. The online questionnaire was distributed via Taiwan Association of Cancer Patients facebook page and monthly activities. Results A total of 114 patients were recruited in this study. The average score of resilience was 134.55(24.83), average health literacy score was 23.94(2.36), and the average of quality of life score was 69.36(10.36). the results revealed working status, cancer stage, treatment status, health status before having breast cancer, and the level of paying attention on their health were associated with resilience; working status and the level of paying attention on their health were associated with cancer health literacy; education level, whether having a religion, and working status were the significant affecting factors toward quality of life. And we also found better cancer health literacy and resilience could bring better quality of life, we also found QoL can be improved 10% through enhancing resilience. Conclusions Cancer treatment has its own stressors, including treatment challenges, adverse events, and life changes. Promoting the level of health literacy and resilience during cancer treatment may encourage better adaptation and other positive psychosocial outcomes during and after treatment. The findings of this study revealed cancer health literacy and resilience were positively associated with quality of life, and the association between cancer health literacy and quality of life can be improved slightly by enhancing resilience.