| Summary: | 碩士 === 國立台北護理學院 === 護理研究所 === 93 === The purpose of this study was to investigate the daily function, helplessness and QOL among the middle age and elder RA patients in the out-patient department and to analyze the predictable factor in QOL.
Cross-sectional design and convenient sampling were used in this study. One hundred and fifty-eight middle age and elderly outpatients were recruited. The difference of QOL between the groups of middle age（50-64yrs）and old age（65yrs and above）was compared. The structural questionnaire was applied as the research tool which included demographics sheet, Health Assessment Questionnaire (HAQ), DAS-28 and Short Form 36 (SF-36). The statistics software of SPSS 11.0 and S-PLUS 6.2 Professional were applied for data analysis, including using description, Person，s product moment correlation and regression analysis methods.
The result showed that middle-aged RA patients got higher score of PCS in QOL than old-aged patients（p＜.05）,but both groups， scores were low.（35.7±9.9 vs. 31.5±11.2）It means that QOL in physical health dimension are not ideal for both groups. Comparison in MCS reveals that both groups have average-level QOL (43.9±11.8 vs.43.6±12.8) in vitality, social functioning, role limitation due to emotional problems and mental health.
Result also showed that disease period (r＝-.20), pain degree (r＝-.20), disease activity (r＝-.53), HAQ (r＝-.20), and Rheumatology Attitudes Index (r<.47) were highly negatively correlated with PCS individually (P<.01). In MCS, pain degree (r＝-.51), disease activity (r＝-.39), HAQ (r＝-.41), and Rheumatology Attitudes Index (r<.41) were also negatively correlated (P<.01).
By Hierarchical multiple regression, the result showed that pain degree and HAQ (raise, walking, hygiene and activity) can explain 68.1% of the total variance of PCS in quality of life. Hygiene and Rheumatology Attitudes Index of HAQ can explain 40.6% of the total variance of PCS in quality of life.
Health care professionals should consider about how to use medicine or non-medicine methods to relieve pain and to delay disability for RA patients. Besides, helping RA patients to decrease helplessness is also important. The findings of this study can provide as the reference for future intervention study or clinical care to promote the better quality of care for middle age and elderly RA patients.
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