本研究在探討全身性紅斑狼瘡(SLE)與類風濕性關節炎(RA)女性患者之 身體功能、心理狀況與社會功能之影響程度及其影響因素。研究以北部某一醫學 中心過敏免疫風濕科門診、16－49歲、確定診斷為SLE及RA女病患為樣本，採隨 機選取診間方式選案，共有有效樣本SLE103人，RA50人。研究工具含風濕病衝 擊問卷表、精神症狀量表、無助指標、修正型紅斑狼瘡活動性量表及簡易類風濕 症狀評量表，以個別訪談及身體評估方式收集資料。研究結果顯示SLE與RA女性 患者的身體功能受限，休閒╱社交╱活動、家事處理、家庭功能與工作均受到影 響，並呈現不等程度之無助與精神症狀。SLE患者身體功能所受影響較RA患者低 (t =－3.17, _p< 0.01)，無助亦然(t =－2.03, _p< 0.05)，但在精神症狀、休閒╱社交 ╱活動、家事處理、家庭功能與工作上的影響均無明顯不同。無助對SLE患者的 一般精神症狀(t = 3.51, _p< 0.001)、休閒╱社交╱活動(t = 2.31, _p< 0.05)、家庭功 能(t = 2.94, _p< 0.01)具影響力；無助對RA患者的一般精神症狀(t = 2.03, _p< 0.05) 具影響力。皆顯示此二類女性患者所受心理、社會衝擊是慢性病及慢性病調適帶 來的個人、家庭與社會的影響。研究建議重視慢性病的調適問題，慢性病照護應 含蓋身體、心理、社會全面性的照護。

　　　　　Women with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) were examined in terms of the physical and psychosocial impact of the illness and related factors. Female SLE and RA patients, aged from 16 to 49, were randomly selected from the Allergy, Immunology, and Rheumatology division of an outpatient clinic at a medical center in Taipei, Taiwan. These patients were interviewed and underwent a physical examination. The structured instruments used in the study were a Rheumatology Living Impact Questionnaire, Symptoms Checklist -90-Revised (SCL-90-R), Rheumatology Attitudes Index (RAI), Modified SLE Activity Measure (M-SLAM), and RA Symptoms Measure. The study included 103 SLE and 50 RA female patients. Patients suffered multi-dimensional life impact, which included physical function, psychiatric symptoms, leisure/social/activities, household chores, family function, and job impact. SLE patients experienced less physical function difficulty ( t = -3.17, _p< 0.01) and helplessness ( t = - 2.03, _p< 0.05). But there was no difference in terms of psychiatric status, leisure/social/activities, household chores, job adjustment and family function. Helplessness was related to the general symptom index ( t=3.51, _p< 0.001), leisure/ social/activities ( t=2.31, _p< 0.05), and family function ( t=2.94, _p< 0.01) for SLE patients. Helplessness was related to the general symptom index ( t=2.03, _p< 0.05) for RA patients. These findings indicate that the chronic illness experiences include the multi-dimensional life impact on physical function, social life, family function, and job adjustment. Our study suggestes that a physio-psycho-social approach in nursing care is essential for chronic patients.