肢體障礙兒童與青少年的自覺生活品質 及其適應情況

Self-perceived Quality of Life and Adaptability of Children and Adolescents with Physical Disability

徐靜怡(Ching-Yi Hsu)

指導教授 ： 林昭宏

高雄醫學大學/健康科學院/行為科學研究所/碩士(2007年)

https://doi.org/10.6832/KMU.2007.00149

摘要

背景和目的：台灣肢體障礙兒童與青少年如何適應障礙的研究目前不多，本研究的目的在於調查肢體障礙學生的生活品質以及長期追蹤他們適應生活的情況。方法：本研究共徵召63位11-18歲肢體障礙組的兒童和青少年以及282位來自相同地區一般正常組學生，他們都是來自於高雄市教育局所管轄國小五年級以上到高中(職)學校的學生。使用學生版全面性生活品質量表 (Student Version of the Comprehensive Quality of Life Scale, Com QOL )做為施測工具，在二年內每隔六個月定期評估肢障組主觀與客觀生活品質七個層面分數變化情況。以多變量變異數分析(Multivariate analysis of variance)肢障組與正常組學生的生活品質量表分數；以皮爾森相關係數(Pearson’s r)檢定生活品質客觀和主觀各層面之間的關聯性；使用雙樣本t檢定(two sample t-test)檢視肢障組兒童與青少年生活品質的相關影響因素；以重複測量變異數分析(Repeated measures analyses of variance)肢障組學生二年間四個時期生活品質分數變化情形。結果：兩組在客觀性生活品質得分有明顯的差異性(F=11.53, p<0.01)，在物質層面上肢障組明顯低於正常組；相反地，在成就
感、安全感、快樂感等層面，得分高於正常組。另一方面，在主觀感受上的生活品質，成就感和快樂感層面得分也明顯高於正常組。對於肢障組而言，在主觀感受及客觀測量生活品質各層面之間，兩者得分在統計上並沒有相關性 (r = 0.20, p = 0.12)。在客觀測量社區地位暨人際關係層面得分，輕度和中度障礙程度的學生明顯高於極重度和重度 (p < 0.01)；另一方面，特殊班學生則明顯低於融合班 (p < 0.05)；不同年齡層11-15歲學生在與家人及朋友的互動客觀測量層面得分明顯高於16-18歲年齡層的學生；然而，在主觀感受上，16-18歲年齡層的學生在社區地位暨人際關係層面得分明顯高於11-15歲年齡層的學生。在二年的追蹤期間，主觀感受成就感層面得分會隨著年齡的增長有明顯改變，且整體主觀感受生活品質表現在各層面上的平均分數有明顯減少 (F=5.11, p <0.05)。結論：肢體障礙和正常學生在主觀和客觀生活品質表現上存在不同層面的差異性；不同障礙程度、班級類型和年齡等因素也會對肢障學生的生活品質造成影響；在兩年追蹤期間肢障學生在主觀感受生活品質分數變化趨勢，顯示他們還在適應生活的情況。

關鍵字

生活品質 ； 主觀感受 ； 肢體障礙

並列摘要

Background and Purpose: Information regarding how children and adolescent with physical disability (PD) adapt with their life is absent in Taiwan. The aim of this study was to longitudinally investigate their status of adaptation in terms of changes in their quality of life (QOL). Methods: Sixty-three children and adolescents with PD, aged 10-18 years from primary (5th grade or above) to high schools in Kaohsiung city, volunteered to participate in the study; 282 children without PD attending schools in the same geographical region were recruited as controls. The Student Version of the Comprehensive Quality of Life Scale (COMQOL-S) was used. They were followed up for 2 years and their QOL scores were recorded at baseline and then every 6 months. Multivariate analysis of variance (MANOVA) was used to examine domain scores simultaneously. Pearson correlation analysis was used to examine the relationship between subjective and objective QOL scores. Two-sample t-test was used to test any significant differences in QOL scores between gender, age groups, class settings and physical disability level. Repeated measures analysis of
variance was used to compare the overall and QOL scores of the seven domains in COMQOL-S at different stages. Results: The two groups were significantly different in objective QOL (F=11.53, p<0.01). Material wellbeing was substantially lower in the PD group when compared to the control group. In contrast, domains such as productivity, safety, and emotion were higher in the PD group. Among the subjective scales, the PD group showed higher productivity and better emotion when compared to the control group. No significant correlation was observed between objective and subjective overall QOL scores (r=0.20, p=0.12) in the PD group. Objective QOL of place in community in mild and moderate PD groups significantly higher than those in severely and very severely PD groups (p<0.01); however, objective QOL of place in community in special class group significantly lower than mix class group. Higher QOL scores of objection intimacy were found in younger age group (11 to 15 at age) than in older age group (16 to 18 at age). Lower subjective QOL scores of place in community were found in younger age group. During the follow-ups, overall subjective QOL scores were significantly declined. Conclusions: These findings showed that
subjects with PD in regular schools demonstrated different patterns in objective and subjective QOL when compared to those without PD. Different extents of variations in self-perceived QOL were observed in different physical disability level, class settings and age groups. The data preliminarily showed that children and adolescents with PD are likely under adaptation process of their PD in terms of changes in subjective QOL scores.

並列關鍵字

Quality of life ； subjective wellbeing ； physical disability

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