手部外傷病患住院期間之急性創傷後反應－量表發展及現況

The Acute Post-Traumatic Responses in Hospitalized Hand Injury Patients-Scale Development and Current Status

陳淑卿(S. C. Chen) ； 賴裕和(Y. H. Lai) ； 林佳靜(C. C. Lin) ； 陳宏基(H. C. Chen)

《長庚護理》 10卷4期 (1999/12) Pp. 31-39

摘要

手部外傷爲最常見的一種意外事件，評估病患急性期的創傷後反應可作爲其對疾病適應的預測，而目前臨床上缺乏一简短的創傷反應量表，故本研究目的爲：(1)發展「急性創傷後反應量表」；(2)檢測「急性創傷後反應量表」之信度及效度；(3)探討手部外傷病患之急性創傷後反應之現況；(4)探討手部外傷病患之人口學特性及創傷特質與創傷反應之相關性。本研究第一階段以訪談指引訪談五位病患，目的爲修正訪談指引及探討手部外傷病患創傷後反應的特質，第二階段則依第一階段訪談內容分析及文獻查證資料，發展Likert類型1-5分法的「急性創傷後反應量表」共計十三题，並檢測量表之信效度及病患受傷之創傷後反應的現況。以立意取樣法於北部某醫學中心，針對120位手部外傷之住院病患進行資料收集。問卷以Cronbach's alpha、專家效度、因素分析法檢測其信效度，並以描述性統計、t檢定及皮爾森積差相關法分析資料。研究結果顯示：(1)量表之內在一致性Cronbach's alpha係數爲.89；(2)量表之因素結構分析明顯呈現一個因素，因素負荷值爲.45~.71，其解釋量爲39.8%；(3)本研究之個案感受到中等程度之急性創傷後反應；(4)女性較男性感受到強烈的急性創傷後反應，創傷嚴重度與創傷後反應呈顯著之互相關。本研究發展之急性創傷後反應量表初步具有良好的信度及效度，且題目內容精简，可提供臨床照護人員在簡短的時間內評估病人住院期間的急性創傷後反應，以提供適切之護理措施改善創傷反應。

關鍵字

手部外傷病患 ； 急性創傷後反應 ； 量表發展

並列摘要

Hand injury is one of the major accidents in Taiwan. Assessing the post-traumatic responses may predict the adaptation of illness. However, few validated assessment tool has been applied for assessing acute post-traumatic responses of patients with hand injury in clinical setting. The purposes o this study were to (1) develop the ”Acute Post-Traumatic Response Scale (APTRS)”, (2) test the reliability and validity of the scale, (3) explore the acute post-traumatic responses in patients with hand injury, and (4) explore the correlation of demographics characteristic and traumatic characteristics with acute post-traumatic responses in patients with hand injury. This study consisted of two steps. Step 1 was to interview five patients using an interview guide. The purposes of step 1 were to revise interview guide and explore the characteristics of acute post- traumatic responses in patients with hand injury. According to the results of the content analysis on interriew data and literature review, ”Acute Post-Traumatic Response Scale (APTRS)” was developed. Step 2 was to administrate Acute Post-Traumatic Response Scale to a latger sample. One hundred and twenty subjects were recruited from an plastic surgery inpatient ward in a medical center in Northern Taiwan by purposive sampling. The Cronbach's alpha coefficient of APTRS was. 89. Based on the results of factor analysis the thirteen items of APTRS were grouped into one factor and accounted for 39.8% of the total variance. The results also indicated that patient with hand injury had moderate post-traumatic responses. Female patients had higher acute posttraumatic responses than male patients. There's a positive correlation between the severity of trauma and acute post-traumatic responses. In conclusion, the APTRS is useful, valid and reliable.

並列關鍵字

hand injury ； acute post-traumatic responses ； development of scale