外傷性腦受傷患者健康相關生活品質之縱貫研究

A Longitudinal Study of Health-related Quality of Life in Patients with Traumatic Brain Injury

陳怡如(Yi-Ju Chen)

指導教授 ： 邱文達

共同指導教授 ： 林茂榮

臺北醫學大學/公共衛生暨營養學院/傷害防治學研究所/碩士(2007年)

https://doi.org/10.6831/TMU.2007.00045

摘要

許多外傷性腦受傷患者在治療後未能完全康復，且生理、心理、認知、行為、情緒及社會功能皆需要長時間的照護。生活品質的研究包含了各方面評估，使得許多研究追蹤生活品質的變化，藉以瞭解疾病的恢復情形。本篇為國內首次以縱貫性研究法蒐集外傷性腦傷患者生活品質，收案對象為2006年4月至10月，於台北市四家醫院求診之新發生外傷性腦受傷患者共203人，追蹤並記錄每位傷者半年內三個時間點的生活品質。在159份填寫完成問卷中，由傷者本人完成問卷的人數計有：受傷前135人、受傷三個月內129人、傷後六個月135人。將收案結果以世界衛生組織生活品質問卷台灣簡明版（WHOQOL-BREF）分析生理、心理、社會關係及環境等四個範疇與人口學特質、傷後結果、認知情形、日常生活能力、社會支持及憂鬱程度等各變項間的相關。在分析時間與健康相關生活品質各範疇的相關變化發現，各範疇皆呈現受傷前分數最高，受傷後三個月內分數最低，受傷後六個月分數開始回升的變化情形。以多變項混和模式分析受傷後六個月內四個範疇與各個變項間的影響，對生理範疇有統計上顯著意義分別為「年齡」：每增加一歲，其生理範疇分數則減少0.3分；「住院天數」：每增加一天，生理範疇分數則減少0.6分；「日常生活功能」及「憂鬱程度」。心理範疇有統計上顯著意義分別為「受傷程度」、「認知障礙」、「社會支持」及「憂鬱程度」。社會關係範疇有統計上顯著意義分別為「慢性疾病數」、「受傷程度」、「社會支持」及「憂鬱程度」。環境範疇有統計上顯著意義分別為「教育程度」、「受傷前有無工作」、「社會支持」及「憂鬱程度」。受傷後有憂鬱情形，在四個範疇皆達統計上顯著。

關鍵字

外傷性腦受傷 ； 縱貫性研究 ； WHOQOL-BREF

並列摘要

Traumatic brain injury (TBI) causes permanent disabilities and death and it has been an important health issue. In doing research of TBI-related quality of life issues, we have suggested some important recommendations in its management. In this longitudinal study, we investigated the health-related quality of life of TBI patients. Through March 1st to October 31st, 2006, we included 203 patients who were older than 18 years old in four hospitals in Taipei. We used the assessment tool of WHOQOL-BREF to evaluate the health-related quality of life at time 0, 3 and 6 months after the TBI, and recorded their outcome, functional status, depression status and social support condition. In this research, only 159 TBI patients finished the study. The result of the study showed that the scores in physical health domain were decreased to 22.5 points after 3 months of the TBI event and were improved to 8.9 points after 6 months of the event. The scores in psychological domain were decreased to 12.1 points after 3 months of injury and were improved to 5.9 points after 6 months. The scores in social relationships and environment domain did not show much difference. In single variable analysis, we found that demography of the population, outcome, cognitive status, functional status and social support were significantly related with their physical and psychological domain scores at time 0, 3 and 6 months after the TBI injury. In multiple variable analyses, we found that patients’ age remained as an important factor for their physical domain scores, that getting one year older, the scores were decreased by 0.3 points, that patients’ depression scores were significantly related with all domains of health-related quality of life especially in the psychological domain, and that with the depression mood, the psychological domain scores were 15.4 point less. In conclusion, TBI patients in our study showed high scores of being depressed status.

並列關鍵字

longitudinal study ； Traumatic brain injury ； WHOQOL-BREF

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