中風患者之壓力感受與因應行為及自我照顧與自我概念相關性之探討

Exploration of Stress Perceptions and Coping Behaviors as Well as the Relationship between Self-care and Self-concept in People with Cerebrovascular Accident

黃曼聰(Mann-Tsong Hwang) ； 黃小玲(Sheau-Ling Huang) ； 薜漪平(I-Ping Hsueh) ； 徐志誠(Chih-Chen Hsu) ； 吳錦喻(Chin-Yu Wu) ； 黃俐貞(Li-Chen Huang)

《職能治療學會雜誌》 13卷 (1995/12) Pp. 35-51

https://doi.org/10.6594/JTOTA.1995.13.04

摘要

本研究目的在探討中風患者的壓力感受與因應行為，自我照顧能力、自我概念，以提供臨床工作者參考，幫助患者早日接受職能治療，克服身、心障礙，促進獨立性和生活品質。本研究者訪談一些職能治療師和患者，再設計和使用結構性的問卷，共使用六種問卷。本研究所得有效回收問卷－病患組共80名，正常組共27名。病患組之樣本來自台灣地區在醫院中接受職能治療之門診或住院病患，正常組之樣本則以隨機取樣的方式取得。
研究結果顯示，病患組在自我概念、自我照顧之得分較正常組低，且具統計學上有意義之差異；病患組在壓力感受之得分比正常組高，亦具統計學上之意義。此外，病患組之自我概念和日常生活功能之得分並未具統計學上有意義之相關性，未支持本研究之假說：中風患者之自我照顧與自我概念呈正相關。不過研究結果顯示中風患者壓力感受較強者，其自我概念和日常生活功能得分皆較低。
超過半數受試中風患者之壓力感覺依序為覺得身體活動不便、手無法活動自如、擔心會再次中風、搭來交通工具不便、無法從事以前的休閑娛樂、覺得身體感覺變差、無法從事以前的社交生活、心情苦悶、無法繼續工作、需依賴別人照顧日常起居、覺得自己是家人的負擔、使家庭氣氛受影響。而超過半數受試者因應方式依序為專心治病、尋求訊息和社會支持、伴病生活、對病主動因應及訂立計畫、訴諸天命無為哲學。
因此除身體上功能之恢復外，職能治療師應注意患者之心理社會問題，提供－綜合性治療計畫，以促進患者之生理、心理、社會功能，使其能早日獨立生活於社區中並享有好的生活品質。

關鍵字

中風 ； 壓力 ； 因應 ； 自我概念 ； 日常生活活動

並列摘要

The purpose of this study was to explore the stress-related perceptions, coping behaviors, and correlations between self-care and self concept in patients with cerebrovascular accident (CVA). The availability of this information will be of benefit to occupational therapy practitioners who then can help these patients receive occupational therapy services at the early stage of the disease, overcome disabilities resulting from CVA and achieve independence as well as quality of life.
The subjects of this study were composed of twenty-seven, normal adults and eighty CVA patients who were receiving occupational therapy treatment in a rehabilitation unit. Based on information from interviewing, a set of structured questionnaires were designed accordingly.
The results showed that CVA patients scored significantly lower than normal group in the areas of self concept and activities of daily flying (Barthel Index). In addition, the stress-related perceptions score of CVA group was significantly higher than that of the normal group. And, the heavier stress perceived by patients with CVA, the lower scores in their self-concept and Barthel Index. More than half of the subjects with CVA expressed stress-related perceptions and their coping behaviors in sequence.
Therefore, occupational therapists working with the CVA population not only need to treat the physical deficits, but also need to solve the psychosocial problems. A holistic treatment program is important in promoting physical, psychological and social functions of the people with CVA. Such program is also helpful for CVA patients to live in their communities independently, which is an essential requirement for quality of life.

並列關鍵字

cerebrovascular accident ； stress ； coping ； self-concept ； activities of daily living