中風病患整體健康相關生活品質之關聯因素探討

Factors Predicting Overall Health-Related Quality of Life in Patients with Stroke

李雅珍(Ya-Chen Lee) ； 吳姿誼(Zi-IWu) ； 邱恩琦(En-Chi Chiu) ； 凃富籌(Fuh-Chour Twu) ； 謝清麟(Ching-Lin Hsieh)

《職能治療學會雜誌》 30卷1期 (2012/06) Pp. 53-67

https://doi.org/10.6594/JTOTA.2012.30(1).03

摘要

健康相關生活品質（health-related quality of life, HRQOL）反映中風病患主觀感受，而整體HRQOL（overall HRQOL, O-HRQOL）可綜合呈現病患之整體健康狀態，方便臨床人員瞭解病患之病情。而且O-HRQOL以單一數值呈現，方便臨床人員解釋病患之評估結果，有助於提升臨床效率。然而研究人員對於影響O-HRQOL之相關因素仍然所知有限，造成臨床人員難以制訂提升病患O-HRQOL之計畫。因此本研究之目的為探討與中風病患O-HRQOL相關之因素。130位中風滿一年之病患接受5個量表（巴氏量表，Barthel Index, BI；芙蘭切活動量表，Frenchay Activities Index, FAI；福格邁爾運動量表，Fugl-Meyer Motor Assessment, FMA；福格邁爾運動量表的平衡次量表，Fugl-Meyer Balance Subscale, FMB；中風病患專屬生活品質量表，Stroke-Specific Quality of Life, SSQOL）的評估。研究者先以t檢定比較不同人口學特性病患間之SSQOL分數是否有顯著差異，並計算SSQOL與其它4個量表得分之相關程度（Pearson's r）。再以逐步迴歸分析（stepwise regression）驗證中風後一年O-HRQOL之相關因素。研究者發現病患的SSQOL得分與其年齡、BI總分、FAI總分、FMA總分及FMB總分有顯著關聯 （p＜.001）。逐步迴歸分析結果發現BI總分、FAI總分與FMA總分為解釋中風後一年O-HRQOL之重要因素（R2＝.66）。以上結果顯示：ADL功能與動作控制能力為O-HRQOL之主要相關因素。此結果亦支持職能治療之理念：促進病患之日常生活活動功能可提升病患之HRQOL。

關鍵字

健康相關生活品質 ； 中風 ； 日常生活活動 ； 動作控制

並列摘要

Health-related quality of life (HRQOL) reflects the subjective experience of patients. Overall HRQOL (O-HRQOL) provides patients' a summarized health status, which helps clinicians determine patients' overall condition. O-HRQOL is displayed in a single index, which is useful for clinicians to interpret the result of assessment and to promote the efficiency of patient management. However, the factors related to stroke patients' O-HRQOL are largely unknown, limiting clinicians' efficiency of patient management. We aimed to investigate the factors associated with O-HRQOL in patients with stroke. One hundred and thirty one-year post stroke survivors were assessed for activities of daily living (ADL) functions (using the Barthel Index, BI and Frenchay Activities Index, FAI), motor control (using the Fugl-Meyer Motor Assessment, FMA), balance (using the Fugl-Meyer Balance Subscale, FMB),and O-HRQOL (using the Stroke-Specific Quality of Life, SSQOL). The data were examined using an independent samples t-test to analyze the difference between the characteristics of stroke patients and the summarized SSQOL scores. Pearson's r was used to determine the relationships between the summarized SSQOL scores and the scores of the other measures (BI, FAI, FMA, and FMB). Stepwise regression analysis was used to identify factors associated with SSQOL scores. We found that the SSQOL score was associated with age, BI score, FAI score, FMA score, and FMB score (p＜.001). Regression analysis showed that BI score, FAI score, and FMA score were strongly related to O-HRQOL (R^2=.66). These results showed that ADL and motor control are important factors associated with O-HRQOL in patients with stroke.

並列關鍵字

Health-related quality of life ； stroke ； Activities of daily living ； Motor control