影響腦中風患者使用居家復健服務相關因素之探討

The Associated Factors in Home-Based Rehabilitation Utilization of Stroke Patients

吳淑娟(Shu-Chuan Wu) ； 張育嘉(Yu-Chia Chang) ； 葉德豐(Te-Feng Yeh) ； 張廷宇(Ting-Yu Chang) ； 呂偉僑(Wei-Chaio Lu) ； 黃建財(Chien-Tsai Huang) ； 林川雄(Chuan-Hsiung Lin) ； 黃麗玲(Li-Ling Huang)

《台灣復健醫學雜誌》 40卷3期 (2012/09) Pp. 147-159

https://doi.org/10.6315/2012.40(3)04

摘要

本研究探討在政府「長期照顧十年計畫」政策推動下，影響腦中風個案使用居家復健服務的相關因素。資料來源為2008年7月至2010年6月期間，初次向「台中縣長期照護中心」申請服務之腦中風個案；本研究擷取個案「長期照顧管理服務個案評估量表」中的資料，依據Andersen健康行為模式理論架構，探討腦中風個案使用居家復健服務的影響因素。本研究共收集759位腦中風個案，其中有119位個案（15.7%）使用居家復健服務。迴歸分析結果發現前傾因素之年齡和婚姻狀況；使能因素之經濟來源和目前使用「居家服務」社會福利資源；需求因素之個案罹患疾病數目和認知功能、個案需要安全維護和復健關節活動的協助、個案申請居家服務和居家護理服務項目者等10個項目為影響腦中風個案使用居家復健服務的關鍵因素。研究結果顯示除了個案的需求外，經濟因素明顯影響腦中風個案使用居家復健服務的意願。政府「長期照顧十年計畫」政策之「居家復健服務」提供腦中風個案更切身的居家復健指導與無障礙環境改善，期望能增進個案日常生活功能的獨立；但相關單位應進一步規畫公平及精確的經濟補助方式，以確保長期照顧服務資源分配之效益與保障病人的照護品質。

關鍵字

腦中風 ； Andersen 健康行為模式 ； 居家復健 ； 長期照顧十年計畫

並列摘要

This study explores the factors correlated to the use of home-based rehabilitation services by stroke patients for whom care is provided according to the state policy pertaining to the 10-year long-term care plan.During July 2008–June 2010, data were collected from 759 stroke patients by using a long-term care management service evaluation form. These patients had initially applied for services at the long-term care centers of the Bureau of Public Health in Taichung County. Of these, 119(15.7%) eventually used home-based rehabilitation services. Using the Andersen health behavior model, we investigated how various factors influence the use of home-based rehabilitation services by stroke patients.Logistic regression analysis showed that from the key factors influencing the use of home-based rehabilitation services, age and marital status are predisposing factors; source of income and current use of home services are enabling factors; and the number of chronic diseases, impairment of cognitive function, necessity for safety maintenance, range of joint motion rehabilitation exercises, application of home services and home care are necessitating factors.The willingness of stroke patients to use home-based rehabilitation services was found to be affected by their varying requirements and was also significantly affected by economic factors.Under the state policy pertaining to the 10-year long-term care plan, the agencies provide stroke patients reliable home rehabilitation services and upgrade the safety levels in their homes according to their disabilities. The agency's goal is to promote independent performance of activities of daily living among stroke patients. The current results indicate that agencies must establish financial subsidies for economically disadvantaged families in order to ensure efficient delivery and adequate allocation of long-term care services and to ensure the quality of long-term care services.

並列關鍵字

stroke ； Andersen health behavior model ； home-based rehabilitation ； 10-year long-term care plan