中風病人施行玻巴斯復健護理方案成效之探討

The Efficacy of Bobath Rehabilitation Nursing Protocol on the Cerebral Vascular Accident Patients

吳麗君(L. G. Wu) ； 高紀惠(C. H. Kao) ； 馬素華(S. H. Maa) ； 陳獻宗(S. T. Chen) ； 潘璦琬(A. W. Pan)

《長庚護理》 7卷3期 (1996/09) Pp. 1-14

摘要

患側感覺活動功能障礙是多數中風病人共有的問題，也是病人疾病適應與日常活動障礙的主因。傳統復健護理强調以健側代償，易促使患側忽略與肌張力異常。因此，目前能有效地重建中風病人活動的復健護理方案尚值得深入探討。玻巴斯復健護理方案強調早期兩側平衡的訓練，能促進肌張力與活動的正常化。本研究目的即是探討玻巴斯復健護理方案，對中風病人平衡、功能獨立性程度、心理反應與復健護理活動進展程度的影響。研究採準實驗法，立意選取某醫學中心50位中風病人，實驗組與對照組各25位。實驗組施行玻巴斯復健護理方案，並以衛教手冊說明，而對服組則接受傳統復健護理。
研究結果顯示：1.兩組病人基本資料無顯著差異；2.施行玻巴斯復健護理者的平衡程度，較施行傳統復健護理者有顯著的改善。3.施行玻巴斯復健護理者的功能獨立性程度，較施行傳統復健護理者有顯著的改善。4.施行玻巴斯復健護理者的負向心理反應，較施行傳統復健護理者有顯著的減低。5.施行玻巴斯復健護理者能獨立完成復健護理活動所需的日數，較傳統復健護理者有顯著的縮短。
由此可見，針對中風偏癱病人施行玻巴斯復健護理方案，可加強兩側的平衡與功能獨立性程度，並能促進心理適應，爲一有效而合適的復健護理方式(Bobath rehabilitation nursing)、平衡(balance)、功能獨立性(functional independence)、心理反應(psychologic response)。

關鍵字

中風 ； 玻巴斯復健護理

並列摘要

Unilateral sensory-motor function impairments are common problems on the stroke patients. Functional dysfunction of the affected side is the major cause of maladaptation and disability. Traditional rehabilitation nursing emphasizing compensation of unaffected sides can result in unilateral neglect and abnormal muscle tone. Therefore, the effective rehabilitation nursing interventions for restoring the functional abilities still needed to be explored. Bobath rehabilitation nursing emphasizing the training of both affected and unaffected sides can promote muscle tone and restore the ability of activities.
The purposes of this study were to explore the effect of Bobath rehabilitation nursing protocol on the balance, functional independence, psychologic responses and progress of activities of the stroke patients. A Quasi-experiment study was designed and 50 patients were consecutively assigned to experimental group (n=25) and control group (n=25). The Bobath rehabilitation nursing protocol was implemented on experimental group whereas control group received conventional rehabilitation nursing.
The results showed as follows: (1) There was no significant difference in demographic data between two groups. (2) Experimental group presented better improvement of balance than control group. (3) Experimental group demonstrated better improvement of functional independence than control group. (4) Experimental-group reflected lower negative psychologic responses than control group. (5) The days to attain the independent activities were more shortened on experimental group than on control group.
Obviously, this study suggested that Bobath rehabilitation nursing protocol could enhance the improvement of balance, functional independence, psychologic negative responses, and independent activities, so that Boboath rehabilition nursing protocal can be a useful intervention for stroke patients.

並列關鍵字

CVA ； Stroke ； Bobath Rehabilitation