應用家庭評估模式於物理治療之經驗－中風個案報告

The Application of Family Assessment Model to Physical Therapy: A Stroke Case Report

謝智伶(Chih-Ching Hsieh) ； 黃惠璣(Hui-Chi Huang)

《物理治療》 30卷5期 (2005/10) Pp. 243-249

摘要

背景與目的：中風的發生除了造成患者身體失能，更影響患者與整個家庭之心理社會問題。本個案報告係運用家庭評估模式，找出家庭功能不良之因，幫助物理治療師在擬定治療目標及計畫時，能針對個案與家庭中的困難進行修正與指引，以期改善療效。方法：以Friedman (2003)的家庭評估模式(Family Assessment Model)為基本評估架構，於家訪及個案門診復健時收集資料，包括個人與家庭基本資料、家庭發展階段及任務、環境、結構、功能與壓力因應等六個面向。結果：經評估分析後，確認主要問題為缺乏疾病認知、情感表達與溝通不良及社會支持不足。因此給予個案對疾病與治療之衛教，鼓勵其學習肯定自我、表達意見；並引導家庭照顧者（女兒）對個案做長期照顧計畫；爾後每次物理治療時，鼓勵個案與其他病患互動，透過經驗分享與支持，促進個案面對本身疾病與失能情況。結論：本個案報告提供物理治療師透過家庭評估，體認全人、全家之照護經驗，未來可應用在社區或居家復健治療，提供更完整的評估與服務。

關鍵字

家庭評估 ； 中風 ； 物理治療 ； 家庭照顧者

並列摘要

Background and purposes: Stroke affects not only the individual physical ability, but also influences his/her family psychosocial problems. The family assessment model was applied in this case in order to find out the reason of poor family function, and then guiding physical therapist how to make adequate goals and plans to promote case's physical status. Methods: According to Friedman's Family Assessment model, there are family's demographics, development stage and task, living environment, family structure, family function, and family stress. Data were collected by home visits and outpatient rehabilitation. Results: The major problems of this case were lacking of the cognition of CVA (cerebrovascular accident), less express self feeling, and poor social support from family. The authors provided her the knowledge of the treatment of CVA, and enhanced her self confidence from learning and expressing her feelings. The authors also guided the main family caregiver- her daughter drafted a home care plan. Subsequently, the case talked to other outpatients and sharing the experiences of treatment and overcome the disability during therapy program. Conclusions: This case report will provide for physical therapists that they consider the patient as a holistic and interact with family by using the family assessment. It can provide a holistic assessment and service to the community or home rehabilitation through the application in the future.

並列關鍵字

Family assessment ； Stroke ； Physical therapy ； Caregiver