影響台灣中風病患三個月生活品質預後的相關因子

The Predictors of 3-month Quality of Life Outcomes for Stroke Patients in Taiwan

劉栩含(Hsu-Han Liu) ； 梁佩蓉(Pei-Jung Liang) ； 王錦滿(Chin-Man Wang) ； 林佩欣(Pay-Shin Lin)

《物理治療》 34卷1期 (2009/02) Pp. 53-64

摘要

背景與目的：本研究的主要目的是調查腦中風病患發病後三個月生活品質的預後情形及探討其影響之相關因子，方法：採用初次中風約三個月之住院患者100名為調查對象。利用面對面訪談來完成中風衝擊量表(Stroke Impact Scale; SIS)、功能獨立自主量表(Functional Independence Measure; FIM)、老人憂鬱量表(Geriatric Depression Scale; GDS)及簡易心智量表(Mini-Mental State Examination; MMSE)的評估。統計分析以ANOVA、t檢定等分析個別影響因子與生活品質各面向的關係，再用線性複迴歸模式，調整因子間的交互影響關係，找出影饗各個面向生活品質預後的共同因子。結果：本研究受試者平均年齡為63.74(±13.72)歲。迴歸分析的結果顯示，功能狀態是影響生活品質各面向的重要因子。其中影響肌力的因子為功能狀態(β=.63, t=3.95, p≦.00)；影響手部功能的因子為功能狀態(β=.80, t=4.49, p≦.00)及中風型態(β=15.02, t=2.23, p≦.05)；日常生活自理能力的因子只有功能狀態(β=1.03, t=13.20, p≦.00)；影響活動力的因子認功能狀態(β=.93, t=6.84, p≦.00)及性別(β=-11.7, t=-2.24, p≦.05)；影響情緒面向的因子為功能狀態(β=.20, t=1.97, p≦.05)及憂鬱現象(β=-12.29, t=-3.42, p≦.05)；影響記憶力的因子為功能狀態(β=.27, t=2.47, p≦.05)、性別(β=8.29, t=2.18, p≦0.5)、憂鬱(β=8.31, t=-2.21, p≦.05)及認知功能(β=2.22, t=7.35, p≦.00)；影響溝通面向的因子為功能狀態(β=.37, t=3.16. p≦.00)、中風型態(β=11.48, t=2.63, p≦.01)、中風位置(β=-12.40, t=-2.92, p≦.01)及認知功向(β=1.38, t=4.19, p≦.00)；影響社會參與面向的因子為功能狀態(β=.30, t=2.11, p≦.05)和多重疾病(β=-16.35, t=3.22, p≦.00)。結論：影響台灣中風患者三個月生活品質預後的相關因子隨不同面向而有不同、共有功能狀態、憂鬱現象、認知功能、中風型態、性別、多重疾病等，其中以功能狀態為最重要的因子。

關鍵字

中風 ； 生活品質 ； 中風衡擊量表 ； 影響因子

並列摘要

Background and Purpose: The purpose of the study was to investigate and determine the predictors of 3-month Quality of Life (QOL) outcomes of stroke patients in Taiwan. Methods: This is a cross-sectional study. One hundred first ever stroke patients onset at about 3 months were recruited from the rehabilitation department of a medical center in northern Taiwan, Basic data. Stroke Impact Scale, Functional Independence Measure. Geriatric Depression Scale, and Mini-Mental State Examination were assessed during patients' admission or visit at hospital. The multiple linear regression analysis was used to determine the Predictors of the QOL outcomes for those patients. Results: The mean age of all stroke patients was 63.74 (±13.72) years old. The most important predictor appears to be the function status, i.e. FIM score. The significant predictor of muscle strength in the SIS was functional status (β=.63, t=3.95, p≦.00), those of the hand function domain were functional status (β=.80, t=4.49, p≦.00) and stroke type (β=15.02, t=2.23, p≦.03), of ADL domain was only functional status (β=1.03, t=13.20, p≦.00), of mobility domain were functional status (β=.93, t=0.84, p≦.00) and gender (β=-l1.7, t=-2.24, p≦.02), of emotion domain were functional status (β=.20, t=1.97, p≦.05) and depression (β=-12.29, t=-3.42, p≦.05), of memory domain were gender (β=8.29, t=2.18, p≦.03), depression (β=-8.31, t=-2.21, p≦.03), functional status (β=.27, t=2.47, p≦.02) and cognition (β=2.22, t=7.35, p≦.00), of communication were functional status (β=.37, t=3.16, p≦.00), stroke type (β=11.48, t=2.63, p≦.01). stroke location (β=-12.40, t=-2.92, p≦.01) and cognition (β=1.38, t=4.19, p≦.00). of social Participation were functional status (β=.30, t=2.11, p≦.04) and multiple disease (β=16.35, t=-3.22, p≦.00). Conclusion: Many factors except age predicted the 3-month SIS outcomes in the individual domain for stroke patients in Taiwan, among them the most significant predictors was functional status.

並列關鍵字

Stroke ； Quality of Life ； Stroke Impact Scale ； Predictors