- 期刊
探討急性後期照護對腦中風病人生活功能之影響
Impact of Post-acute Care on Quality of Life in Stroke Patients
摘要
目的：腦中風患者多半會留下後遺症，例如肢體癱瘓、行動不便等，因此，本研究探討急性後期照護（PAC）對於腦中風病患生活功能之改變及其重要影響因子。方法：針對整體功能狀態（MRS）2-4級的腦中風病患，於2015年至2017年在南部兩間醫學中心（non-PAC組）及兩間區域醫院與一間地區醫院（PAC組）接受持續復健訓練者為研究樣本，以巴氏量表（BI）、吞嚥進食功能（FOIS）、健康相關生活功能評估（EQ5D）、工具性日常生活功能（IADL）、姿勢控制平衡功能（BBS）、認知功能（MMSE）問卷做為生活功能之測量工具，評估時間點包括住院復健前、復健後6週及12週。結果：本研究樣本共368位，317位（86.1%）為缺血性腦中風。研究期間兩組病患之生活功能皆有顯著改善（p＜0.05），PAC組病患相較於non-PAC組病患在EQ5D和IADL有較顯著之改善（p＜0.05），PAC組、較年輕、缺血性及住院時生活功能分數較高者相較於其對照組，其有顯著的生活功能改善（p＜0.05）。結論：PAC試辦計劃能夠顯著改善腦中風病患生活功能，且及早接受復健治療其生活功能改善愈好，建議未來應持續長期追蹤。
並列摘要
Objectives: With the aging population, stroke is the main cause for physical disability in the elderly. Therefore, the purpose of this study is to explore the impact of post-acute care (PAC) on quality of life among stroke patients. Methods: This prospective study evaluated stroke patients in levels 2-4 of the Modified Rankin Scale (MRS) from 2015 to 2017 in two medical centers (non-PAC group) two regions hospitals and a district hospital (PAC group). The Barthel index, Functional oral intake scale, Euro QoL-5D, Lawton-Brody IADL Scale, Berg Balance Scale, Mini-mental state examination were used to evaluated quality of life at before rehabilitation, 6-week and 12-week after rehabilitation. Results: 368 patients were sampled in study and 317 (86.10%) had ischemic stroke. During the study period, all patients had a statistically significant improvement in quality of life (p ＜ 0.05). Compared to non-PAC group, PAC group showed a statistically better improvement in the EQ5D and IADL simultaneously (p ＜ 0.05). Pre-rehabilitation quality of life was positively associated with post-rehabilitation throughout the 12-week study (p ＜ 0.05). Conclusions: The PAC program can significantly improve the quality of life of stroke patients. The better the quality of life, the better the rehabilitation treatment. Long-term follow-up study is recommended.