腦中風急性後期照護計畫之職能治療介入成效—病例報告

患有心房顫動、慢性阻塞性肺病和慢性腎臟疾病第三期的69歲男性，因右側中大腦動脈梗塞性中風後左側乏力、構音障礙、吞嚥困難。在不同階段提供個別化訓練方案後，個案認知狀況、自我照顧能力與上肢動作能力皆有改善。急性後期整合照護計畫能維持高強度復健且較有治療的連續性，但是病人往往參與計畫時無法確認期程長短，擬透過訂定個別化治療計畫與照護團隊的支持，可以避免個案因計畫期程差異而必須突然回歸社區。此外注意個案憂鬱情形與發展合適的認知評估對於治療計畫的制訂也有幫助。

關鍵字

急性後期照護；腦中風；職能治療；病例報告

並列摘要

A 69-year-old man with atrial fibrillation, chronic obstructive pulmonary disease, and stage III chronic kidney disease was admitted for post-acute care (PAC) program due to right middle cerebral artery territory infarction with left side weakness, dysarthria, and dysphagia. After individualized training in different stages, his cognitive status, self-care ability, and upper limb movement improved significantly. PAC program can maintain high-intensity rehabilitation and more sustainable treatment. However, the participation period in the PAC program cannot be determined in advance. By planning an individualized treatment plan and the medical care team's support, the problem of a sudden return to the community due to the difference of plan periods can be avoided. Besides, paying attention to the patient's depression and developing appropriate cognitive assessments helps develop treatment plans.

並列關鍵字

post-acute care ； stroke ； case report ； occupational therapy

參考文獻

吳冠穎，吳肖琪，洪燕妮等。台灣腦中風病人急性後期照護需要之探討。台灣衛誌 2012；31(3)：251-62。

竇文宏，馬上閔，陳啟忠等。接受腦中風急性後期照護病患之物理治療成效探討：以南部某區域醫院為例。慈惠學報2019；15： 53-62。

許志民，莊培凱，李奕瑩等。以價值為基礎之職能治療照護。北市醫學雜誌2019； 16(2)：107-16。

謝清麟，陳官琳，邱恩琦等。本土必要之中風病人職能治療研究議題。職能治療學會雜誌2011；29(2)：7-20。

Prager EM, Lang CE. Predictive Ability of 2-Day Measurement of Active Range of Motion on 3-Mo Upper-Extremity Motor Function in People With Poststroke Hemiparesis. The American Journal of Occupational Therapy 2012; 66(1): 35-41

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