台灣地區神經科醫護人員對美國國家衛生研究院腦中風評估量表之臨床應用

Clinical Application of the National Institute of Health Stroke Scale by Neurological Care Professionals in Taiwan

鄭貴月(Guey-Yueh Jeng) ； 邱素真(Su-Chen Chiu) ； 孫漬官(Tzu-Kuan Sun) ； 葉淑惠(Shu-Hui Yeh) ； 張谷州(Ku-Chou Chang) ； 陳廷耀(Ting-Yao Chen) ； 林祖功(Tsu-Kung Lin)

《實證護理》 2卷3期 (2006/09) Pp. 189-200

https://doi.org/10.6225/JEBN.2.3.189

摘要

本研究目的在調查台灣地區神經科醫護人員於臨床使用美國國家衛生研究院腦中風評估量表（national institute of health stroke scale，以下簡稱NIHSS）的狀況及其相關因素。分層取樣選取台灣地區8家醫療院所的神經科護理人員188位及醫師62位，以結構式問卷進行資料收集。研究結果顯示，受訪者臨床上使用NIHSS的比率護理人員為18%，醫師為90%；曾接受NIHSS訓練課程的受訪護理人員為27%，醫師為82%；受訪者普遍認同NIHSS可以用來評估缺血性腦中風病患之神經缺損程度，然而認為英文版的NIHSS有學習及使用上的困擾；受訪醫護人員對臨床使用NIHSS的態度傾向正面。曾使用NIHSS的受訪者在臨床使用NIHSS的行為情境介於「很少」到「有時」之間，其中記載NIHSS之評分結果於病歷的行為頻率最低。因此，推廣NIHSS於臨床護理的應用仍有待努力，建議採用完整及有信度、效度的NIHSS中文版、開辦相關受訓課程，並增設表列式紀錄單，將有助於推廣NIHSS於臨床的應用及快速、有效地評估缺血性腦中風病患之神經缺損程度。

關鍵字

美國國家衛生研究院 ； 腦中風評估量表 ； 臨床運用

並列摘要

The purpose of this study was to investigate the status of utilization of the national institute of health stroke scale (NIHSS) and factors influencing its clinical application by neurological care professionals in Taiwan. A total of 62 neurologists and 188 neurology nurses, stratified and selected from eight hospitals in Taiwan, were administered a structured questionnaire. We found that 18% of nurses and 90% of neurologists interviewed had used NIHSS. However, only 27% of interviewed nurses and 82% of interviewed neurologists had participated in NIHSS training courses. While respondents agreed that this scale is good for assessing neurological defect in stroke patients, they indicated some problems with learning and implementing the NIHSS English version. Most respondents' attitudes were positive with regard to using NIHSS in clinical practice. The frequency of clinical application ranged between ”seldom” to ”sometimes” in respondents who reported previous use of NIHSS. Among the aspects of clinical practice, frequency of recording this scale in medical records ranked lowest. Thus, more efforts are needed to extend usage of NIHSS in clinical practice. A comprehensive Chinese version of NIHSS with reliability and validity, adequate training programs and easyassessment scoring sheets are mandatory to enhance and broaden the clinical application of NIHSS for rapid and adequate evaluation of neurological defects in stroke patients.

並列關鍵字

national institute of health NIH ； stroke scale ； clinical application