影響冠狀動脈繞道術後病患參與復健運動因素之探討

研究旨在探討冠狀動脈繞道術後病患參與復健運動之現況，人口學屬性、復健運動經驗及感受和生理、心理及社會整體健康功能，與病患術後參與復健運動的相關性及預測因子。研究者以立意取樣，收集南部某醫學中心接受冠狀動脈繞道手術之253位病患為研究對象，進行研究。研究設計為橫斷性、描述相關性研究，以結構式問卷及量表調查，研究工具包括基本資料調查表、個案復健運動經驗及感受問卷與台灣版SF-36健康評估量表，並使用描述性統計、卡方檢定、獨立樣本t檢定及逐步淘汰對數迴歸分析為統計方法。研究結果發現：（1）研究對象的術後復健運動參與率僅27.7％。（2）合併慢性疾病數、個人平均月收入、術後運動習慣及就醫便利性，與術後復健運動參與有關。（3）復健運動之重要性、接受復健運動資訊及期望參與復健運動方案的不同，與術後復健運動參與有關。而個人感受醫療人員推薦、鼓勵參與術後復健運動、對復健運動感受重要及喜愛程度的得分，也與術後復健運動參與有關。（4）健康評估量表中之身體生理功能、因生理功能導致的角色限制、一般健康、活力、社會功能、心理健康等六個範疇及生理、心理兩大向度得分，與術後復健運動參與有關，得分越高，則參與情況越佳。（5）病患感受醫療人員推薦參與術後復健運動的程度，具有93％的正確預測力。本研究結果不僅可呈現，目前冠狀動脈繞道術後病患復健運動參與的現況，也藉由所發現的顯著相關因素及預測因子，作為本土實證性的資料，期望可提供臨床人員未來在設計、推動術後復健運動方案時的指引及介入性研究的參考，最終希望能協助病人早日恢復生活功能，提昇醫療資源的利用率。

關鍵字

冠狀動脈繞道手術；心臟復健運動； SF-36健康評估量表

並列摘要

The purpose of this study was to explore the clients’ participation in rehabilitation exercise program after coronary bypass survey, its related factors such as demographic, client’s experience with the rehabilitation program, physiological, psychological and social wellbeing. This is a cross-sectional, descriptive, correlational study. With the purposive sampling approach, a total of 253 clients underwent coronary bypass surgery were recruited from a medical center in Southern Taiwan. Structured questionnaires were utilized for data collection. Instruments included demographic data sheet, survey of client’s experience of rehabilitation exercise program, and Short Form-36 Health Survey (SF-36) -Taiwan Form.Data were analyzed using description statistics, chi-square, independent-sample t-test, and stepwise logistic regression test. Results: (1) In the sampled 253 participants, only 27.7% engaged in the rehabilitation exercise program after their cardiovascular surgery. (2) Factors such as the number of chronic illness, average individual monthly income, routine exercise habit, the accessibility to medical setting were found to relate to clients’ likelihood of participation in the post cardiovascular surgery rehabilitation exercise program. (3) Client’s perceived necessity and importance of post cardiovascular surgery rehabilitation was associated with their view toward the program, and the degree of the utilization. (4) The higher the Short Form-36 Health Survey-Taiwan Form the higher the probability a client was to participate in the rehabilitation exercise program post coronary bypass surgery. Positive correlations were noted in both the Physical Component of SF-36 (physical functioning, role limitation due to physical problems, vitality) as well as the Mental Component of SF-36 (social function, general health, mental health). (5) There was 93% positive predictability for clients to engage in the post cardiovascular surgery rehabilitation exercise program if the program was recommended to them by health care providers. This study provides knowledge foundation about the influential and predicating factors of the clients’ participation in the rehabilitation exercise program post coronary bypass surgery. The results of this study may be utilized by clinicians for tertiary prevention planning, and rehabilitation program design. Ultimately, to promote post surgical recovery and to enhance client’s functioning through encouraging the use of available rehabilitation program.