脊髓損傷患者之神經性疼痛、睡眠品質與生活品質之相關性研究

The relationship among neuropathic pain, quality of sleep, and quality of life in patients with spinal cord injury

黃玉雰(Yu-Fen Haung)

指導教授 ： 周汎澔

高雄醫學大學/護理學院/護理學系研究所/碩士(2008年)

https://doi.org/10.6832/KMU.2008.00100

摘要

本研究探討脊髓損傷患者之神經性疼痛及睡眠品質情形與生活品質之相關性，研究目的為：（1）探討脊髓損傷患者神經性疼痛之情形。（2）探討脊髓損傷患者睡眠品質之情形。（3）探討脊髓損傷患者生活品質之情形。（4）探討脊髓損傷患者神經性疼痛、睡眠品質與生活品質之相關性。（5）探討脊髓損傷患者之個人基本屬性、神經性疼痛及睡眠品質是否為生活品質之重要預測因子。採橫斷式相關性研究設計，以結構式問卷進行資料收集，內容包括人口學資料與疾病特性、神經性疼痛量表、睡眠紊亂量表及生活品質量表等四部份，共收131人，所得資料以次數分配、百分比、平均值、標準差、t檢定、單因子變異數分析、皮爾森積差相關分析及階層迴歸分析等進行統計分析。
研究結果發現：（1）本研究對象有61.07%之脊髓損傷患者診斷為神經性疼痛，指標得分為39.81分，神經性疼痛為中低程度。（2）睡眠困擾指標得分為44.91，睡眠困擾程度為中等程度嚴重，失眠情形有36位（27.48%）。（3）脊髓損傷生活品質量表指標得分為58.57，為中等程度生活品質，四範疇中以社會關係範疇得分最高，其次為環境範疇及心理範疇，最低為生理健康範疇。（4）年齡與生活品質呈顯著性相關；教育程度在生活品質呈顯著性差異；受傷時間愈久，生理健康範疇生活品質愈佳；損傷部位愈高，生理健康範疇生活品質愈差；ASIA 分級為A級者在生理健康範疇、社會範疇及環境範疇上之得分比其他分級差；四肢癱瘓者之生理健康範疇生活品質較半身癱瘓者差。（5）脊髓損傷患者的神經性疼痛與睡眠品質呈顯著性正相關。（6）脊髓損傷患者的神經性疼痛與生活品質及其生理健康範疇、心理範疇、社會範疇及環境範疇達顯著性負相關。（7）脊髓損傷患者的睡眠品質與生活品質及其四範疇達顯著性負相關。（8）教育程度、損傷部位、ASIA分級、神經性疼痛及睡眠品質為脊髓損傷患者生活品質的預測因子，可解釋之總變異量為32.90%，最重要之預測因子為睡眠品質。
本研究結果可提供健康專業人員對於脊髓損傷患者的神經疼痛及睡眠品質情形與生活品質之相關性有更進一步的了解，亦可提供臨床照護上與復健成效之參考，以促進健康專業人員能有效地運用適切性的措施，改善脊髓損傷患者之神經性疼痛及睡眠狀況，進而增進生活品質。

關鍵字

脊髓損傷 ； 神經性疼痛 ； 睡眠品質 ； 生活品質

並列摘要

This study was to explore the relationship among neuropathic pain, quality of sleep, and quality of life (QOL) in 131 patients with spinal cord injury (SCI) in southern Taiwan. The purposes of this study were to: (1) understand the neuropathic pain of SCI participants, (2) understand the quality of sleep of SCI participants, (3) understand the quality of life of SCI participants, (4) examine the relationship of demographic variables, illness characteristics, neuropathic pain, quality of sleep, to the quality of life, (5) explore the important predictors for the quality of life. This is a cross-sectional correlation study design and four structured questionnaires (including the Personal Characteristics, Neuropathic Pain Questionnaire, General Sleep Disturbance Scale and Quality of Life Questionnaire for Persons with Spinal Cord Injury) were used. Descriptive statistics were used to describe the distribution of all variables. Pearson’s correlation coefficient was used to know the relationship among neuropathic pain, quality of sleep, and QOL. Besides, hierarchical regression was used to establish the QOL predictive models.
Patients reported the neuropathic pain in 61.07% patients, insomnia in 27.48% patients, the moderate to low level of the neuropathic pain, the moderate level of the quality of sleep and quality of life. The neuropathic pain and quality of sleep had significant positive effects on the quality of life. The education status, injury of level, ASIA level, neuropathic pain and quality of sleep were the significant predictors of QOL, and explained about 32.90% of the variance. The most important predictor is quality of sleep.
Study results may assist health professionals in understanding quality of life in SCI patients, and the relationship among neuropathic pain, quality of sleep, and quality of life in SCI patients. The study can be used as a basis for further study as well as for designing effective strategies for improvement of patient health related quality of life.

並列關鍵字

spinal cord injury ； neuropathic pain ； quality of sleep ； quality of life

參考文獻

一、中文部份

王榮德（2002）•特輯：健康相關的生活品質之新進展－緒言•

台灣醫學，6(2)，181-182。

王榮德、游正芬、鍾智文、姚開屏（2000）•廿一世紀之健康照

護效性評量：生活品質與生活品質調整後之存活分析•台灣