以使用者為中心需求構面設計之自主居家復健手部輔具

中風是造成全球人口死亡與失能的主要原因之一，近 70%中風患者因手部失能而影響日常生活活動。中風患者復健需要頻繁的往返醫院診所進行復健造成醫療資源的浪費與金錢的消耗。因應疫情時代，醫院診所進行人流的控管，使得醫院診所復健困難重重，因此提倡居家復健(Home-based rehabilitation)顯得很重要，其中的輔助科技更為重要。因此本研究想透過自以使用者為中心-需求構面設計之自主居家復健手部輔具來解決問題。透過問卷調查、日常生活活動作業觀察等方式的半結構式訪談。分析以質性研究為主要方法對專業醫療人員、中風患者及主要照顧者進行手部輔具之日常生活使用不便、使用者需求。本次研究之受測者共招募 26 位，包含 11 位專業醫療人員、10 位中風患者以及 5 為照顧者。訪談之錄音被轉錄並使用定性數據分析軟件 NVivo 12 pro 進行編碼，以使用歸納方法對受訪者進行本質主義的文本分析。將使用者需求與受訪者使用的使用困境進行比較，發現現今手部輔具仍有不足之處。根據數據及文本分析，本研究確定了 94 個開放代碼，24 個主軸代碼並將其整理為 6 個關鍵核心範疇亦即使用者需求構面，分別是為「設備需求」、「情感需求」、「成就需求」、「政策需求」、「安全需求」及「其他需求」。針對所有訪談內容整理出輔具之改善方向，建構出符合人因工程的需求模型。期望未來可針對所分析之使用者需求結果進行手部輔助設備的萃取，透過真正符合中風患者居家手部復健需求之輔助設備使中風患者能透過居家日常生活活動(Activities of daily living；ADLs)進行有效且持續的復健，除提升日常生活活動獨立執行能力外亦能回歸正常生活，家庭角色及職場，同時降低門診復健所造成的龐大全民健康保險醫療負擔。實現產品落地，促進且推廣自主居家復健，改善中風患者之良好的生活品質。

關鍵字

中風；居家復健；手部輔具；使用者需求；質化研究

並列摘要

Stroke is one of the leading causes of death and disability in the global population, and nearly 70% of stroke victims suffer from hand disability that affects their activities of daily living. Stroke patients need to travel frequently to hospitals for rehabilitation, resulting in a waste of medical resources and money. In response to the epidemic era, the control of pedestrian flow in hospitals has made hospital-based rehabilitation difficult, so it is important to promote home-based rehabilitation, in which assistive technology is even more important. Therefore, this study aims to solve the problem by the demand dimension design of self-residential rehabilitatiom hand assistive device based on user-centered concept . Semi-structured interviews were conducted through questionnaires and observation of daily living activities. A qualitative study was conducted to analyze the inconvenience of daily use and user needs of the assistive devices for medical professionals, stroke patients and primary caregivers. A total of 26 subjects were recruited, including 11 medical professionals, 10 stroke patients, and 5 caregivers. Interview recordings were transcribed and coded using qualitative data analysis software NVivo 12 pro to conduct a qualitative thematic analysis of senior clinical practitioners' responses using an inductive approach.A comparison of user needs with respondents' use dilemmas revealed that there are still deficiencies in today's hand aids. Based on the data and textual analysis, 94 open codes were identified and 24 axial codes were organized into 6 key core areas, i.e., user needs constructs, namely, "device needs," "emotional needs," "achievement needs," "policy needs," "safety needs," and "other needs". Based on all the interviews, we have compiled the improvement directions of the auxiliary devices and constructed a demand model in line with human factors engineering. It is expected that the results of the user needs analysis will be used to extract manual assistive devices in the future, so that stroke patients can have effective and continuous rehabilitation through activities of daily living (ADLs) by using assistive devices that truly meet the needs of stroke patients for home rehabilitation. It also reduces the huge burden of universal health insurance for rehabilitation. The product will be implemented to promote and promote independent home rehabilitation and improve the quality of life of stroke patients.

並列關鍵字

stroke ； home rehabilitation ； hand aids ； user needs ； qualitative research

參考文獻

英文部分

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