- 期刊
影響中風病患復健動機相關因素之探討
Factors Affecting Stroke Patients' Motivations for Rehabilitation
摘要
本研究係以南部某醫學中心與某準醫學中心為研究場所，自民國80年12月起至81年4月止共收集30位初次中風住院之病患，以動機量表、健康內外控信念量表、復健動機歸因問卷等工具評估病患之復健動機及影響動機之相關因素進行二至三次評估，結果發現，復健動機於住院中的二至三次評估皆呈定狀態，而肢體活動和日常生活能力（activities of daily living; ADL）于住院中有顯著進步。教育程度、內控分數、ADL在護理人員及治療師的動機評分上呈正相關，以具小學程度以上者、內控分數高者、或ADL良好者之動機較強，其它背景變項則與動機無關。護理人員與治療師之動機評分非完全一致，護理人員所評估之動機強弱與ADL功能有較高之正相關，治療師所評估之動機強弱則傾向於與肢體活動能力有較高之正相關。 在復健動機的兩類歸因問卷中，以「較早點恢復健康」、「認為復健有效果」、「配偶的鼓勵」、「想家」等項目普遍被認為是增強復健動機的因素，而「心情不好」、「家人不能配合」、「擔心其他的事」、「缺乏家人的鼓勵」等項目則普遍被認為是減弱動機的理由。在增強復健動機因素中高動機組比低動機組更為在意「不想依賴別人」。在減弱復健動機中高動機較為在意「對自己病情不了解」、「飲食差，沒體力」等因素，低動機組則認為易受「擔心其它的事」、「做復健很累，很費力」、「想家」、等因素之影響而減弱復健動機。
關鍵字
無資料並列摘要
Factors correlated to the motivation for rehabilitation in stroke patients were studied. Thirty patients who had had only one stroke were recruited between December 1991 and April 1992 for our study. Several assessment tools including the Motivational scale, the Health Locus of Control scale and a questionnaire were used. According to the results of the assessment, the stroke patients´ motivation remained stable when assessed two to three times during the hospital stay, whereas their UE/LE Brunstrom stage stage scores and activities of daily living skill (ADL) improved significantly. The motivation of the patients was closely correlated with the degree of education, the internal scores and ADL performance: patients with education levelhigher than primary school, higher internal scores, or better ADL performance had stronger motivation for rehabilitation. On the other hand, motivational assessments between the nursing staff and the therapists were not completely in agreement. The ADL performance was better correlated with the degree of motivation on the nursing assessment, whereas the Brunstrom stage scores of UE/LE were more closely correlated with the therapists´ assessment. Items on the motivational questionnaire such as 〝eagerness to recover earlier〞, 〝recognition of the effectiveness of rehabilitation〞, 〝support of spouse〞 and 〝homesickness〞were commonly considered to be positive factors. However, the other factors such as 〝being in bad mood〞, 〝lack of family cooperation〞, 〝worrying about things other than finances〞 and 〝lack of family support〞 were commonly considered to be negative factors on motivation. In the comparison between high and low motivation groups, the high motivatin group payed more attention to the positive factors such as 〝eagerness to be independent〞 and such negative factors as 〝lack of understanding of illness〞 as well as〝poor appetite and fatigue〞. The low motivation group was considered to be more affected by such negative factors as 〝worrying about things other than finances〞,〝not good enough facilities〞 and 〝homesickness〞which resulted in lessening the motivation for rehabilitation.