慢性腦中風復健門診患者之健康相關生活品質及其相關因素探討

Health-related Quality of Life and Related Factors among Chronic Stroke Patients in Rehabilitation Outpatient Clinics

李金和(Ching-Ho Li) ； 王俊毅(Jiun-Yi Wang) ； 林怡儒(Yi-Ju Lin)

《長期照護雜誌》 16卷2期 (2012/09) Pp. 143-158

https://doi.org/10.6317/LTC.201209_16(2).0004

摘要

本研究目的在探討慢性腦中風復健門診患者之健康相關生活品質及其相關因素。採橫斷式研究設計，以結構式問卷進行資料收集，問卷內容包括患者基本屬性、健康狀態、疾病特性、復健情形、短版憂鬱量表、巴氏量表及中風衝擊量表。研究對象為中部某區域醫院復健科門診患者，共收案92名。相關資料以描述性統計、獨立樣本t 檢定、單因子變異數分析及線性複迴歸模式進行統計分析。結果發現：影響慢性腦中風復健門診患者之健康相關生活品質（共八個層面）的顯著相關因素，包括宗教信仰、跌倒經驗、憂鬱傾向、功能狀態、中風復發、中風類型及復健密度；而影響整體健康相關生活品質的顯著相關因素，則為憂鬱傾向（β=-5.0, p＜.05）、功能狀態（β=-12.4, p＜.001）和中風復發（β=-6.7, p＜.05）。建議醫療人員可針對有憂鬱傾向的患者，安排合適的心理諮商輔導；依據患者生活功能狀態，設計適當的復健；並提醒患者監測血壓、按時服藥及回診，避免中風復發，以期能改善其整體健康相關生活品質。

關鍵字

腦中風 ； 健康相關生活品質 ； 中風衝擊量表

並列摘要

The purpose of this study was to explore the health-related quality of life (HRQOL) and its related factors among chronic stroke patients in rehabilitation outpatient clinics. With a cross-sectional design, data were collected by means of a structured questionnaire. The questionnaire included patients' characteristics, health status, disease-related characteristics, rehabilitation intensity, Center of Epidemiological Studies Depression (CES-D) Scale, Barthel Index (BI) and Stroke Impact Scale (SIS). Ninety-two subjects were recruited from the rehabilitation department of a regional teaching hospital in Taichung. Data were analyzed by descriptive statistics, independent t-test, one-way ANOVA and multiple linear regression models. The results showed religious beliefs, history of falls, depression status, functional status, recurrence of stroke, type of stroke, and rehabilitation intensity were significantly related to at least one dimension of HRQOL. Depression status (β=-5.0, p＜.05), functional status (β=-12.4, p＜.001) and recurrence of stroke (β=-6.7, p＜.05) were significantly associated with the global HRQOL. We recommend that medical personnel introduce suitable psychological counseling for those patients who are depressive and arrange appropriate plans of rehabilitation according to patients' functional status. They could also remind patients of regularly monitoring blood pressure, medication and follow-up to avoid the recurrence of stroke. These manners may help chronic stroke patients improve their global HRQOL.

並列關鍵字

stroke ； health-related quality of life ； Stroke Impact Scale