影響腦中風患者使用長期照護機構的因素

Factors Influencing Long-term Care Institution Utilization for Stroke Patients after In-Patient Rehabilitation

林昭宏(Jau-Hong Lin) ； 李建宏(Chien-Hung Lee) ； 黃茂雄(Mao-Hsiung Huang) ； 劉景寬(Ching-Kuan Liu) ； 林永哲(Young-Tso Lin)

《物理治療》 25卷4期 (2000/07) Pp. 192-200

摘要

研究背景與目的：本研究目的是以前瞻性方式探討住院復健科的腦中風患者使用長期照護機構的影響因素。方法：本研究以高雄醫學大學附設中和醫院民國八十六年一月至十二月期間因腦中風住院在復健病房接受復健治療之患者163位為對象。分別使用功能獨立自主量表(Functional Independence Measure, FIM)來評估日常生活功能狀況和傅格－梅爾量表(Fugl-Meyer Sensorimotor Assessment, FMSA)中平衡測試項目來評估平衡能力。並且收集患者社會人口學及住院期間臨床診斷和出院前臨床評估FIM得分和FMSA平衡項目得分結果做為預測變項。結果：出院半年後共完成151位個案日常生活狀態的追蹤訪視，結果發現訪視時正住在長期照護機構者共有23位(15.2%)。單變項分析結果顯示影響中風病患復健治療使用長期照護機構的主要因素包括出院前意識狀況是否正常、FMSA量表平衡項目得分能力和FIM量表得分能力、是否再發性中風、是否兩側肢體運動功能皆受損等變項。結論：對數複迴歸分析結果發現，出院前FMSA量表平衡項目得分是否有站立能力和兩側肢體運動功能是否受損皆為重要預測因子。

關鍵字

腦中風 ； 復健治療 ； 長期照護機構 ； 功能獨立自主量表 ； 傅格－梅爾量表

並列摘要

Background and purpose: To investigate predictive factors of the utilization of long-term care institution for stroke patients after rehabilitation therapy. Methods: We prospectively studied 163 stroke patients who were consecutively admitted to the inpatient rehabilitation department of Kaohsiung Medical University Hospital from January 1 to December 31, 1997. Functional ability was evaluated with the Functional Independence Measure (FIM(superscript TM)) instrument at discharge from hospital. Balance status was measured using the 7-item balance subscale of Fugl-Meyer Sensorimotor Assessment (FMSA). In addition, sociodemographic and major medical factors were examined during hospitalization period as independent variables. Results: Of the 151 patients surveyed at a minimum of 6-months after discharge, 23 (15.2%) had been living in long-term care institutions. Univariate statistical analysis indicated that the significant factors related to long-term care institution utilization included impaired orientation, functional and balance status at discharge, recurrence of attack, and bilateral limb involvement. Conclusions: Stepwise logistic regression analysis based on the significant factors indicated that the strongest predictors of long-term care institution utilization for stroke patients were poor standing balance ability at discharge and bilateral limb impairment.

並列關鍵字

Stroke ； Rehabilitation therapy ； Long-term care institution ； Functional independence measure ； Fugl-Meyer sensorimotor assessment