獨立功能程度與自我概念狀況對脊髓損傷患者重返職場的影響

The Influence of Functional Independence and Self-Concept on Return-to-Work in Patients with Spinal Cord Injury

楊淑華(Shu-Hua Yang) ； 楊淑娟(Shu-Chuan Yang) ； 程敏華(Min-Hua Chen) ； 張維琴(Wei-Chin Chang) ； 李雅萍(Ya-Ping Lee) ； 邱雅芳(Yar-Fang Chiou)

《護理暨健康照護研究》 8卷3期 (2012/09) Pp. 191-200

https://doi.org/10.6225/JNHR.08.3.191

摘要

背景：脊髓損傷患者因身體心像改變與獨立功能降低，常以負向的想法看待自己，產生負向自我概念，而降低重返工作的動機與勇氣。目的：探討脊髓損傷患者獨立功能程度和自我概念狀況對於重返職場的相關程度。方法：採橫斷式研究設計，研究工具為結構式問卷，內容包括「社會人口學資料」、「功能獨立程度量表」、「肢體殘障者自我概念量表」。以立意取樣於北部某醫學中心住院及門診之脊髓損傷患者，共收案104名。結果：獨立功能程度對於脊髓損傷者重返職場有顯著的正相關，而自我概念狀態較好者，重返職場的比率也較高。另外年齡或受傷年齡較輕者、教育程度越高、受傷年數較久、有固定照護者以及有參與職訓者較有機會重返職場。結論／實務應用：臨床照護實務上，針對此類患者護理與復健方向應著重自我照顧能力與職業訓練。心理層面則鼓勵患者參與病友團體，透過各種活動彼此分享與支持，加強自我概念狀態，進而加強重返職場動機。

關鍵字

脊髓損傷 ； 獨立功能 ； 自我概念 ； 重返職場

並列摘要

Background: Spinal cord injury (SCI) patients tend to suffer from low self-concept, and think negatively toward themselves due to physical incapacitation and loss of functional independence.Purpose: This study investigated correlations between self-concept and the variables level of functional independence and post-SCI return-to-work rate.Methods: A cross-sectional study with purposive sampling using a structured questionnaire was conducted with 104 SCI patients currently receiving treatment at a medical center in northern Taiwan. A demographic datasheet, self-reported functional measurement scale, and self-concept scale for physically disabled individuals were used to collect data for analysis.Results: Results found functional independence and self-concept most positively correlated with post-SCI return-to-work. Other factors of influence on post-SCI return-to-work included current age, age at time of injury, education level, length of time since injury, caregiver status, and participation in vocational training.Conclusions / Implications for practice: Nurses and rehabilitation teams should conduct self-care training for SCI patients in acute and sub-acute SCI units; SCI patients should have convenient access to appropriate vocational training programs; more patient-support groups should be set up in hospitals and communities to facilitate SCI patient recovery and reintegration into society. We hope study results provide a reference for healthcare policymakers.

並列關鍵字

spinal cord injury ； functional independence ； self-concept ； return-to-work

參考文獻

陳淑貞、翁毓秀（2006）．非行少年依附、解釋風格與自我概念之相關研究．輔導與諮商學報，28（1），29－49。

蔡春金，黃瓊玉（2007）．脊髓損傷者憂鬱症狀及其相關因素之探討．志為護理，6（2），64－73。

楊凱婷（2006）．生活品質與冒險程度對脊髓損傷患者重回職場的影響（未發表的碩士論文）．臺北醫學大學傷害防治學研究所。

Bricout, J. C. (2004). Using telework to enhance return to work outcomes for individuals with spinal cord injuries. Neuro Rehabilitation, 19(2), 147－159.

Cameron, A. P., Wallner, L. P., Tate, D. G., Sarma, A. V., Rodriquez, G. M., & Clemens, J. Q. (2010). Bladder management after spinal cord injury in the United States 1972 to 2005. The Journal of Urology, 184(1), 213－217. doi:10. 1016/j.juro.2010.03.008