腦中風患者復健期之生活品質及其相關因子之研究

背景：腦中風為台灣十大死因第四位，腦中風後存活的人數逐漸增加，而腦中風患者的治療目標也由傳統上以維持及恢復生理功能為重點的觀念，逐漸轉變為以改善患者整體生活品質為目標。而淡漠可能對照顧者的壓力、病人的失能與生活品質產生重要影響，而針對腦中風患者之淡漠、活動參與及生活品質的相關研究相對缺乏。目的：探討腦中風復健患者之生活品質的相關因子，並進一步分析淡漠、活動參與對患者生活品質的影響。方法：採橫斷式相關性研究設計，以台中市某醫學中心神經內外科病房、復健科病房及門診之腦中風患者為取樣對象，運用巴氏量表、中風患者生活品質量表及冷漠評估量表收集資料，資料以SPSS 22.0中文版套裝軟體進行描述性統計、獨立樣本t檢定、單因子變異數分析及多元逐步迴歸分析進行分析。結果：本研究共收案100位腦中風患者（平均年齡59.89歲，標準差12.139）。結果發現淡漠與生活品質呈現顯著的負相關(r = -.702, p = .000)，即淡漠得分越高，生活品質得分越低，而活動參與與生活品質呈現顯著正相關(r = .860, p = .000)，即活動參與得分越高，患者生活品質得分越高。另外，逐步迴歸分析顯示以活動參與得分的Beta值最大(Beta = .689)，顯示其對「生活品質得分」有較大的預測力，可解釋全部變異的79.3%。整體而言，活動參與、淡漠、高血壓病史及年齡四種變項，可以解釋「生活品質」總變異的84.5%。結論：影響腦中風患者復健期生活品質的重要因素包括活動參與、淡漠及高血壓病史。

關鍵字

腦中風患者；淡漠；活動參與；生活品質

並列摘要

Background: Stroke is the fourth leading cause of death in Taiwan with the number of stroke survivors gradually increasing. The treatment goals of stroke patients have also evolved from a traditional focus on maintaining and restoring physiological function to aiming to improve patients’ overall quality of life. However, apathy may have an impact on the stroke survivor caregivers’ stress level, patients’ own disability, and quality of life. Furthermore, there is a lack of relevant research on apathy, activity participation, and quality of life for stroke survivors. Objective: The purpose of this study was to explore the related factors that affect stroke survivors’ quality of life during their rehabilitation, and to further analyse the impact of apathy and activity participation on their quality of life. Methods: A cross-sectional correlation study design was adopted. Participants were sampled from neurosurgery ward and rehabilitation ward, and the outpatient clinic of a medical center in Taiwan. The Barthel Index, Stroke Specific Quality of Life Scale, and Apathy Evaluation Scale were used to collect data, and all data is analyzed using the SPSS 22.0 Chinese version package software for descriptive statistics, independent sample t-test, single factor variance analysis, and multiple stepwise regression analysis. Results: A total sample of 100 stroke patients was enrolled in this study with a mean age of 59.89 years (SD = 12.139). The findings show that quality of life was significantly negatively correlated with apathy (r = -0.702, p = .000), that is, patients which reported higher apathy presented lower the quality of life. Conversely, quality of life was significantly positively correlated with activity participation (r = 0.860, p = .000), that is, patients reporting higher activity participation presented a higher quality of life. The regression analysis shows that the beta value of participation in activities was the largest (beta = 0.689), indicating that it has a greater predictive power for ‘quality of life’, which could explain 79.3% of the total variation. Activity participation, apathy, history of hypertension, and age explain 84.5% of the total variation in ‘quality of life’. Conclusion: Important factors that affect the quality of life of stroke patients during the rehabilitation period include activity participation, apathy, and a history of hypertension.