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  • 學位論文

腦中風患者身體功能與健康相關生活品質之追蹤研究

A longitudinal study of physical function and health-related quality of life in stroke patients

指導教授 : 白香菊
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摘要


腦中風是造成病患失能最常見的原因,腦中風病患往往因身體失能使得日常活動無法獨力完成,導致日常生活型態改變。日常活動功能可視為生活獨立程度及生活品質之重要指標,若能進一步了解身體功能與生活品質相關性,不僅有助於腦中風病患日常活動功能之恢復,更可提升腦中風病患的生活品質。 研究目的:瞭解腦中風病患人口學特性、疾病特性、身體功能及生活品質的分布情形;探討腦中風病患、疾病特性、身體功能及生活品質的關係;探討腦中風病患身體功能及生活品質的相關性;探討腦中風患者身體功能及健康相關生活品質表現之趨勢變化;探討腦中風病患身體功能情況對生活品質的預測能力。 研究方法:本研究為相關性與縱貫式研究設計,採方便取樣,於中部某醫學中心復健科病房,以初次腦中風病患為研究對象,採用研究者與受試者面對面之方式,並以結構式問卷進行資料收集三次。研究工具包括:個人基本資料表、美國國家衛生研究院腦中風評量表(NIHSS)、巴氏量表(Barthel index)、腦中風衝擊量表(SIS),所搜集之資料以描述性統計、皮爾森相關係數、廣義估計方程式進行資料分析。 研究結果:本研究第一次收案82位病患,完成三次問卷共40位腦中風患者,研究結果發現:(1) 腦中風患者的疾病嚴重度(NIHSS)隨著在不同時間(入復健病房住院第三天、收案第一個月後、收案第三個月後)有下降趨勢;而身體功能 (Barthel index)得分則也顯著逐漸上升情形。(2)以皮爾森相關係數分析各變項的相關性,三次測量都顯示患者的疾病嚴重度(NIHSS)與生活品質(SIS)呈現顯著負相關(-0.63; -0.69; -0.69, p < .001),而身體功能與生活品質呈現顯著正相關(0.62; 0.73; 0.85, p < .001)。(3)以多元回歸分析,其疾病嚴重度(NIHSS)可解釋生活品質變異量為47.9%,加入身體功能(Barthel index)後可解釋變異量為51.9%,疾病嚴重度(NIHSS)仍維持顯著水準(P =.004);但身體功能(Barthel index)則無顯著差異(P=.087),研究顯示疾病嚴重度為病患生活品質的重要預測因子。 結論:整體而言,本研究藉由不同之三個時間點追縱初次腦中風病患身體功能與生活品質上的變化,發現初次腦中風患者透過復健活動訓練期間,可以改善疾病嚴重度情形,也能有效提升病患生活品質。

關鍵字

腦中風 身體功能 生活品質

並列摘要


Background: Stroke is the most common cause of disability in patients. Patients with stroke often fail to complete daily activities because of physical disabilities, leading to changes in daily life patterns. Daily activities are important indicators of the degree of independence in life and quality of life. Further understanding of the correlation between physical function and quality of life will not only help the recovery of daily activities of patients with stroke but also improve their quality of life. Objective: The purpose of this study was to (1) understand the demographic characteristics, characteristics of the illness, temporal characteristics, physical function, and quality of life in patients with stroke; (2) explore the relationship between stroke, characteristics of the illness, temporal characteristics, physical function, and quality of life; (3) examine the relationships between physical function and quality of life in patients; (3) explore the predictive power of physical function on quality of life; (4) evaluate the dynamic changes in physical function and quality of life in patients with stroke. Research method: This study had a correlational and longitudinal research design. A convenient sampling was used, and recruitment from the rehabilitation ward of a medical center hospital in Central Taiwan was conducted. Patients with primary stroke were invited to participate in the study. The researcher and subjects met face-to-face, and structured questionnaires were used to collect data three times. The tools included basic information, the National Institutes of Health Stroke Scale (NIHSS), Barthel index, and Stroke Impact Scale (SIS). Collected data were analyzed using descriptive statistics, Pearson product-moment correlation coefficient, and generalized estimating equations (GEE). Results: A total of 82 patients were admitted for the first time in this study, and 40 patients with stroke completed three questionnaires. The study found the following: First, the severity of illness in patients decreased at different times (the third day in the rehabilitation ward, after the first month of acceptance, and after the third month of acceptance). The physical function scores also increased. Second, the Pearson product-moment correlation coefficient, which analyzed the correlation of each variable, showed that the severity of illness in patients was significantly negatively correlated with quality of life (-0.63; -0.69; -0.69, p < .001), while the function of daily living was significantly positively correlated with quality of life (0.62; 0.73; 0.85, p < .001). Finally, multiple regression analysis revealed that the severity of illness explained the 47.9% variance in quality of life. After adding the physical function (Barthel index), the variance was 51.9%. The severity of illness was significant (P = .004). However, physical function (Barthel index) was not significant (P=.087). This showed that the severity of illness is an important predictor in patients’ quality of life. Conclusion: Overall, this study used three different times to follow up on the change in physical function and quality of life in patients with primary stroke. Rehabilitation activities for patients with primary stroke were found to reduce the severity of illness and effectively improve their quality of life.

並列關鍵字

Stroke Physical function Quality of life

參考文獻


中文參考文獻
台 灣 腦 中 風 學 會 ( 2008). 台 灣 腦 中 風 防 治 指 引 2008.https://www.stroke.
org.tw/GoWeb2/include/pdf/08%20%E5%8F%B0%E7%81%A3%E8%85%A6%E4% B8
%AD%E9%A2%A8%E9%98%B2%E6%B2%BB%E6%8C%87%E5%BC%952008.pdf
台灣版世界衛生組織生活品質問卷發展小組(The Whoqol-Taiwan Group)(2000).台灣版世

被引用紀錄


楊孟釗、黃威銘、洪鵬翔(2022)。自動化識別用於數位腦血管攝影醫材管路之智能系統健康科技期刊8(2),1-10。https://doi.org/10.6979%2fTJHS.202203_8(2).0001

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