腦中風病患之日常活動自我效能
及其相關因素

本研究以橫斷式相關性研究設計，探討腦中風患者發病三日至半年內之日常活動自我效能及其與個人基本屬性、疾病特性、身體功能、社會支持的相關性。以南台灣某兩家醫學中心及一家區域教學醫院住院及門診發病三日至半年內腦中風患者為研究對象，共收案106位。研究工具採結構式問卷，內容包括：個案基本屬性、疾病特性、功能獨立自主量表、社會支持量表及自我效能量表，將所收集的資料以SPSS/PC 10.0套裝軟體進行描述性及推論性統計分析。研究結果發現如下：（1）腦中風患者之日常活動自我效能的平均值為58.87分、中位數為61.00分，屬於中等程度，其代表研究對象執行日常活動之信心，屬於中等程度。（2）研究對象性別、年齡、受教育年數與其日常活動自我效能相關經單因子變異分析發現男性患者之日常活動自我效能明顯較女性為高，年齡小於64歲的研究對象其日常活動自我效能明顯較年齡大於65歲的研究對象為高、受教育年數愈久的研究對象其日常活動自我效能明顯優於受教育年數少者。即男性、年齡小於64歲、受教育年數愈久者在日常活動自我效能得分愈高。（3）研究對象發病距離訪談之天數、此次中風嚴重程度與其在日常活動自我效能總量表得分有顯著正相關，意即發病天數愈久、身體功能獨立者在日常活動自我效能愈好。（4）除外來自家屬的實質性支持未與日常活動之自我效能成顯著相關外，整體而言，社會支持對研究對象其日常活動之自我效能都呈正相關性。（5）身體功能、受教育年數以及社會支持是腦中風患者之日常活動自我效能的重要預測因子，總解釋變異數為80.3%。研究結果可提供臨床護理人員進一步瞭解腦中風患者的日常活動自我效能與基本屬性、疾病特性、身體功能、社會支持的關係，提高自我效能為醫護人員提供照護的方向。建議臨床護理人員加強對腦中風患者的日常活動自我效能評估，發展個別性及適切性的日常活動檢核表，並且運用其為評估的工具，篩檢低自我效能、不良的身體功能和不足的社會支持，進而提供適宜護理措施，增進腦中風患者在執行日常活動的信心與能力。

關鍵字

腦中風；日常活動自我效能；社會支持；身體功能

並列摘要

The purpose of this study was to explore self-efficacy on activities of daily living in relations to physical function and social support in the Patients with Stroke. Cross-sectional and correlational design was used. Subjects consisted of 106 Patients with Stroke from a local and two medical centers in Kaohsiung. A structured questionnaire and face to face interview used to collect data. The questionnaire was constructed for this study including personal demography, disease characteristics, Functional Independence Measure(FIM), social support and Falls Efficacy Scale(FES).The data was analyzed by using SPSS 10.0 for window. The result of this study were found as follows mainly: (1) The standardized score of ADL self-efficacy on patients with stroke was 58.87 and the median score of ADL self-efficacy was 61.00. (2) ADL self-efficacy strongly positive correlated with gender, age, education years, physical function and social support. (3) According to a multiple stepwise regression analysis, physical function, education years and social support were found to explain 80.3% variance of ADL self-efficacy. The results of this study could be offer to clinical nurse to understand the ADL self-efficacy of stroke patient, in relations to disease characteristic, physical function, and social support. To enhance self-efficacy is the direction of care.The clinical nurse could develop specific daily activity check list to find subjects who is low self-efficiency, low physical function or insufficient social support, then, providing appropriate nursing care to promote the confidence of stroke patient on carrying out the daily activity.