目的:本篇研究的目在探討居住在社區的慢性中風患者的自我效能與家屬態度以及家庭的基本屬性對於ADL和IADL的相關性。 方法:本研究採用橫斷式研究設計,在中部兩大醫學中心的復健科收集符合收案標準的病患,進行關於病患自我效能、工具性日常活動能力以及家屬態度的問卷訪問,以及經由職能治療師對於病患進行的專業評估,包括布朗斯壯動作分級(Brunnstrom Stage)、柏格氏平衡量表(Berg balance scale)以及功能獨立量表(Functional Independence Measure, FIM)。 結果:在ADL的迴歸分析中發現Berg平衡量表分數、病患認知能力、自我效能、上肢近端關節Brunstrome stage、是否有請佣人、家屬認知層面態度等為重要預測因子。在IADL的迴歸分析中發現家屬的認知層面態度、Berg平衡量表分數、自我效能為重要預測因子。 討論:病患的自我效能與家屬態度與病患在執行ADL和IADL之間有關並具有預測性。在將來臨床的治療模式中,對於病患自我效能與家屬的衛教上是有需要加入治療的思考架構中。
Objectives: The objectives of this cross-section study, undertaken in chronic stroke patients undergoing rehabilitation, were to find the patient’s self-efficacy and family attitude in relation to ADL and IADL performance, and what factors can predict ADL and IADL performance. Methods: The study comprised 79 patients, aged above 18 years. Main outcome measure instruments were the Self-Efficacy Scale, Berg Balance Scale, Brunnstrom stage, Functional Independence Measure and Families’ attitude Survey. Result: The patient’s self-efficacy and their family’s cognitive dimension of the attitude were significantly related to the performance of ADL and IADL. The rest predicted factors of ADL were Berg balance scale, cognition of patient, Brunnstrom stage of upper limb’s proximal part, and if they hired chore worker or not. Besides self-efficacy and family’s attitude, Berg balance scale was related to IADL too. Conclusion: To minimize dependence in ADL and IADL, it is suggested as an important clinical approach to improve patients’ self-efficacy and provide education program to their family.