An Investigation of Post-Discharge Status of Surviving Stroke Patients in Keelung

基隆區腦中風病患出院後居家情況追蹤報告

張春琴(Choon-Khim Chang) ； 陳文玲(Wen-Ling Chen) ； 黃美涓(May-Kuen Wong)

《中華民國復健醫學會雜誌》 20期 (1992/12) Pp. 91-98

摘要

為了解基隆區腦中風病患在出院後居家情形，吾人以在民國74年4月至76年12月期間因腦中風疾患(只含高血壓性腦出血及顱內血管病變兩種出血及缺血性腦中風疾患病患)而住進基隆長庚紀念醫院的病患為調查對象，探討他們出院後居家情形。調查方式以問卷為主，配合採電話訪問或家中訪視。1445位個案中抽樣其中1/3個案做訪問。得有效問卷共343份，以SPSS法作整理及分析。
343位病患中男女各為170位及173位，把仍存活病患歸為A組，有158位;已去世者歸為B組，共有185位。由於B組中病患已去世，所得資料不夠完整，所以只分析A組病患資料。A組中，出院後追蹤時間平均為50.2±8.9個月。
A組中，有90位(57%)病患出院後仍有繼續服藥的習慣，其中63%對所服用藥物非常了解，6%不太了解藥物的作用，31%根本不了解藥物的作用。雖然如此，仍有部份病患(93.3%)是按醫囑準時服藥的。其餘43%沒繼續服藥的病患，分析其原因以改服中藥為中的佔多數，有32.4%。
出院後仍有繼續居家復健者佔39.2%，其餘沒有做居家復健患者中，40.5%病患是因運動功能已完全恢復，10.1%是因病患拒絕而放棄運動，及6.9%病患是照料者因素所致(沒有時間或不會做)，其餘的2.5%原因不詳。
在神經行為變化上，有43.0%病患脾氣變得比中風前更暴躁。在記憶力衰退方面，有44.3%病患自認有現象。
在中風後自理能力方面的變化，以Barthel Index來評估，發覺有53位(33.5%)病患在出院後日常生活自理能力比在出院時進步。單獨評估病患獨立進食及步行能力時，亦發現各有29位 (18.4%)及36位(22.8%)病患在這兩方面的能力上有比出院時進步。

並列摘要

From April 1985, to December 1987, 1445 patients were admitted to Chang Gung Memorial Hospital, Keelung under the diagnosis of cerebral vascular accident ( hemorrhagic or infarction type). By random selection, 343 patients were analyzed by the SPSS. Of these 343 patients, 185 had died by the time this study was carried out. Thus the data available for analysis was incomplete for this deceased group. Only the data of those who survivied was analyzed in the results. The average duration of follow-up was 50.2±8.9 months (36-67 months). Among the survivors (n=158), 57% (n=90) received regular medication treatment, yet only 63% of these 90 patients fully understood the action of drug they received. The resons why 68 patients (43%) stopped taking the medication after discharge were analyzed. There were 66% of patients who had regular home rehabilitation program. For neuro-behaviour changes, 43% and 44.3% of patients had deterioration in their temper and memory respectively. There were 33.5% of patients reporting improvement in their ability to perform activities of daily living on follow-up.

並列關鍵字

cerebro-vascular disorder ； follow-up