臺灣北部地區腦性麻痺兒童之一般醫療與復健醫療情形

Medical Care and Rehabilitation Services Providing to Children with Cerebral Palsy in Northern Taiwan

廖華芳(Hua-Fang Liao) ； 吳淑瓊(Shwu-Chong Wu) ； 鄭素芳(Suh-Fang Jeng) ； 王本榮(Pen-Jung Wong) ； 李素菁(Su-Ching Lee) ； 周文博(Wen-Po Chow)

《中華民國復健醫學會雜誌》 25卷2期 (1997/12) Pp. 105-117

摘要

為了解腦性麻痺兒童接受一般醫療及復健醫療之情形及其影響因素，於1995年6月至7月間，寄發2435份問卷給北部地區可能為腦性麻痺兒童之家長，得回收問卷689份（28%）。分析其中18歲以下腦性麻痺兒童之426份有效問卷（17.5%），結果顯示：在過去半年來，有389位（95%）曾接受西醫門診，平均次數為11.7± 10.4次（範圍1~67次）；其中以小兒科（77%）為最多數，復健科其次（50%）。曾接受中醫門診者91位（24%），曾接受針灸者76位（20%）。全民健保實施後，西醫門診次數略有上升。在復健方面，95%的腦性麻痺兒童過去曾接受復健醫療，在調查期間三個月內有241位（58%）仍接受復健醫療；其中物理治療207位（51%），職能治療94位（23%），語言治療47位（12%），裝具輔具47位（12%），心理治療14位（4%）。平均接受物理治療6.2±3.8次/月（中位數4次/月），職能治療5.4±3.2次/月，語言治療4±2.7次/月。因此所接受之各項復健醫療中以物理治療為最多。73%主要照顧者認為所接受之復健醫療仍不夠。影響有無接受復健醫療之因素包括：患童之年齡、患童之功能、確定腦性麻痺診斷時醫師給予之建議、父母親之教育程度、家中收入與家長對患童未來獨立之預期。患童家長對醫療之需求以提供有關醫療資訊者佔最多數。

關鍵字

腦性麻痺 ； 復健醫療 ； 醫療照護

並列摘要

The condition of medical and rehabilitation services for children with cerebal palsy（CP）in Taiwan has rarely been investigated. Such information is crucial for the health services planning. To understand the current status of medical and rehabilitation cares of CP children and related influencing factors, we sent 2435 copies of questionnaires to the main caregivers of possible CP children in the northern Taiwan. Six hundred and eighty-nine copies (28%) were returned. Four hundred and twenty-six copies were of CP children younger than 18 years of age（17.5%）. Their data were analyzed for this report. In 6-month period prior to this investigation, three hundred and eighty-nine CP children (95%) consulted at clinics of western medicine, averaging 11.7±10.4 visits. Pediatric service was the most (77%) and rehabilitation service (50%) the secondary. Ninty-one CP children (24%) also consulted at clinics of Chinese medicine and seventy-six CP children (20%) also received acupuncture treatment. For rehabilitation therapy, two hundred and forty-one CP children (58%) were receiving rehabilitation therapy during the three-month investigation period. The distributions of physical therapy, occupational therapy, speech therapy, orthotic therapy, and psychological therapy were 51%, 23%, 12%, 12%, and 4% respectively. The average frequency of physical therapy was 6.2±3.8 sessions per month; of occupational therapy, 5.4±3.2 sessions per month; of speech therapy, 4±2.7 sessions per month; of orthotics, 3.7±5.3 sessions per 3 months; and of psychology therapy, 10±22.3 sessions per 3 months. In conclusion, among the specialists of rehabilitation therapy physical therapy was the most that children with cerebral palsy had received. Factors influencing the amount of rehabilitation services were age and the level of functional ability of the CP child, education level of the parents, family income, first suggest that received while CP was diagnosed and parents' expectation of the CP child. The availability of medical information was mostly requested by the parents of CP children.

並列關鍵字

cerebral palsy ； rehabilitation ； medical care