- 期刊
Predicting the Grade of Disability 1 Year after Stroke Following Rehabilitation
腦中風病人復健治療預後身心障礙等級的預測
摘要
本研究目的是追蹤探討腦中風患者復健治療出院一年後身心障礙等級的預測因子。研究對象徵召某醫學大學附設醫院因腦中風住院在復健病房接受復健治療之患者。病發一年後身心障礙鑑定資料結果做為評量障礙等級的依據。在剛住院復健科、出院前和出院六個月後的訪視時，分別使用功能獨立自主量表(Functional Independence Measure，FIM)來評估日常生活功能，並且收集患者主要社會人口學及住院期間臨床診斷和評估資料做為預測變項。完成109位個案追蹤調查，結果發現有64位(58.7%)身心障礙等級為重度或極重度。邏輯廻歸分析顯示重要預測因子包括兩側肢體動作功能皆受損者（勝算比值10.8）對比單側肢體受損者，出院時定向功能異常者（勝算比值3.6）及日常生活功能情況較差者（勝算比值7.6）。根據這些重要預測因子所建立邏輯迴歸分析模式，可以正確歸類出68.0%的重度或極重度患者。本研究有較高比例的重度或極重度等級的身心障礙患者可能研究對象是相對較嚴重住院接受復健治療之中風患者和使用特定的身心障礙鑑定量表。這些結果可以提供有用的資料做為規劃中風患者後續復健醫療和擬訂相關社福政策的參考。
並列摘要
The purpose of this study was to identify predictors of grades of disability at least 1 year after stroke rehabilitation therapy. We recruited stroke patients from the inpatient rehabilitation department of a university hospital. The degree of disability was graded using the disability evaluation at least 1 year after stroke onset. Functional ability was evaluated using the Functional Independence Measure instrument on admission, on discharge from the inpatient rehabilitation program, and at the 6-month follow-up visit after discharge. Major sociodemographic, medical, and rehabilitative factors were also collected during the hospitalization period. Of the 109 patients surveyed, 64 (58.7%) had severe or very severe grades of disability. The correlates of severe or very severe disability in logistic regression analyses were bilaterally affected (odds ratio, OR, 10.8), impaired orientation (OR, 3.6), and poorer functional ability at discharge (OR, 7.6). Based on the significant predictors identified, the logistic regression model correctly classified severe or very severe disability in 68.0% of subjects. The higher frequency of severe or very severe disability in this study may have been due to the relatively more severely affected stroke patient population in the inpatient rehabilitation service and the use of unique disability evaluation criteria. These results may provide information useful in planning continuous rehabilitation care and setting relevant socio-welfare policies for stroke victims.
延伸閱讀
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