腦中風病患之日常生活能力評估：日間照護與家庭照護病患之比較

The Evaluation of Functional Recovery of ADL in Stroke Patient: A Comparison between Day-care Patient and Family-care Patient

徐弘正(Horng-Jeng Shyn) ； 潘文弘(Wen-Hong Pan) ； 賴慧貞(Huey-Jen Lai) ； 吳坤霖(Luen-Lin Wu) ； 許國敏(Kuo-Ming Hsu)

《中華民國復健醫學會雜誌》 20期 (1992/12) Pp. 79-89

摘要

本院日間照護服務開始於七十九年八月一日，主要對象為行動不便需要扶持但不需要住院治療之病殘老人，利用本院醫療復健設施及專業人員提供專業性，多元性之照護。本研究個案對象為日間照護病患及家庭照護病患(79.8-81.6)各二十人，於復健科接受復健治療──包括物理治療，職能治療及日常生活訓練，且連續治療一個月以上者，再予以四個月以上之觀察。此二十組病患，以配對法找尋個案，所配對的個案有相同側之偏癱，相同上下肢之運動功能分類(Brunnstrom Stage)，有相同之日常生活活動的分數(Modified Barthel Index)，每組予以相同之觀察期，以收案及結案之(Barthel Index)分數來分析討論。
結果顯示，日間照護組與家庭照護組，各組內收案及結案時，同時有進步項目包括修飾，大小便控制，轉位於椅子及行走。日間照護組除共同進步項目外，另有進食，轉位於廁所有進步。而家庭照護組除共同進步項目外，另有穿褲子項目進步。於結案時，兩組相比，於進食功能有統計學上意義之差異(P=0.0036)，日間照護組於進食功能上之進步大於家庭照護組。
日間照護組因生活於團體生活中，故於進食功能較家庭照護組進步本身亦於轉位至廁所較有進步。家庭照護組因運動功能進步較多，故本身於穿褲子功能上較有進步。在主要照護者方面，兩組均以子女照顧為多，由配偶照護者以家庭照護病患較多，由媳婦照護者以日間照護病患較多。

關鍵字

日間照護 ； 日常生活活動 ； 腦中風 ； 家庭照護 ； 主要照護者

並列摘要

The Purpose of this study was to compare the stroke patients within day-care center　to patients within family-care about the function of activity of daily living. They were selected as twenty groups. Each group had the same hemiplegic side, the same motor stage, and the same score of Barthel Index. They also got the same observation duration. No significant difference at admission were found between the two groups, except that the day-care patient had higher scores in dressing lower body (P=0.04). At discharge, the day-care patient had higher functional score in feeding than the family-care patient (P=0.0036). Within-group functional change from admission to discharge were found. There were the same significant gains in grooming, bladder and bowel control, transfer to chair and ambulation. Day-care patient got extra gains in feeding and transfer to toilet. The family-care patient got extra gain in dreeing lower body. In primary care-giver, most of them were taking care by their children.