影響腕隧道症候群患者穿戴豎腕副木配合度之相關因素調查

Factors Affecting Therapeutic Compliance in Wearing a Cock-Up Splint by Patients with Carpal Tunnel Syndrome

背景及目的：職能治療針對腕隧道症候群的治療，其一為穿戴豎腕副木固定保護腕部，以達到症狀緩減，故患者穿戴豎腕副木之執行狀況影響治療效果甚深。本研究的目的，先了解患者執行豎腕副木穿戴治療的配合度及執行狀況，再藉由調查進一步分析，找出影響不同角色、職業或職能活動背景的患者豎腕副木穿戴配合度之相關因素。方法：本研究採用質性研究方法，藉由問卷調查合併訪談法的設計，以追蹤調查患者的實際執行治療狀況及影響之相關因素。結果：患者穿戴豎腕副木的執行狀況及配合度，全部為有穿戴但非全天候的狀況，並非治療師所建議的全天候穿戴。影響豎腕副木穿戴配合度的相關因素，關聯程度最高的為環境因素中的「職業工作內容或環境不適合」，而此項因素則隨不同的患者職業，產生職業工作內容或環境的個別化與特殊性。其次的相關因素為生理因素之「症狀減緩」和環境因素之「日常生活活動內容或環境不適合」。結論：本結果提供職能治療師，將來推廣並衛教腕隧道症候群患者，接受職能治療之豎腕副木穿戴治療的方向，可提昇職能治療效果，以加速患者病症緩減及恢復時間。

Background and Objective: One of the purposes of prescribing a cock-up splint for patients with carpal tunnel syndrome in occupational therapy is to protect the wrist joint and reduce clinical symptoms; however, the way the splint is utilized will have a significant influence on the effectiveness of treatment. The aim of this study was to explore the factors associated with the level of compliance in wearing a cock-up splint, especially the influence of different roles, occupations, and occupational activities. Methods: This study used questionnaires and interviews to explore patients' utilization of the splints and the effect of this treatment. Results: All patients wore the cock-up splint as the therapist prescribed, however not everyone kept in on all day as suggested. The strongest factor that influenced the level of compliance was inappropriateness due to job demands or the workplace setting (i.e. environmental factor). Other significant factors were a decrease in clinical symptoms (i.e. biological factors) and the inappropriateness of wearing it for activities of daily living (i.e. environmental factors). Conclusion: This study will assist occupational therapists in encouraging patients with carpal tunnel syndrome to comply with the use of cock-up splints in order to increase the effectiveness of treatment, reduce clinical symptoms, and improve the time of recovery.