腦中風患者健康相關生活品質之初探

The First Probe for Stroke Patient’s Health-related Quality of Life

根據行政院衛生署95年最新統計料顯示，台灣地區民眾腦中風死亡率由94年的每十萬人口死亡數57.8人降低為95年的每十萬人口55.2人，就預防醫學而言，中風後倖存的個案，其後遺症會引起運動神經功能、認知及感覺障礙，導致日常生活型態之改變；若能善加利用健康照護資源，不僅有助於中風患者功能之恢復，更可減輕照顧者心理社會的負擔。本文目的在探討採用腦中風衝擊量表3.0版來測量中風病患健康相關生活品質之現況。於2008年1月2日至2008年2月29日採立意取樣方式，針對腦中風住院患者124位為研究對象，樣本來自北部某醫學中心、區域教學及地區醫院，計回收有效問卷124份。研究結果顯示：（1）人口變項之年齡、性別、教育程度、婚姻狀態，皆與健康相關生活品質顯著相關。（2）不同病程（急性、亞急性）在活動力、社會參與度健康相關生活品質構面上呈顯著差異。（3）不同疾病嚴重度（輕度、中度）於各項健康相關生活品質構面上（社會參與度除外）均呈顯著差異。（4）不同中風類型於「情緒」健康相關生活品質構面呈顯著差異。（5）不同肢體偏側於「溝通」健康相關生活品質構面呈顯著差異。本研究建議，中風初期即應將損傷程度、活動限制能力等表現納入治療評估計畫，進而讓病人獲得較佳的健康相關生活品質。

According to the latest statistic of 2006 done by Department of Health - Executive Yuan, the death rate of stroke for Taiwan people is reduced from 57.8 people per one hundred thousands people in 2005 to 55.2 people per one hundred thousands in 2006. In the view of advance medicine, the individual case for who survived by good luck after stroke has led to the sequela of exercise nerve function, recognition, sense obstacle and change of common life style. If we can use the health care source properly, it can not help stroke patient’s function recover but also reduce the mental burden of who looks after. This research purposes it to discuss the application of Storke Impact Scale version 3.0 in order to measure the current status of stroke patient’s health relative life quality. From Jan. 2nd, 2008 to Feb. 29, 2008, by determined sampling method, we take 124 stroke patients who are in hospitalization as research objects. The sampling is came from some medical center in Northern Taiwan、 district teaching and district hospitals. The retrievable effective questionnaires are 124 in total. The research result shows: (1) age, sex, education status and marriage status of population transformation are all related to health relative life quality. (2) Obvious difference in health relative life quality level of activity, social participation and self-consciousness recover according to different illness (acute or second acute). (3) Obvious difference on variety of health relative life quality level (excluding social participation) according to illness consequence (mild or moderate). (4) Obvious difference on “emotion” health relative life quality according to different stroke category. (5) Obvious difference on “communication” health relative life quality according to different limbs and trunk hemiplegia. Our suggestion is taking injury level, activity limitation ability into treatment evaluation plan in the beginning of stroke and then having patients get better health relative life quality.