嘉義某地區醫院6位成年腦中風患者疾病適應歷程之研究

he studying in the Adaptation Experience of six middle aged Patients with stroke in a Local Hospital in chiayi

本研究旨在了解中年腦中風患者疾病適應歷程，透過年齡限制及腦中風障礙及失能評估量表（NIHSS）篩選出六位研究對象，採用戈登人格剖析量表及深入訪談法進行資料蒐集，探索中年腦中風患者疾病適應之歷程。研究結果發現：疾病適應良好與社會支持系統及正向的人格特質有關。患者在急性期時因失去身體控制感，對未來產生負向情感時，此時社會支持系統所提供的情緒性支持及家庭經濟穩定，可降低受訪者負向情感。進入黃金復建期時，患者看見自己生理狀態不如以往，親友的情緒性支持與受訪者的人格特質將影響患者如何調整自己心理狀態以面對疾病造成的不便，但此階段因復原進展明顯，多數受訪者在此階段對自己的復原都能抱持正向積極的態度。邁入慢性復原期後，因復原進展趨緩，且一旦稍有怠惰，就需面對肌肉緊繃、肢體僵硬退步的生理情況，此時的支持系統與自我概念動態的轉變更顯重要。在了解腦中風患者疾病適應歷程後，研究者根據研究結果的整理，針對實務工作者、患者及家屬及對急性後期照護計畫政策提出具體建議，以協助腦中風患者盡快適應病後生活。

The purpose of this study is to explore the experience and disease adaption of patients with stroke in their middle ages. Research method adopted in-depth interview method and GPP-I scale to collect data. Six samples were selected by age, stroke impairment and disability assessment scale （NIHSS）. The results that process of disease adaptation in patients with stroke are influenced by recovery, self-concept and social support systems. In initial stage, due to life limited by body impairment that patients with stroke fall into negative self-concept, however, family support and financial stable would reduce pessimistic concept. In middle rehabilitation stage, if patients with stroke are dramatically progress in their rehabilitation, they would have positive self-concept about their difficult with disability. In chronic stage, recovery of patients with stroke is slow down. If patient was neglecting to rehabilitate, they would become joint stiffness and move limitation. Therefore, family support is highlight factor to patients with stroke as well as positive self-concept to cope with body impairment. The suggestions are also discussed to practitioners and those families with stroke patients that assist patient to adapt the disease and disability.