呼吸放鬆改善中風病人自律神經、疲憊、焦慮、壓力與生活品質之成效

Breathing Relaxation Improves Autonomic Nervous System, Fatigue, Anxiety, Stress and the Quality of Life for Stroke Patients

背景：高居台灣十大死因第三位的中風不但影響病人生理層面，甚至會引起心理與生活品質等健康問題。然而，這些相關問題，可運用呼吸放鬆訓練加以改善。目的：本研究旨在評值呼吸放鬆訓練對中風病人的自律神經、疲倦、焦慮、壓力及生活品質之改善成效。方法：本研究為隨機控制試驗。中風病人以隨機分配成兩組。控制組（n=37）提供常規治療與照護，實驗組（n=39）除常規治療與照護並增加呼吸放鬆介入措施。重複量測之血壓、心跳次數、血氧濃度、疲憊指數等變項資料以廣義估計方程式進行統計分析。前後量測之焦慮知覺、壓力知覺與生活品質等變項，則以獨立t檢定進行統計分析。結果：呼吸放鬆訓練成效，分析結果的後測一時間點，實驗組之平均收縮壓下降8.53mmHg（p<.001）、舒張壓下降2.21mmHg（p=.02）、心跳下降1.2次／分（p=.01）、血氧上升0.82%（p<.001）及疲倦指數降低0.94（p<.001）。而在後測三時間點，實驗組之平均舒張壓下降6.32mmHg（p=.01）、血氧上升0.98%（p=.01）及疲倦指數降低2.87（p<.001）。此外，住院焦慮程度改變（p<.001）及生活品質第二部分之程度改變（p=.004）達統計上顯著差異；而在壓力知覺感受（p=.60）則無顯著差異。結論：呼吸放鬆訓練有助於改善中風病人之自律神經反應、疲倦狀態、住院焦慮程度及生活品質的自覺健康狀態。此實證研究結果可以提供照護中風病人之臨床實務照護參酌。 Background: Stroke ranks third in the top ten causes of death in Taiwan in 2012. This stroke burden notonly affects the physiological aspect but also psychological health and quality of life. However, breathingrelaxation training may improve such related health problems.Purpose: This study aimed to evaluate the effect of breathing relaxation training on autonomic nervoussystems, fatigue, anxiety, stress, and quality of life in patients with stroke.Methods: A randomized controlled trial was conducted. Participants were randomly assigned to thecontrol group (n=37) received the usual care, or the experimental group (n=39) received the usual careand breathing relaxation training. Outcomes were repeatedly measured blood pressures, heartbeat,blood oxygen concentration, and fatigue, which were analyzed by the generalized estimating equation.Additionally, perceived stress, hospital anxiety, and quality of life were measured before and after theintervention and analyzed group-difference by the independent t test.Results: After interventions, the experimental group significantly decreased in systolic blood pressure(8.53mmHg, p< .001), diastolic blood pressure (2.21mmHg, p= .02), heartbeat (1.2 beat/min, p= .01), andfatigue (0.94, p< .001), and increased in blood oxygen concentration (p<.001) at posttest 1. At posttest 3,there was significant decrease of diastolic blood pressure (6.32mmHg, p=.01) and fatigue (2.87, p< .001),and increase of blood oxygen concentration (0.98%, p= .01). In addition, there was a significant differencein hospital anxiety (p< .001) and quality of life (p= .004), but not perceived stress (p= .60).Conclusions: This study supports the effect of breathing relaxation training that may improve theregulation of autonomic nervous systems, fatigue, hospital anxiety, and health status of quality of life inpatients with stroke. The findings could be expected as a reference to care stroke patients.