溫水足浴對中風病患疲憊與睡眠品質之成效探討

The Effect of Warm-water Footbath on Fatigue and Sleep in Stroke Patients

背景：大多數中風後病患常有疲憊和睡眠障礙的問題，若是忽略可能會影響整體健康狀況和復原。目的：本研究在探討溫水足浴對中風後病患的疲憊和睡眠品質之成效。方法：本研究採類實驗型研究設計，研究對象為北部某地區醫院復健病房之住院病患，控制組51人，實驗組41人。控制組病患採常規照護；實驗組病患持續七天在睡前接受41℃的溫水足浴。兩組皆接受結構式問卷調查，測量工具包括：病人基本資料、疲憊嚴重程度量表、維辛式睡眠量表，所收集的資料以SPSS18.0統計軟體執行資料處理及分析。結果：控制組與實驗組樣本皆有疲憊狀況（4.24±0.98 vs. 4.16±0.94）。控制組隨著住院天數增加，後測（4.43±1.00）疲憊程度高於前測（4.24±0.98），達統計上顯著差異（t＝-3.23, p＝.02）。實驗組後測（3.13±1.03）的疲憊程度低於前測（4.16±0.94），達統計上顯著差異（t＝8.93, p＝＜.001）。此外，控制組的睡眠品質前測（728.43±145.24）和後測（730.55±136.25）差異不大（t＝-0.39, p＝0.70），但實驗組後測的睡眠品質（958.10±117.41）高於前測（698.93±212.39），且達統計上顯著差異（t＝-10.60, p＝＜.001）。結論：本研究發現，足浴可緩解疲憊並改善睡眠狀況。值得嘗試於臨床中推廣。

Background: Most stroke patients experience fatigue and sleep disturbance in different phases of disease. Untreated fatigue and sleep disturbance can lead to worsening overall health of patients and a slowed recovery process. Purpose: This study aims to investigate the effect of warm-water footbath on fatigue and sleep in hospitalized post-stroke patients. Methods: In our study, a quasi- experimental design was applied. The stroke subjects were recruited from two rehabilitation wards in a regional hospital located in northern Taiwan. Fifty-one subjects in the control group received routine care, while forty-one subjects in the experimental group received additional warm water footbath. The warm water footbath with 41℃ was lasted 15 minutes before bedtime for 7 nights. All subjects received structured questionnaires, including Fatigue Severity Scale and Verran and SnyderHalpern Sleep Scale. All data were analyzed using SPSS Windows 18.0 statistical software. Results: Fatigue was common in both the experimental (4.16±0.94) and control (4.24±0.98) groups. However, the severity of fatigue increased significantly in the control group (t=-3.23, p= .02) whereas the severity of fatigue was decreased in the experimental group (t=8.93, p= < .001). After the implementation of footbath, only the experimental group reported significant sleep improvement (t=-10.60, p= < .001). Conclusion: We found that warm water footbath could relieve the severity of fatigue and improve the quality of sleep. Clinical implication is strongly suggested.