類風濕性關節炎個案使用掌指副木之滿意度分析：個案報告

The Satisfaction Level Analysis of Using A Metacarpophalangeal Splint in An Individual with Rheumatoid Arthritis: A Case Report

背景：副木設計必須符合類風濕性關節炎個案之生理與心理需求，方可增進他們穿戴副木的意願。目前，尚未有研究探討類風濕性關節炎個案穿戴掌指副木之動機（心理需求）。目的：透過類風濕性關節炎個案之滿意度觀點，以瞭解個案穿戴掌指關節副木之動機。方法：個案報告。一位53 歲女性類風濕性關節炎個案參與。受試者之右手在抓握時，有輕度的掌內肌強勢之姿勢發生。由職能治療師客製化掌指副木供個案穿戴。評估內容有：滿意程度、穿戴時間、疼痛層級、握力、捏力和精細動作表現。初評與第二次評估時間間隔三個月。結果：受試者滿意度層級、握力和捏力都呈現退步狀態。結論：副木設計缺失是影響受試者穿戴意願的主要因素，未來職能治療師可以就材質的防水性和掌內支撐結構兩方面進行設計上之改善。

Background: The clinical effectiveness of the metacarpophalangeal (MCP) splint for individuals with Rheumatoid Arthritis (RA) improves with extended wearing. No studies have explored the satisfaction with the MCP splint for individuals with RA. Purpose: To understand the subjective factors influencing the motivation to wear an MCP splint, from the perspective of the user satisfaction of an individual with RA. Method: A case study. The participant was a 53-yearold female diagnosed with RA. The MCP splint was custom-made by an occupational therapist. The satisfaction evaluation, time of wearing the splint, Visual Analog Scale, grip strength, pinch strength, and dexterity were recorded at the initial evaluation and the second evaluation. Results: The participant exhibited a proper grasp posture and well-supported hand joints, but a decline in satisfaction level, grip strength, and pinch strength. Conclusion: The main factors decreasing the patient’s motivation for using the MCP splint were the design flaws. The absorbent material and palmar support of the MCP splint need immediate attention to ameliorate the problematic design.