影響癲癇病患經濟獨立的相關因素探討

Exploration the Related Factors of Financial Independence in Patients with Epilepsy

目的：罹患癲癇疾病常常造成患者生理、心理及社會層面的重大影響，另外，癲癇疾病也常常被污名化，衍生低工作比率、低社會經濟及較高失業率等問題，而目前國內尚未有相關的研究探討這些議題，因此，本研究目的為藉由探討影響癲癇病患經濟獨立的相關因素，可作為協助癲癇患者經濟獨立及醫療人員臨床照護之參考。
方法： 採橫斷式相關性設計，以立意取樣選取台灣北部某家教學層級醫院門診之癲癇病人為對象，採用結構式問卷進行資料收集。
結果： 共有165 位癲癇病患參與研究。結果顯示若癲癇病患教育程度越高(χ2=21.33, p<0.001)、健康狀況沒有合併其他疾病(χ2=15.62, p<0.001)、第一次發作年齡在13-19 歲以後(χ2=11.0, p=0.01)、就業狀況呈現工作穩定(χ2=57.37, p<0.001)、工作年數有持續超過一年以上(χ2=42.67, p<0.001)、找工作沒有困難(χ2=26.23, p<0.001)、有擔任主管(χ2=16.22, p<0.001)及有穩定個人月收入(χ2=84.63, p<0.001)，則經濟較獨立。其中，沒有其他疾病(OR=8.73,95% CI=2.45-31.07)、工作年數1-10 年者(OR=6.33, 95% CI=1.73-23.15)、找工作沒有困難者(OR=5.70, 95% CI=1.89-17.23) 及個人每月收入大於2 萬者(OR=62.39, 95% CI=16.15-241.07) 對於經濟獨立有顯著影響力。
結論： 由於研究結果顯示沒有合併其他疾病、有穩定的工作、找工作順利及每月至少有2 萬以上收入對於經濟獨立有顯著影響力，我們建議醫護人員應鼓勵及指導癲癇病患，多注意自己身體健康避免產生其他疾病，以及培養自信心及專業能力，並走出來面對人群，要求自己可以努力找到穩定的工作；另外可以增加社會民眾的癲癇相關知識教育，期望可以減少大家對於癲癇的誤解，並多給癲癇病患工作及減少找工作受挫機會，讓其可以貢獻所長。

Purpose: Epileptic seizures often impact patients significantly in physical, psychological, and social dimensions. In addition, epilepsy was often stigmatized to cause low occupation rate, low socio-economic status, and high unemployment. There are no related research exploring these issues. Therefore, the purpose of this study was to investigate the related variables of financial independence in patients with epilepsy. The results to help epilepsy patients understand the factors associated with financial independence and improve the quality of clinical care. Methods: A cross-sectional study design was used. The epilepsy outpatients between 20 and 65 years old from one medical center of northern Taiwan was recruited by convenience sampling. Results: A total of 165 questionnaires were collected. Results showed significant association between financial independence and the following factors: higher education (χ2=21.33, p＜0.001), health status without comorbid chronic diseases (χ2=15.62, p＜0.001), first seizure after 13 to 19 year old (χ2=11.0, p=0.01), have stable employment status (χ2=57.37, p＜0.001), over one year of employment (χ2=42.67, p＜0.001), no difficulty in finding a job (χ2=26.23, p＜0.001), a manager (χ2=16.22, p＜0.001), and have stable personal monthly income (over 20 thousand Taiwanese dollars) (χ2=84.63, p＜0.001). Logistic regression analysis indicated that patients without comorbid chronic diseases (OR=8.73, 95% CI=2.45-31.07), have employment for 1 to 10 years (OR=6.33, 95% CI=1.73-23.15), no difficulty in finding a job (OR=5.70, 95% CI=1.89-17.23), and personal monthly income over 20 thousand NT dollars (OR=62.39, 95% CI=16.15-241.07) were significantly associated with financial independence. Conclusions: According to this study, we suggested that health care providers have to pay more attention on these factors and encourage the patients with epilepsy to keep healthy, decrease comorbid chronic disease, and increase self-confidence, and improve professional capability to keep a stable job. Health care providers should educate people to eliminate the misunderstanding about patients with epilepsy and provide more job opportunities.