住院期間腦出血病人的肢體功能、憂鬱症狀與生活品質關係探討

The Relationships among Limb Function, Depressive Symptom and Quality of Life in Patients with Intracranial Hemorrhage

背景：腦出血病人可能出現肢體功能受損與憂鬱情緒，而影響生活品質，但現況較少針對住院期間情況進行探究。
目的：探討住院期間腦出血病人的肢體功能、憂鬱症狀與生活品質的影響關係。
方法：為橫斷性描述相關研究，於某醫學中心神經內外科病房收案，以上肢動作評估量表及簡短身體表現測量測量肢體功能、以台灣人憂鬱量表測量憂鬱症狀、及歐洲生活品質量表測量生活品質。
結果：110 位研究對象平均年齡57.61歲，62.7% 為男性，66.4% 屬於自發性腦出血，96.4% 無憂鬱症狀。左手與右手肢體功能平均得分分別為50.59 與53.83，下肢肢體功能平均4.67分，生活品質平均分數為0.57。影響生活品質的因素有肢體功能及憂鬱症狀，調整後解釋變異量72% (F=69.80, p< .001)，上下肢的肢體功能越好則生活品質越好；憂鬱症狀越高，生活品質越差。
結論／實務應用：肢體功能與憂鬱症狀為生活品質的影響因素，醫護人員須定期評估監測病人的肢體功能的障礙程度以及憂鬱症狀，以適時提供合適與具體的照護措施，以期提升病人的生活品質。

Background: Patients with intracranial hemorrage may experience poor limb function and depressive symptom, and then impact the quality of life, but the current situation is less researched on the situation during hospitalization.
Purpose: To explore the relationships among limb function, depression, and quality of life in patients with intracranial hemorrhage.
Methods: This study is a descriptive, correlational, and cross-sectional design. Patients who with intracranial hemorrhage in a neurosurgery ward of a medical center at northern Taiwan were invited to participated in this study. Using the Motor Evaluation Scale for Upper Extremity in Stroke Patients and Short Physical Performance Battery, Taiwanese Depression Questionnaire, and Europenic Quality of Life Five Dimensions (EQ-5D) to collect data.
Results: There were 110 patients with intracranial hemorrhage included in this study. The average age was 57.61years, 62.7% were male, 66.4% were spontaneous hemorrhage, and 96.4% had no depressive symptom. The mean score of left and right upper limb function was 50.59 and 53.83 separately. The mean score of lower limb function was 4.67, Average quality of life score of 0.57. Multiple regression analysis showed that the predictors of quality of life was the limbs function and depressive symptom. Patients who had better limbs function and lower depression symptom will have better quality of life. The adjusted explanatory variation was 72% (F=69.80, p<.001).
Conclusion/implication for practice: The significant factors associated with quality of life were limbs function and depressive symptom. In order to improve the quality of care, nurses and other healthcare professionals must base on the limbs function and emotional status to provide specific care plan.