初次腦中風病患記憶表現及其相關因素探討

Memory Performance and Related Factors in Patients after Their First Stroke

背景：腦中風是一種中樞神經系統障礙，臨床表徵依血管病變位置而有所不同。在眾多的後遺症中，記憶障礙的發生率相當高，除影響患者的日常生活活動外，其後續照護對於家庭和社會也產生重大影響。故本研究欲瞭解初次中風患者的記憶表現，以利其照護品質之提升。目的：探討初次腦中風病患記憶表現及其相關因素之情形。方法：本研究採橫斷式研究法，以中部某醫學中心復健科病房之腦中風病患共100位為研究對象，探討初次腦中風患者之記憶表現及其與個人基本屬性、憂鬱和身體活動功能的相關性，並以信、效度良好之魏氏記憶（WMS-III）量表、憂鬱（TLSA-短版CES-D）量表、日常生活功能評量表（BADL）等為研究工具。將所收集的資料以SPSS 12.0套裝軟體進行描述性及推論性統計分析。結果：（1）初次腦中風患者在WMS-III主要八個指數分數之平均值介於81.57（視覺延宕指數）至90.63（聽覺延宕再認指數），屬於中下到中等的水準表現。（2）研究對象性別、年齡、婚姻、教育程度、中風前職業別、肢體偏癱側、中風部位、發病危險因子及發病時間距離訪談天數在記憶表現有顯著性差異。（3）憂鬱、身體活動功能與記憶表現呈現顯著相關。結論：本研究驗證魏氏記憶量表中文版第三版應用於國內初次腦中風患者記憶表現評估的成效性，同時找出其最有影響的相關性，研究結果可提供國內學術研究與臨床工作者應用魏氏記憶記憶量表於初次腦中風患者之參考。其次，在護理實務上，本研究結果可提供臨床照護者進一步瞭解初次腦中風患者的記憶表現與基本屬性、憂鬱及身體活動功能的關係。建議未來護理人員應積極扮演提升患者記憶功能表現的媒介，可透過與中風患者互動，評估及了解其心理健康情形，給予患者適時鼓勵與回饋，增加其價值感。

Purpose: The aims of this study were to explore factors associated with memory performance among first stroke survivors and to provide appropriate nursing care to improve their quality of life. Methods: A cross-sectional and correlational design was used. Subjects were 100 patients with first stroke from a medical center in Taichung city. Results: (1) The standardized scores on the WMS-III for patients with first stroke ranged from 81.57 to 90.63, or below average. (2) Memory performance was significantly correlated with gender, age, marital status, years of education, job, hemiplegic side, stroke location, duration of disease, and risk factors for disease. (3) Memory performance was significantly correlated with depression and physical function. Conclusions: This study may provide clinical nurses with an understanding about patients’ first strokes as they relate to depression, physical function, and memory performance. The clinical nurse may then provide appropriate care to promote memory performance and enhance the quality of life for first stroke patients.