探討影響中風患者復原力的相關因素

研究背景：先前研究顯示當中風病患進入復健期，復健成效會因個人、家庭、社會文化等因素影響，復健期間患者可能因為失落感而影響復健及自我照顧成效，因此，探討中風患者復健期間的復原過程及心理的調適是重要的議題。此外，復原力會因為患者的疾病經歷而影響復健成效，然而針對影響中風患者復原力的相關因素研究尚缺乏。研究目的：本研究旨在探討腦中風復健病人的疾病經歷、日常生活功能獨立、社會支持與復原力之相關性，並探討人口學資料、疾病經歷(復健天數)、日常生活功能獨立、社會支持是否為中風患者復原力的預測因子。研究方法：研究採橫斷式研究設計，以結構式問卷進行資料收集，問卷內容包括腦中風病人人口學資料（含基本屬性、疾病特性）、疾病嚴重度量表、日常生活功能獨立量表、復原力量表及社會支持量表。分析方法有描述性統計、推論性統計、獨立樣本t檢定(Independent-t test)、單因子變異數分析(One way ANOVA)、皮爾森積差相關分析(Pearson product-moment correlation)、逐步迴歸分析，採用SPSS 22.0電腦套裝軟體進行資料分析。研究結果： 有41位(男性22人；女性19人)中風患者參與本研究問卷填寫，有53.7％（22人）患者為缺血性中風，出血性中風則為46.3％ (19人)，平均年齡為59.2歲（標準差=11.9），平均已復健日為55.2天（標準差=114.2），整體復原力表現為中上程度(平均值為151分)。結果顯示，教育程度教高者及有宗教信仰者，其復原力表現比教育程度低者及無宗教信仰者為高，而家人親友社會支持與復原力具有正相關(r = 0.57, p < 0.01)，經逐步迴歸分析顯示教育程度與家人親友社會支持為復原力的重要預測因子，解釋力為37.9%。建議臨床醫護人員於照顧中風後復建病人，可提供心理層面的諮商，儘早發現問題，主動提供家屬與患者有效之衛教或照護技巧，或協助轉介社會資源、提供相關資訊給予協助，增加中風患者之復原力。

Background:Previous studies have indicated that the patients’ rehabilitation effectiveness will be affected by individual, family, and social culture. In addition, when patients feel loss may affect their rehabilitation and self-care efficacy during rehabilitation. Therefore, it is an important issue to explore the recovery process and psychological coping of stroke survivors during rehabilitation. In addition, patients’ resilience will affect outcome during their disease experience. However, there are still few studies to explore the related factors that influence resilience of stroke patients.Objectives:The aim of this study was to explore the relationships among disease history, activities of daily living (ADL), social support, and resilience in stroke survivors. Further, we examined demographic data, disease history (length of rehabilitation time), ADL, and social support as predictors of resilience in stroke survivors during rehabilitation.Methods:This study used a cross-sectional research design and collected data by structured questionnaire. The questionnaire included demographic data (basic attributes, disease characteristics), Modified Rankin Scale (MRS), Barthel Index, Social support Scale, and Resilience Scale for Adults (RSA). The independent sample t-test, one-way analysis of variance (one-way ANOVA), Pearson correlation, and stepwise regression were used to examine the research hypotheses, and data analysis was performed using SPSS 22.0 computer suite software.Results:Of the 41 stroke patients who participated (22males; 19 females) in the study, 53.7% (n=22) had (experienced) ischemic stroke and 46.3% (n=19) had (experienced) hemorrhagic stroke. There are 53.7% (n = 22) were ischemic stroke, and 46.3% (n = 19) were hemorrhagic stroke. Their mean age was 59.2 years (SD = 11.9), average recovery days were 55.2 days (standard deviation = 114.2), and overall elasticity was medium to high (mean 151 points). The results further showed that patients who had higher education levels and those that had religious beliefs reported greater resilience than those who with low education levels and those who had no religious beliefs. Additionally, the social support from family and friends was significantly and positively correlated with resilience (r = 0.57, p < 0.01). Stepwise regression analysis showed that the education level and social support from family and friends are important predictors of resilience, with an explanatory power of 37.9 %.