脊髓損傷患者生活品質與損傷、功能間關係之研究

Abstract

本研究的目的乃是(1) 驗證適合 脊髓損傷者的生活品質問卷；(2)描述 影響脊髓損傷者生活品質的因素及第 一年的改變；(3) 驗證世界衛生組織的 能力障礙模式。採用縱斷式族群的研 究方式，針對119 名創傷型脊髓損傷 個案，於其傷病時及一年後之生活品 質調查。採用 SPSS 及AMOS 進行描 述性統計、推論統計分析及驗證式因 素分析。結果顯示世界衛生組織所發 展之WHOQOL-BREF 適用於脊髓損 傷患者之生活品質調查。脊髓損傷患 者一年間，在生理健康及環境之生活 品質滿意度上有顯著的增加，而心理 健康及社會支持的生活品質滿意度上 雖然有降低但是並沒有顯著差異。影 響脊髓損傷患者生活品質的因素為活 動參與頻率（FAI），影響脊髓損傷患 者活動參與頻率的因素為日常活動的 執行能力（BI），影響脊髓損傷患者日 常活動的執行能力的因素有損傷程度 及傷病後仍有的健康問題數目。同 時，世界衛生組織的障礙模式在脊髓 損傷患者生活品質上也獲得驗證。 關鍵詞：脊髓損傷、生活品質、國際 功能、障礙及健康分類（ICF）

The purposes of this study are (1) to validate the WHOQOL-BREF for people with spinal cord injuries (SCI); (2) to describe the influencing factors and changes of quality of life; and (3) to validate the relationships among body structure and function, activity limitation, participation limitation, contextual factors, and quality of life (QOL), based on the Model of Disablement presented in the International Classification of Functioning, Disability and Health, (ICF). This longitudinal and cohort study included 119 subjects with traumatic SCI. We surveyed subjects with a designed questionnaire at the time of hospitalization and one year after injury. We used SPSS and AMOS to conduct descriptive analysis and confirmatory analysis. Results showed that the WHOQOL-BREF was usable among subjects with SCI. One year after onset, the physical health and environmental domains of WHOQOL were significantly increased. There were no significant differences among psychological health and social relationship domains. Participation was significantly associated with QOL; self care ability was significantly associated with participation; impairment and number of health problems were significantly associated with self care ability. Results validated the disablement model developed by WHO. Keywords: spinal cord injury, quality of life, ICF