臺灣博碩士論文加值系統

背景與目的：健康相關生活品質（health-related quality of life, HRQL）和粗動作功能（gross motor functions）皆被視為在腦性麻痺兒童（cerebral palsy）健康照護上的重要結果指標（outcome indictors）。本研究的目的是檢測腦性麻痺兒童的粗動作功能與HRQL之生理及社會心理層面的關係。方法：本研究採橫斷面設計（cross-sectional design），以立意方便取樣（purposive sample of convenience），徵召85位5至14歲的腦性麻痺兒童（51位男生，34位女生；平均年齡為8.2歲）參與。以粗動作功能量表（Gross Motor Function Measure, GMFM）來評估兒童粗動作功能；利用家長填寫子女健康問卷-家長版50（Child Health Questionnaire - Parent Form 50, CHQ- PF50）做為兒童HRQL評估。使用描述性統計及皮爾遜積差相關係數（Pearson product-moment coefficient of correlation）做統計分析。結果：腦性麻痺兒童的粗動作功能與HRQL面向呈現不同的關係。腦性麻痺兒童之GMFM-66的分數與CHQ的『生理總分』部份有中度的正相關性（r=0.72, p<0.01），而與CHQ的『社會心理總分』部份關係低（r=-0.07，p=0.54）。結論：本研究結果表示粗動作功能可能影響HRQL生理層面，但對於腦性麻痺兒童的社會心理層面影響甚小。因此專業人員不只要增進腦性麻痺兒童的動作功能，也需著重兒童的HRQL中之社會心理層面，以促進兒童的最佳預後。

BACKGROUND AND PURPOSE: Health-related quality of life (HRQL) and gross motor (GM) functions are both considered important outcome indicators in health care for children with cerebral palsy (CP). The purpose of this study was to examine the relationships among GM functions and physical component, as well as psychosocial component, of HRQL in children with CP. METHODS: Using a cross-sectional design, a purposive sample of convenience included 85 children with CP aged 5 to 14 years of age. Gross Motor Function Measure (GMFM) was used to quantify their GM functions.Their HRQL was determined by the Child Health Questionnaire-Parent Form 50 (CHQ- PF50), completed by their caregivers. Descriptive statistics and the Pearson product-moment coefficient of correlation calculations were used for data analysis. RESULTS: Different relationships among GM functions and components of HRQL for children with CP were noted. A significant moderate positive correlation(r=0.72, p<0.01) existed for physical summary scores of CHQ-PF50 and GMFM-66 scores. Psychosocial summary scores of CHQ-PF50 were weakly related to GMFM-66 scores in CP (r=-0.07, p=0.54). CONCLUSIONS: GM functions may have influence on physical component of HRQL, but have little or no influence on psychosocial component of HRQL. In order to optimalize the outcomes of children with CP, professionals should facilitate not only their GM functions, but also need to address the psychosocial componenet of their HRQL.

第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的 6
第三節 研究假設 6
第二章 文獻回顧 7
第一節 簡介 7
第二節 腦性麻痺兒童的結果量測 8
第三節 腦性麻痺兒童的粗動作功能 20
第四節 腦性麻痺兒童的HRQL 21
第五節 腦性麻痺兒童之HRQL的相關性研究 24
第六節 名詞解釋 29
第三章 研究方法 40
第一節 研究對象 40
第二節 研究工具及使用目的 41
第三節 研究步驟 44
第四節 資料擷取與統計分析 45
第四章 結果 50
第一節 受試兒童與CHQ-PF50填寫人的家庭背景特徵 50
第二節 粗動作功能的狀況 50
第三節 HRQL的狀況 51
第四節 粗動作功能與HRQL的相關情形 52
第五節 其它對腦性麻痺兒童之HRQL的可能影響因素 54
第五章 討論 67
第一節 腦性麻痺兒童粗動作功能和HRQL表現 67
第二節 腦性麻痺兒童在HRQL的次面向和粗動作功能的相關性探討 70
第三節 腦性麻痺兒童在HRQL的生理部份和粗動作功能之相關性探討 72
第四節 腦性麻痺兒童在HRQL的社會心理部份和粗動作功能之相關性探討 76
第五節 研究上的限制與未來研究方向 80
第六章 結論 87

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