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研究生:余文君
研究生(外文):Wen-Chun Yu
論文名稱:出院燒傷病人生活品質及其相關因素之探討-以某復健機構服務之病人為例
論文名稱(外文):Discharged Burn Patients Quality of Life and Related Factors: Survey at Rehabilitation Institution
指導教授:張媚張媚引用關係
指導教授(外文):Mei Chang
口試委員:林艷君張慈惠
口試委員(外文):Yen-Chun LinTsyr-Huei Chang
口試日期:2014-07-11
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:護理學研究所
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2014
畢業學年度:102
語文別:中文
論文頁數:103
中文關鍵詞:燒燙傷出院病人生活品質日常生活功能
外文關鍵詞:discharged burn patientsquality of lifeActivities of Daily Life
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燒傷是一種創傷性的損傷,燒傷病人除了需要承受住院時的生理煎熬及心理上的衝擊,出院後還須面對傷口的後續照護、疤痕增生、肢體攣縮及變形、復健治療等後續照護問題,外觀及日常生活的改變,更影響到生活品質。本研究目的在探討接受復健機構服務之出院燒傷病人生活品質及其相關影響因素。採橫斷式描述性設計,以立意取樣選取於陽光社會福利基金會接受復健與照顧之32位燒傷病人為研究對象。研究測量工具為結構式問卷,包括個人基本屬性、疾病特性、日常生活活動功能量表及世界衛生組織生活品質問卷台灣簡明版等四部分。統計方法包括將差異性者進行曼惠特尼U考驗(Mann-Whitney U test)與克-瓦二氏單因子等級變異數分析(Kruskal-Wallis One-Way ANOVA)執行檢定,關聯性者將以史皮爾曼等級相關分析(Spearman Rank Correlation)進行檢定,以多元迴歸分析(Multiple Regression)發現生活品質之預測因子。
研究結果顯示(一)本研究機構內燒傷病人的整體生活品質平均得分為48.44,低於一般民眾及其他慢性病病人。(二)個人基本屬性與「整體生活品質」的生活品質感受並無顯著關係。僅宗教信仰與社會範疇的生活品質有顯著關係,有宗教信仰病人在社會範疇的生活品質感受優於無宗教信仰者。(三)大部分的疾病特性與生活品質皆無明顯的關聯性存在,僅疾病特性(燒傷面積、燒傷部位數、疤痕攣縮部位數、疤痕影響關節部位數)與社會範疇的生活品質有顯著關係,疤痕攣縮部位數亦與整體生活品質有顯著的正相關。(四)日常生活活動功能與生活品質無顯著相關,可能因研究樣本在「日常生活活動功能」指數的差異程度不大。(五)燒傷病人生活品質之預測因子:「燒傷面積」為「生理範疇」生活品質之預測因子,解釋力為23.8%,面積>25%之重度燒傷者較面積<15%之輕度燒傷者差。接受機構服務項目數是「心理範疇」生活品質之預測因子,解釋力為15.8%,接受機構服務項目越多者,越佳。疤痕攣縮部位數、宗教信仰及教育程度是「社會範疇」生活品質之預測因子,三者解釋力共43.0%,疤痕攣縮部位數越多、有宗教信仰者,「社會範疇」生活品質越好;大學以上畢業者較高中職以下畢業者有較差的「社會範疇」生活品質。燒傷面積及婚姻是「環境範疇」生活品質之預測因子,解釋力共28.7%。燒傷面積>25%優於面積<15%者及已婚者優於未婚者。燒傷面積亦為整體生活品質之預測因子,解釋力為17.1%,面積>25%者優於面積<15%者。

Burns is a traumatic injury. In addition to suffering the physiological and psychological impact during hospitalization, burn patients had to face the subsequent wound care, hypertrophic scars, scar contractures, deformed limbs, rehabilitation therapy, other follow-up care issues, and change in appearance and daily life after discharge. All of above affect their quality of life.
The purpose of this study was to investigate the correlation between quality of life and burn-related factors for discharged burn patients who assisted by a rehabilitation institution. We adopted cross-sectional descriptive correlation design and purposive sampling in 32 burn patients who were rehabilitated and taken care of by Sunshine Social Welfare Foundation.
Research tools were questionnaires which included four parts as below: basic personal attributes scale, disease characteristics scale, Activities of Daily Life(ADL) scale, and World Health Organization Quality of Life-BREF(WHOQOL-BREF).
Inferential statistical methods included testing the differences by using the statistical tests, "Mann Whitney U test" and "Kruskal-Wallis One-Way ANOVA" testing the relevance by using "Spearman Rank Correlation analysis" and found the predict factor of life quality by using "Multiple Regression" .
The results showed that:
(1) The average score of quality of life for burn patients in this research was 48.44 which was lower than general population and patients with other chronic diseases.
(2) There was no direct correlation existed between basic personal attributes and "overall quality of life". The only related variable with quality of life was religion. The result showed that patients with religion achieved better quality of life than non-believers.
(3) In the summary of correlation analysis of disease characteristics and quality of life, there was no obvious correlation between the majority of disease characteristics and quality of life. The social relationship domain was the only variable related to more disease characteristics (burn surface area, figures of burn areas, figures of scar contractures, and figures of joints affected by scars) in quality of life category. The overall quality of life had significantly positive correlation with the number of scar contractures.
(4) Daily life functions and quality of life relevance: Because there was no big difference in the variable of daily life functions index for burn patients, it was difficult to predict the correlation between "daily life functions" and "quality of life".
(5)The predictive factors of quality of life in burn patients: "Total burn surface area (TBSA)" was the predictive factor to determine the quality of life in "physical domain". The explanatory power was 23.8%(R2 = .238). Severe burn patients with TBSA > 25% were worse than those mild burn patients with TBSA<15%. The item number of acceptance service was the predictive factor to determine the quality of life in "psychological domain". R2 =0.158. The more service item person accepted, the better was his quality of life. Figures of scar contractures, religion, and education were the predictive factors to determine quality of life in "social relationship domain". Total R2 of these three items was 0.430. The person who had religion and more scar contractures had better quality of life in social relationship domain. The person with bachelor degree or higher had worse quality of life in social relationship domain than those with high school diploma or lower. TBSA and marriage were the predictive factors to determine the quality of life in environment domain. R2=0.287. The person with TBSA>25% was better than the TBSA<15%. Married person was better than those unmarried. TBSA was the predictive factor as well to determine the overall quality of life. R2=0.171. The person with TBSA>25% was better than the TBSA<15% in overall quality of life.

口試委員審定書
致謝
中文摘要......................................................................................................................i
英文摘要....................................................................................................................iii
第一章 緒論................................................................................................................1
第一節 研究背景與動機........................................................................................1
第二節 研究目的....................................................................................................3
第二章 文獻探討........................................................................................................4
第一節 燒傷之特性................................................................................................4
第二節 生活品質之概念........................................................................................7
第三節 生活品質與燒傷之相關研究...................................................................10
第三章 研究方法.......................................................................................................12
第一節 研究架構...................................................................................................12
第二節 研究假設...................................................................................................13
第三節 名詞界定...................................................................................................14
第四節 研究設計...................................................................................................15
第五節 研究對象與場所.......................................................................................16
第六節 研究流程...................................................................................................17
第七節 研究工具...................................................................................................18
第八節 研究工具之信、效度...............................................................................21
第九節 資料處理與分析.......................................................................................24
第十節 倫理考量...................................................................................................26
第四章 研究結果與分析...........................................................................................27
第一節 基本資料之次數分配...............................................................................27
第二節 日常生活功能及生活品質之現況分析...................................................34
第三節 個人基本屬性與生活品質之關聯性.......................................................37
第四節 疾病特性與生活品質之關聯性...............................................................45
第五節 日常生活功能及生活品質之相關性.......................................................59
第六節 燒傷病人生活品質之預測因子...............................................................60
第七節 研究結果總結...........................................................................................65
第五章 討論...............................................................................................................66
第一節 生活品質概述...........................................................................................66
第二節 個人基本屬性與生活品質之相關...........................................................68
第三節 疾病特性與生活品質之相關...................................................................69
第四節 日常生活功能與生活品質之相關...........................................................71
第五節 燒傷病人生活品質之預測因子...............................................................72
第六章 結論與建議....................................................................................................74
第一節 結論............................................................................................................74
第二節 研究與限制................................................................................................76
第三節 建議............................................................................................................77
參考文獻......................................................................................................................79
中文部份..................................................................................................................79
英文部份..................................................................................................................81
附錄一 財團法人陽光社會福利基金會同意研究計畫核准函................................86
附錄二 日常生活活動功能量表................................................................................87
附錄三 台灣版世界衛生組織生活品質問卷使用授權書........................................88
附錄四 台灣簡明版世界衛生組織生活品質問卷四個範疇題目............................89
附錄五 專家效度名單................................................................................................90
附錄六 國立台灣大學附設醫院研究倫理委員會通過審查函................................91
附錄七 正式研究問卷內容........................................................................................93

中文部分
台灣版世界衛生組織生活品質問卷發展小組(2005)‧台灣簡明版世界衛生組織生活品質問卷之發展及使用手冊(第二修訂版)‧台北:台灣簡明版世界衛生組織生活品質發展小組。
李明濱、吳其炘(2004)‧燒傷之心身醫學觀‧北市醫學雜誌,1(3),252-260。
李雅珍、吳姿誼、邱恩琦、&;#20931;富籌、謝清麟(2012)‧中風病患整體健康相關生
活品質之關聯因素探討‧職能治療學會雜誌,30(1),53-67。
李德芬、林欣潔、吳佳玟、吳嘉純、林美珍(2004)‧燒燙傷病患的疼痛處置&;#65381;疼痛醫學雜誌,14(2),74-85。
姚開屏(2000)‧簡介與評論常用的一般性健康相關生活品質量表兼談對未來研究的建議‧中國測驗學會測驗年刊,47(2),111-138。
姚開屏(2002a)‧台灣版世界衛生組織生活品質問卷之發展與應用‧台灣醫學,6(3),193-200。
姚開屏(2002b)‧健康相關生活品質概念與測量原理之簡介‧台灣醫學,6(2),183-192。
鈕淑芬(2004)‧透析病患之生活品質及其相關因素探討‧臺灣腎臟護理學會雜誌,3(2),88-101。
張慈惠(1997)‧燒傷病患生活品質及其相關因素之探討‧未發表碩士論文‧台北:國立台灣大學護理學研究所。
陽光福利基金會(2012)‧陽光的故事‧取自http://www.sunshine.org.tw/about/story.asp
葛魯蘋(2004)‧台灣版簡易疼痛量表之簡介‧疼痛通訊,45,8-14。
靳燕芬(2007)‧傷口換藥疼痛護理‧護理雜誌,54(3),87-91。
歐陽秀芳、顧乃平、吳肖琪、王先震(2000)‧出院燒燙傷病患健康信念、社會支持與自我照顧相關之探討‧醫學研究,20(6),279-294。
藍麗美、陳芬芳、洪美慧、劉錦鳳(2007)‧灼燙傷病人出院後身體生活功能恢
復程度與自我效能之相關因素研究‧實證護理,3(2),149-160。

英文部份
Abbey, A., &; Andrew, F. M. (1985). Modeling the psychological determinants of life quality. Social Indicator Research, 16, 1-34.
Anzarut, A., Chen, M., Shankowsky, H., &; Tredget, E. (2005). Quality-of-Life and Outcome Predictors following Massive Burn Injury. Plastic and Reconstructive Surgery, 116(3), 791-797. doi: 10.1097/01.prs.0000176257.22583.4b
Andrews, R. M., Browne, A. L., Wood, F., &; Schug, S. A. (2012). Predictors of patient satisfaction with pain management and improvement 3 months after burn injury. Journal of Burn Care &; Research, 33(3), 442-52.
Bezuhly, M., &; Fish, J. S. (2012). Acute burn care. Plastic &; Reconstructive Surgery, 130(2), 349-358.
Brandt, C. P., &; Fratianne, R. B. (1994). Diagnosis and management of common industrial burns. Dermatologic Clinics, 12(3), 469-476.
Briggs, S. E. (1990). Acute Management of the Burned Patient. Philadelphia: WB Saunders.
Browne, G., Byrne, C., Brown, B., Pennock, M., Streiner, D., Roberts, R.,...Dabbs, R. (1985). Psychosocial adjustment of burn survivors. Burns, 12(1), 28-35.
Campbell, A., Converse, P. E., &; Rodgers, W. L. (1976). The quality of American life: Perceptions, evaluations, and satisfactions. New York: Russell Sage Foundation.
Ciofi-Silva, C. L., Rossi, L. A., Dantas, R. S., Costa, C. S., Echevarria-Guanilo, M. E., &; Ciol, M. A. (2010). The life impact of burns: The perspective from burn persons in Brazil during their rehabilitation phase. Disability and Rehabilitation, 32(6), 431-437.
Collin, C., Wade, D.T., Davies, S., &; Horne, V. (1988). The Barthel ADL index: A reliability study. International Disability Studies, 10(2), 61-63.
Corry, N., Pruzinsky, T., &; Rumsey, N. (2009). Quality of life and psychosocial adjustment to burn injury: Social functioning, body image, and health policy perspectives. International Review of Psychiatry, 21(6), 539-548.
Cromes, G. F., Holavanahalli, R., Kowalske, K., &; Helm, P. (2002). Predictors of Quality of Life as Measured by the Burn Specific Health Scale in Persons With Major Burn Injury. Journal of Burn Care &; Rehabilitation, 23(3), 229-234.
DeVellis R. F. (1998). Scale Development: Theory and Applications. CA: Sage.
Druery, M., Brown, T. L. H., &; Muller, M. (2005). Long term functional outcomes and quality of life following severe burn injury. Burns, 31(6), 692-695. doi: 10.1016/j.burns.2005.03.001
Eastman, S. M. (2005). Burn Injuries. Plastic Surgical Nursing, 25(3), 133-139.
Elsherbiny, O. E. E., Salem, M. A., El-Sabbagh, A. H., Elhadidy, M. R., &; Eldeen, S.M.A. ( 2011). Quality of life of adult patients with severe burns. Burns, 37(5), 776-789.
Erickson, F. (1998). Qualitative research methods for science education. Dordrecht, Netherlands: Kluwer.
Fauerbach, J. A., Lezotte, D., Hills, R. A., Cromes, G. F., Kowalske, K., de Lateur, B. J.... &; Patterson, D. R. (2005). Burden of burn: A norm-based inquiry into the influence of burn size and distress on recovery of physical and psychosocial function. Journal of Burn Care &; Rehabilitation, 26(1), 21-32.
Ferrans, C. E., &; Powers, M. J. (1985). Quality of life index: Development and psychometric properties. Advances in Nursing Science, 8(1), 15-24.
Ferrans, C. E. (1996). Development of a conceptual model of quality of life. Research and Theory for Nursing Practice, 10(3), 293-304.
Forjuoh, S. N. (2006). Burn in low- and middle- income countries: A review of available literature on descriptive epidemiology, risk factors, treatment, and prevention. Burns, 32(5), 529-537.
Hall, B. (2012). Care for the patient with burns in the trauma rehabilitation setting. Critical Care Nursing, 35(3), 272-80.
Latarjet, J., &; Choinere, M. (1995). Pain in burn patients. Burns, 21(5), 344-348.
Mahoney, F. I., &; Barthel, D. W. (1965). Functional evaluation: the Barthel index. Maryland State Medical Journal, 14, 61-65.
Marahall, P. A. (1990). Cultural influence on perceived quality of life. Seminar in Oncology Nursing, 6(4), 278-284.
Moss, L. S. (2010). Treatment of the burn patient in primary care. Advances in Skin &; Wound Care, 23(11), 517-524.
Moi, A. L., Vindenes, H. A., &; Gjengedal, E. (2008). The experience of life after burn injury: A new bodily awareness. Journal of Advanced Nursing, 64(3), 278-286.
Osborn, K. (2003). Nursing burn injuries. Nursing Management, 34(5), 49-56.
Pallua, N., Kunsebeck, H. W., &; Noah, E. M. (2003). Psychosocial adjustments 5 years after burn injury. Burns, 29(2), 143-152.
Park, S.Y., Choi, K. A., Jang, Y. C., &; Oh, S. J. (2008). The risk factors of psychosocial problems for burn patients. Burns, 34(1), 24-34. doi: 10.1016/j.burns.2007.03.012
Salvador-Sanza, J. F., Sanchez-Paya, J. &; Rodriguez-Marin, J. (1999). Quality of life of the Spanish burn patient. Burns, 25 (7), 593-598.
Sen, S., Greenhalgh, D., &; Palmieri, T. (2012). Review of burn research for the year 2010. Journal of Burn Care &; Research, 33(5), 577-586. doi: 10.1097/BCR.0b013e3182644fba
Serlin, R. C., Mendoza, T. R., Nakamura, Y., Edwards, K. R., &; Cleeland, C. S. (1995). When is cancer pain mild moderate or severe? Grading pain severity by its interference with function. Pain, 61(2), 277-284.
Wieibelhaus, P., &; Hansen, S. L. (2001). What you should know about managing burn emrencies. Nursing, 31(1), 36-41.
Wilson, I. B., &; Cleary, P. D. (1995). Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes. The Journal of the American Medical Association, 273(1), 59-65.
Zhan, L. (1992). Quality of life: Conceptual and measurement issues. Journal of Advanced Nursing, 17(7), 795-800.
Zhang, L. J., Cao, J., Feng, P., Huang, J., Lu, J., Lu, X. Y., &; Xia, Z. F. (2014). Influencing factors of the quality of life in Chinese burn patients: Investigation with adapted Chinese version of the BSHS-B. Burns, 40(4), 731-736. doi:10.1016/j.burns.2013.09.011

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