失語症對中風病患止痛劑使用量之影響

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題名:	失語症對中風病患止痛劑使用量之影響 The Impact of Aphasia on Use of Pain Medications in Stroke Patients - A Population Based Study
作者:	張芳苑 Fang-Yuan Chang
貢獻者:	護理學研究所
關鍵詞:	失語症中風病患止痛劑使用量 aphasia stroke patients use pain medications
日期:	2006
上傳時間:	2009-09-11 15:37:35 (UTC+8)
摘要:	疼痛是中風後最常見的臨床合併症之ㄧ，根據統計中風後高達65%病患於半年內皆有可能出現中重的疼痛，且有三分之二的病患未給予適當的疼痛控制，進而造成睡眠障礙、疲倦、情緒改變，甚至造成理解力降低及壓力的產生。另外，疼痛是主觀之症狀，大部分藉由語言表達，因此，推測失語症可能是中風病患疼痛控制的一大影響因子。故本研究旨在瞭解失語症對中風病患止痛劑使用量之差異。研究方法採橫斷性研究，以2004年全民健康保險學術研究資料庫中擷取中風合併失語症及中風無合併失語症病患，並篩選醫令有使用止痛劑者成為研究樣本，分別有686人及52,598人。資料分析採描述性統計、t檢定、卡方檢定、及複迴歸分析（multiple regression analysis）。研究結果顯示中風合併失語症病患在注射型Keto、Acetaminophen及鴉片類止痛劑的每人每次平均住院每天的止痛劑使用量皆顯著低於中風無合併失語症病患，且均達統計上顯著差異(p<0.05)；在複迴歸分析結果顯示共同影響此三類止痛劑使用量之預測因子，包括失語症、病患年齡、Charlson Index、醫師專科別、醫師服務量、醫院地區別、醫院服務量等七項，均達統計上顯著差異(p<0.05)。本研究結果將能夠提供醫療專業人員及醫事機構執行失語症疼痛處置之參考，使中風合併失語症病患遠離疼痛，以提升病患生活品質。 Pain is a frequent complication after stroke. 65% of stroke patients may suffer from moderate to severe pain during half years post stroke. Although two-thirds of post stroke patients received inadequate pain control. Most people are using verbal communication to express their experience of pain, there are some groups of aphasia with stroke who have difficult in communication to express their pain. Hence aphasia may have an impact of pain control. The purpose of the study was to investigate the impact of aphasia on use of pain medications in stroke patients. A Cross-sectional study design using the “2004 National Health Insurance Research Database” was undertaken. A total of 53,284 patients who had used analgesics during hospitalization, including 686 with aphasia and 52,598 without aphasia, were selected in the analysis. Descriptive analysis, t test, Chi-square test, and multiple regression analysis were used for data analysis. Results from the study show that stroke patients with aphasia received significantly lower analgesics consumption than stroke patients without aphasia (p<0.05). The result of multiple regression analysis show that predictive factors for analgesics consumption were aphasia, patient’s age, Charlson Index, physician specialist, physician volume, hospital location and hospital volume. This survey may serve the medical personnel and institutions as an important reference for pain management, in order to improve life quality by relieving post stroke pain timely and effectively for stroke patients with aphasia.
資料類型:	thesis
顯示於類別:	[學士後護理學系] 博碩士論文

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