人工關節置換術患者生活品質及其相關因素之探討

Quality of Life and Its Related Factors for Patients after Total Joint Replacement

10.7081/NR.200004.0165

林碧珠(Pi-Chu Lin)；張蘇鈺(Su-Yu Chang)；莊琴英(Chin-Yin Chuang)

人工髖關節 ； 人工膝關節 ； 生活品質 ； total hip replacement ； total knee replacement ； quality of life

護理研究

8卷2期（2000 / 04 / 01）

165 - 176

繁體中文

本研究目的在追蹤接受人工關節置換術患者，手術後生活品質改善情形。採蹤貫研究法(longitudinal approach)，以修訂之第二版關節炎衡擎量表(AIMS-2)作爲研究工具。比較患者手術前和手術後6週、3個月、6個月生活品質之差異。採立意取樣法，預試收案23人，正式收案80人，全髖關節置換術40人，全膝關節置換術40人。選擇標凖爲：年齡在18歲以上、意識清楚且識字者、願意接受填寫問卷者、因骨折而接受手術者除外。統計方法包括：描述性統計、paired t-test、MANOVA、one-way ANOVA。所得結果如下：(1)至手術後六週，患者疼痛程度較手術前顯著減輕。(2)至手術後三個月，走路和彎身能力已較手術前顯著進步。(3)至手術後六個月，患者移動程度較手術前後顯著改善。(4)至手術後三個月，患者對生活品質整體的滿意度已較手櫅前後顯著提高。(5)影響生活品質的因素，在手術前有性別、宗教信仰、罹病關節數、合併其他疾病。手術後影響生活品質的有性別、識業、經濟情形三變項。根據研究結果提出以下建議：(1)研究結果可作爲臨床床護理人員提供患者手術前衛教及出院衛教之參考。(2)可做更長期追蹤人工關節置換術後患者生活品質情形。

The purpose of this study was to describe changes in patient’s perceptions of quality of life before and after arthroplasty of the hip or knee. A longitudinal approach was designed. The modified Arthritis Impact Measurement Scales (AIMS-2) were used to collect data on the patients immediately prior to surgery and at 6 weeks, 3 months and 6 months after total hip and knee arthroplasty. The subjects were chosen from a medical center in metropolitan Taipei. Convenience sampling was used, with the sampling criteria subjects over 18 years old, and able to read. Fractured subjects were excluded. Total sample size was 80. Descriptive analysis, paired t-test, MANOVA, and one-way ANOVA were used to analyze collected data. The results were as follows: (1) A significant decrease in pain 6 weeks after total joint replacement was noted. (2) At 3 months, pain remained significantly less than preoperatively, and these was significant improvement in patient’s perception of walking and bending ability. (3) At 6 months, mobility level was significantly improved. (4) A significant improvement in patient’s satisfaction with overall of quality of life, was noted 3 months post-operatively. (5) The influencing factors of quality of life were, pre-operatively: sex, religion, number of affected joints, other diseases, and post-operatively: sex, occupation level, economic status. The results could be used for clinical nurses to educate patients with total hip or knee arthroplasty. Continual evaluation of changes in patients’ perception of quality of life post-operatively is recommended.

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