生活品質與冒險程度對脊髓損傷患者重回職場的影響
The Influence of Health-related Quality of Life and Risk-Taking Level on Return-to-Work in Persons with Spinal Cord Injuries
中文摘要
本研究對台灣五家醫學中心外傷性脊髓損傷者進行兩年的追蹤，測量整體生活品 質，分析自評生活品質對於重回職場所造成的影響；並以感官追求量表(Sensation Seeking Scale,簡稱 SSS)測量冒險程度及無聊忍受度，測驗個人的特質對於重回 職場的影響。研究設計為世代追蹤，研究對象在 1999 年 6 月至 2003 年 12 月經 醫師判定為外傷性脊髓損傷者，年齡在 16 歲到 65 歲之間，且受傷當時有工作者。
資料收集是以醫院抄錄病歷後於出院兩週內進行電話訪問，追蹤兩年間重回職場 的狀況。電話訪問資料包括：社會人口學資料、身體功能、受傷情形、受傷前的 工作情況、出院當時生活品質及受傷前冒險程度等。病患中受傷前有工作者為 219 位，兩年後重回職場者有 71 位，重回職場的比率為 32.4％。Logistic Regression 分析發現，整體生活品質較好(Odds Ratio (OR) = 1.78，95％Confidence Interval (CI)
= 1.01-3.15)、較具冒險性格(OR = 1.19，95％CI = 1.06-1.35)、年齡較輕(OR = 0.96，95％CI = 0.93-0.99)、教育程度較高(OR = 5.95，95％CI = 1.85-19.07)、最 近一年沒有身體不適症狀(OR = 0.3，95％CI = 0.13-0.71)、日常活動能力獨立(OR
= 5.4，95％CI = 1.92-15.617)、以及具有交通獨立性(OR = 3.67，95%CI = 1.33-10.08) 與重回職場有顯著相關。提高脊髓損傷者重回職場的機率除了身體功能的復健 外，也必須對個人的心理層面進行復健，提高個人的整體生活品質，並對不同教 育程度、年齡以及個人特質的人給予不同的就業協助與輔導，以增加重回職場的 機率。
英文摘要
The purpose of this study was to identify the determinants of return- to-work in persons with traumatic spinal cord injuries (SCI), especially for
health-related quality of life (QOL) and risk-taking level. During the period of July, 1999 to December, 2003, 219 subjects who had sustained traumatic SCI in five medical centers in the Northern Taiwan, who aged from 15 to 65 years, and were employed immediately to the injury were recruited in the study. A structured questionnaire was use to collect demographics, injury-related status, functional independence status, and pre- and post-injury employment status. Until December in 2004, 71 (32.4%) cases returned to work. The result of logistic regression analysis showed that higher scores in the overall quality of life (Odds Ratio (OR) = 1.78, 95%Confidence Interval (CI) = 1.01-3.15), higher levels of risk-taking level (OR = 1.19, 95%CI = 1.06-1.35), younger ages (OR = 0.96, 95%CI = 0.93-0.99), high
education levels ( OR = 5.95, 95%CI = 1.85-19.07), no comorbid conditions (OR = 0.3, 95%CI = 0.13-0.71), functional independence (OR = 5.4, 95%CI = 1.92-15.17), and independent of transportation (OR = 3.67, 95%CI = 1.33-10.08) were
significantly associated with predictors return-to-work among persons with SCI. For helping persons who sustained SCI return to work, It is important to pay heed to both the rehabilitation of physical and psychological components for improving personal overall quality of life and providing different vocational training and assistance among different education level, age groups, and personal traits.
