脊髓损伤患者康复期生存质量的影响因素

The influence factors of quality of life in individuals with spinal cord injury during rehabilitation stage

目的:通过对住院康复期的脊髓损伤人群生存质量的影响因素研究,探讨改善脊髓损伤患者生存质量的干预方式。方法:对91例初次发病后1—2个月住院康复期的脊髓损伤者生存质量及其社会人口统计学指标、生理学指标、功能活动等17种可能相关因素进行调查、评估,采用逐步多重线性回归分析法进行分析,筛选影响患者生存质量的相关因素。结果:影响生存质量总分的多因素分析,进入回归方程的变量共有4个:日常生活活动能力、家庭摩擦、医疗费来源及性别,复相关系数为0.773。影响生理领域的多因素分析,进入回归方程的变量共有4个:康复治疗方法、日常生活活动能力、大小便自控能力及并发症,复相关系数为0.703。影响心理领域的多因素分析,进入回归方程的变量共有4个:日常生活活动能力、家庭摩擦、婚姻状况及性别,复相关系数为0.668。影响社会领域的多因素分析,进入回归方程的变量共有2个:性生活满意与否、婚姻状况,复相关系数为0.462。影响环境领域的多因素分析,进入回归方程的变量共有3个:闲暇活动、日常生活活动能力及并发症,复相关系数为0.593。结论:影响脊髓损伤患者康复期生存质量的相关因素涉及社会人口统计学、心理、生理及康复治疗方法等多方面的因素,对这些因素的干预是提高脊髓损伤患者生存质量的重要手段。

Objective：To find out the influence factors of quality of life（QOL） in individuals with spinal cord injury （SCI） during rehabilitation stage.To discuss how to intervene to improve the QOL in individuals with SCI. Method： Ninety-one survivors were involved in this study at the beginning of I--2 months after SCI. Their QOL and seventeen factors,such as sociodemographic and medical data, were recorded and analyzed with multiple linear regression analysis, and the influence factors were screening. The scales included WHO QOL-BREF （Chinese edition）, ASIA,Barthel Index and a questionnaire. Result： The influence factors of QOL in individuals with SCI during rehabilitation stage includes four aspects, such as marital status, fee-for service payment, ADL, etc. The factors which influence the total scores of QOL were BI, family annoyance, fee-for service payment and gender. The factors which influence the physical domain scores of QOL were rehabilitation treatment, BI, bladder and bowel control and medical complication. The factors which influence the psychological domain scores of QOL were BI, family annoyance, marital status and gender. The factors which influence the social domain scores of QOL were sexual life and marital status. The factors which influence the social domain scores of QOL were leisure situation, BI and medical complication. Conclusion： The influence factors includes many aspects, including the physical, psychological and social factors. The interventions for these influence factors are important means for improving QOL of SCI patients.