中老年脊椎滑脫症病患生活品質及其相關因素之探討
The Quality of Life and Correlates of Middle-aged and Elderly Patients with

Spondylolisthesis

本研究旨在了解脊椎滑脫症病患之生活品質，分別探討性別、年齡、教育程度、職業狀況、宗教信仰、疾病嚴重度、病程長短、疼痛情形、生活功能受限程度等因素對病患生活品質之影響。研究採橫斷式調查法，研究對象為北部某醫學中心罹患脊椎滑脫症，以Meyerding’s 分級之第一級(含)以上，並預接受外科手術治療之個案為研究樣本，抽樣人數為150人。利用疼痛視覺類比量表(Visual Analog Scale, VAS)、巴氏量表(Barthel Index)及脊椎滑脫患者生活品質問卷測量個案疼痛、身體功能受限及其生活滿意度情形。以結構式問卷與實際訪談的方式進行資料收集，所得資料以獨立樣本t-檢定、ANOVA、卡方檢定及逐步迴歸分析法等統計方法進行分析。重要結果如下：

ㄧ、研究對象有中等之生活品質，在各個範疇的生活品質中以「社會關係」最 佳，「心理」則最差。
二、研究對象之基本資料對疾病特性之影響：「年齡」、「婚姻狀況」與「滑脫部位」，「職業狀況」、「教育程度」及「宗教信仰」與「疼痛情形」間具有顯著差異。
三、基本資料對生活品質之影響：具有職業者，生理健康範疇之生活品質優於無職業者；有宗教信仰者，生理健康範疇之生活品質優於無宗教信仰者。
四、疾病特性對生活品質之影響：疼痛情形愈輕微，生理健康及心理範疇之生活品質愈佳；生活功能受限程度愈輕微，依賴程度愈低，則生理健康範疇之生活品質愈佳。
五、研究對象之基本資料及疾病特性對生活品質之影響：疼痛情形同時為生理健康、心理及環境範疇之生活品質的重要預測因子；另生活功能受限程度為生理健康範疇之生活品質的重要預測因子。

he purpose of this research was to evaluate the quality of life for patients with spondylolisthesis, and to evaluate the degree of effects of each of possible related factors, including gender, age, education, career, religion, severity and duration of this disease, degree of painful sensation, and the limitation of function of daily life. This study was conducted in a cross-sectional manner to patients of spondylolisthesis in a medical center in North Taiwan. Patient with disease severity of Meyerding’s grade 1 or above and was subject to surgical treatment was included in this study. The number of patients included was 150 in total. Data collection was through structural questionnaire and visiting for each patient. Parameters evaluated in this study include degree of painful sensation, disability, and degree of quality of life through following methods: Visual Analog Scale (VAS), Barthel Index, and questionnaire about degree of quality of life in order. Statistical methods include dependent t-test, ANOVA, Chi-square test, and stepwise regression analysis. Following are some important conclusions:

1.The quality of life of study population was median in general. Among the parameters evaluated in quality of life “social relationship aspect” scores best and“psychological aspect” scores the least.

2.Relationship between patients’ demographic data and their disease characters: Significance of relationship was noted between following items: between “age”, “marriage status” and “location of spondylolisthesis”; between “occupation”, “education”, “religion” and “painfulness due to disease”.
3.Relationship between patients’ demographic data and their quality of life:Quality of life in terms of physiological aspect is better in patient who keeps his job than that of patient who dose not posses a job. Quality of life in terms of physiological aspect is better in patients with a faith than that of patients who are atheists.
4.Relationship between disease character and quality of life: The lesser the pain, the better the quality of life in terms of both physiological and psychological aspects. The lesser the limitation of daily activity, the better the quality of life in terms of physiological aspect.
5.Relationship between demographic data, disease character and quality of life: “Painfulness due to disease” is an important predictive factor to quality of life in terms of either physiological, psychological, and environmental aspects. In addition, limitation in daily activity is an important predictive factorto quality of life in terms of physiological activity.