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系統識別號 U0026-2207201020480300
論文名稱(中文) 中風患者記憶缺失與功能性表現之探討
論文名稱(英文) Memory impairments after stroke: Relation to functional performance
校院名稱 成功大學
系所名稱(中) 職能治療學系碩博士班
系所名稱(英) Department of Occupational Therapy
學年度 98
學期 2
出版年 99
研究生(中文) 張業婕
研究生(英文) Yeh-Chieh Chang
學號 T7697102
學位類別 碩士
語文別 中文
論文頁數 105頁
口試委員 指導教授-蔡佩倫
口試委員-林克忠
口試委員-杜宜軒
中文關鍵字 中風  記憶缺失  前瞻性記憶  後設記憶  功能性表現 
英文關鍵字 stroke  memory impairments  prospective memory  metamemory  functional performance 
學科別分類
中文摘要 研究背景及目的:認知缺損是中風患者相當常見的症狀之一,其中記憶功能更是影響患者獨立生活能力不可或缺的必備要素,但迄今仍少有研究針對中風患者之特定記憶缺失及其功能性表現進行相關探討。故本研究旨在深入了解中風患者各種記憶功能的缺損情形,且依照世界衛生組織之國際健康功能與身心障礙分類系統(International Classification of Functioning, Disability and Health),進一步檢驗患者之記憶缺失對其活動與參與兩層級之功能性表現的影響,並分析不同記憶類型的缺失與各功能性表現的相關性。

研究方法:本研究招募60位單側腦中風個案,所有個案皆需接受有關記憶(身體功能層級;包括回溯性記憶(retrospective memory)、前瞻性記憶(prospective memory)與後設記憶(metamemory)、日常活動(活動層級)、以及社會參與和生活品質(參與層級)等評量。資料分析包括各類型記憶缺失之比例,及其與不同層級之功能性表現的相關性檢定及迴歸分析。

研究結果:45%~63.7%的受試者在回溯性記憶、前瞻性記憶及後設記憶方面有所缺失,而其與功能性表現存在顯著相關(r值介於.26~.64,ps<.05),且與活動層級之相關性高於參與層級。此外,後設記憶對不同層級之功能性表現的預測力最高,回溯性記憶和前瞻性記憶則次之,且以預測活動層級的表現為主。

結論:中風患者確實在各類型之記憶皆有所缺失,且此缺失對其各方面之功能性表現的影響不容小覷。在臨床上,治療師除了需詳細評估患者不同面向的記憶能力、進行相關的介入外,並需特別強調後設記憶的評估與訓練。
英文摘要 Background & purpose: Cognitive deficits are common among patients with stroke and have been linked to poor recovery of daily living and rehabilitation outcome. Memory is one aspect of cognition that has been viewed as the key component for independent living. However, there are few researches designed to explore specific memory impairments and functional performance among patients with stroke. The purposes of the study were to examine types of memory impairments in strokes and to explore the impact of memory impairments on functional performance.

Methods: A total of 60 patients with stroke were recruited in this study. And according to the International Classification of Functioning, Disability and Health (ICF), all participants completed assessments regarding retrospective memory, prospective memory and metamemory (the body function and structures level), activities of daily living and everyday memory abilities (the activity level), and social participation and quality of life (the participation level). Correlation and regression analyses were conducted to examine the purposes of the study.

Results: 45%~63.7% participants have retrospective memory, prospective memory, or metamemory impairments. Significant correlations between memory impairments and functional performances are presented, and are stronger in activity level than in participation level. In addition, metamemory is the best predictor between three types of memory of fucntional performances. Retrospective memory and prospective memory for next, and are mainly predict the performances of activity level.

Conclusions: The study revealed memory impairments in the patients with stroke with a negative impact on functional performances. Our findings not only promote the knowledge about memory deficits of stroke patients, but also facilitate therapists to develop individualized rehabilitation strategies for stroke patients and maximize their independence.
論文目次 中文摘要 I
English Abstract III
誌謝 V
目錄 VI
圖目錄 IX
表目錄 X
第一章 緒論 1
第一節 研究動機及重要性 1
第二節 研究目的及研究假設 3
第二章 文獻回顧 4
第一節 記憶功能介紹 4
壹 記憶類型 4
貳 記憶評估工具 6
第二節 中風患者之記憶功能缺失 10
壹 回溯性記憶 10
貳 前瞻性記憶 12
參 後設記憶 13
肆 相關因素 14
第三節 記憶缺失與功能性表現 16
第四節 文獻回顧總結與研究問題 19
第三章 研究方法 21
第一節 研究參與者 21
第二節 研究工具 22
第三節 研究流程 29
第四節 資料分析 30
第四章 研究結果 32
第一節 人口學資料及各項測驗的分析 32
壹 人口學資料分析 32
貳 記憶測驗結果分析 33
參 功能性表現評估結果 34
肆 人口學資料與記憶測驗表現之相關 35
伍 人口學資料與功能性表現之相關 37
第二節 記憶缺失與功能性表現之相關性檢驗 39
壹 活動層級 39
貳 參與層級 41
第三節 記憶缺失對功能性表現之預測值 43
壹 活動層級 44
貳 參與層級 47
第五章 討論 50
第一節 中風患者各類型之記憶缺失情形 51
第二節 人口學資料與損傷特性對記憶之影響 54
壹 人口學資料 54
貳 損傷相關特性 55
第三節 記憶與功能性表現之相關探討 57
壹 回溯性記憶 57
貳 前瞻性記憶 58
參 後設記憶 59
第四節 記憶對功能性表現之預測力探討 62
壹 活動層級 62
貳 參與層級 65
第五節 臨床應用與研究限制 69
第六章 結論 72
參考文獻 73
自述 105
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