| Summary: | 碩士 === 國立陽明大學 === 物理治療研究所 === 92 === Abstract
Background. Traumatic brain injury (TBI) is a common cause that affecting the health status and functioning, and also results in disabilities, in children. Many studies have investigated different aspects in the scope of health status in children with TBI. But, there is a lack of studies that were able to provide full information of the scope of the health status in children with TBI, that is the physical and psychosocial health. Many studies found that the severity or CT findings of the brain damage, lost of consciousness, age at onset, gender, family conditions, and rehabilitation services received influenced the prognoses of children with TBI. But factors influenced the health outcomes of children with TBI were still controversial. Purposes. The purposes of this study were to investigate the health status in children with TBI and to explore the factors that influenced their health status. Study Design. A combined descriptive and exploratory research design was utilized for the study. Methods. This study recruited 236 children with TBI and with their age at onset of TBI between 0 to 14 years old. These subjects were admitted to one of the 4 hospitals in Taipei metropolitan area from November of 1992 to November of 2003. The inpatient medical records of diagnosis and intervention for TBI and their basic information in these children with TBI were retrieved from hospital charts. The parent proxy-report forms of the Pediatric Quality of Life inventory 4.0 Generic Core Scale (PedsQL 4.0) Taiwanese versions were used to measure the health status of children with TBI via telephone interview. The outpatient rehabilitation services received after discharged from hospitalization for the TBI and the personal and family information of children with TBI were also recorded via telephone interview. Descriptive statistics was used to describe the health status in children with TBI. Multiple regression analysis was then utilized to identify the factors, which influence health status in children with TBI. Results. This study completed successful telephone interview of the parent proxy-report on children health status of 135 children with TBI. In children with severe TBI, their physical health score was lower than that of the psychosocial health. In children with mild or moderate TBI, their psychosocial health was lower than that of the physical health. School function was the lowest score in the psychosocial health domains of children with mild or moderate TBI. Factors of the outpatient rehabilitation services received after discharged from hospitalization for the TBI and the family incomes could explain 28.5% of the variance in total health (F=6.399，p<0.001) and 16.8% of the variance in psychosocial health (F=4.645，p<0.001) of children with TBI. Factor of the outpatient rehabilitation services received after discharged from hospitalization for the TBI alone could explain 35.2% of the variance in physical health of children with TBI (F=12.419，p<0.001). Based on the multiple regression analysis, children with TBI received rehabilitation after discharge had worse total health, physical health and psychosocial health performance compared to those in children with TBI who did not receive outpatient rehabilitation services. Children with TBI whose average monthly family income below twenty thousand NT dollars were worse in total health than those with average monthly family income above twenty thousand NT dollars and were worse in psychosocial health than those with average monthly family income above forty thousand NT dollars. Conclusions. Children with severe TBI had poorer physical health, and children with mild or moderate TBI had poorer psychosocial health. Received rehabilitation after discharge and family income were the most important factors influence the health status of children with TBI. We suggested early medical, and special education intervention and social supporting program should be provided for children with TBI.
Key words：Health status, children, traumatic brain injury.
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