本研究旨在瞭解下半身癱瘓者的失能程度與其出院後健康相關生活品質(整體生活品質、整體健康、生理健康範疇、心理範疇、社會關係範疇、環境範疇)的相關情況，以及就業與婚姻狀況是否造成其生活品質的差異？
方法：本研究採立意取樣， 共有36位中部某區域教醫院復健科脊髓損傷病患及該地區脊髓損傷協會之會員，年齡18至55歲，認知正常的下半身癱瘓者參與本研究。以身心障礙鑑定功能量表成人個案版測量其失能程度，並利用脊髓損傷生活品質問卷測量其對健康相關生活品質的滿意程度。資料分析以Pearson積差相關係數(γ)來瞭解其失能程度與生活品質之相關；並以t檢定分別分析就業及婚姻狀況在其生活品質上的差異。
研究結果發現：(1) 下半身癱瘓者的失能程度與其生活品質呈現低至中度負相關。(2)有就業的下半身癱瘓者僅在「生理健康範疇」及「環境範疇」的生活品質顯著高於無就業者，其他範疇並無顯著差異。無婚姻之下半身癱瘓者僅在「生理健康範疇」的生活品質顯著高於有婚姻者，其他範疇並無顯著差異。
結論：下半身癱瘓者自覺對生活品質環境範疇的不滿意程度會影響其社會參與及就業，因此，提高個案的社會參與及就業或許可提升脊髓損傷個案的生活品質；此外，無障礙環境及設施、適當的輔具或他人協助、社會參與及就業也會影響下半身癱瘓者的生活品質。

This study aims to investigate the correlation of disability severity and quality of life in patients with paraplegia after discharged from the hospitals. In addition, the study would also explore if there is difference of the quality of life caused by the employment condition and marriage status in patients with paraplegia.
Methodology: Thirty-six patients with paraplegia, aged from 18 to 55, recruited from the rehabilitation department of a regional teaching hospital in central Taiwan and the Association of Spinal Cord Injury in that area, participated in this study. These participants are patients with normal cognition. The Functioning Scale of the Disability Evaluation System-Adult Version was used to measure the level of disability severity of the participants. In addition, the questionnaires called ‘Quality of Life of Spinal Cord Injury patients’ was used to measure their satisfaction degrees on the health-related quality of life of these participants. The researcher employed Pearson correlation coefficient (γ) to understand the correlation of disability severity and quality of life for these participants. The t test was used to analyze the difference in Quality of Life between the employment condition and marital status of these participants.
The results indicated that there is low to medium negative correlation between disability severity and quality of life in the paraplegia patients. Second, the employed paraplegia patients show higher scores in “Physical Health Category” and “Environmental Category” of quality of life than the unemployed ones. However, there were no significant differences in other domains of quality of life between employed and unemployed paraplegia. Besides, the unmarried paraplegia patients show higher socres in “Physical Health Category” of quality of life than the married paraplegia patients. It also makes no major differences for the other five domains.
In conclusion, the paraplegia patients’ sense of the dissatisfaction on “the Environmental Category” in quality of life will affect their social participation as well as their employment. The researcher believes that promoting these patients’ social participation and employment probably can enhance the quality of life for patients with paraplegia. Therefore, the researcher holds the viewpoint that these factors such as offering barrier-free environment and facilities, proper assistive devices or other personal assistance, social participation, and being employed can influence the quality of life in patients with paraplegia.

中文文獻
中央健保局(2010)。全民健康保險重大傷病各類疾病檢附資料項目參考表。摘自http://www.nhi.gov.tw/Resource/webdata/Attach_16670_2_Attach_5375_2_%E9%87%8D%E5%A4%A7%E5%82%B7%E7%97%85%E5%90%84%E9%A0%85%E7%96%BE%E7%97%85%E6%AA%A2%E9%99%84%E8%B3%87%E6%96%99%E5%8F%83%E8%80%83%E8%A1%A8990721%E4%BF%AE.pdf
王顏和、張彧(2004)。脊髓損傷患者生活品質與損傷、功能間關係之研究。行政院國家科學委員會專題研究成果報告(報告編號：NSC93-2614-B-002-002)，未出版。
王顏和(2008)。脊髓損傷概論。載於：身心障礙者服務資訊網http://disable.yam.org.tw/life/625
王雲東(2008)。身心障礙者社區化就業服務採個案委託付費制度之可行性初探研究-以台北市社區化就業服務為例。社區發展季刊，121，363-384。
吳明宜、花敬凱、許華慧、許靖蘭、陳美利（譯）（2008）。研究。載於吳明宜、花敬凱、許華慧、許靖蘭、陳美利（譯），復健諮商手冊（原作者：F. Chan, S. M. Miller, G. Lee, S. R. Pruett, C. C. Chou）（171-183頁）。台北：心理。
吳明隆(2007)。SPSS操作與應用：問卷統計分析實務。台北市：五南。
林茂榮、姚開屏、黃景祥、王德榮(1999)。台灣版世界衛生組織生活品質問卷量尺語詞的選擇。中華公共衛生雜誌，18，262-270。
周俐君、王智弘、姜義村(2009)。脊髓損傷者就業、工作滿意度與生活品質研究。復健諮商，3，77-103。
社團法人中華民國脊髓損傷者聯合會(2012)。認識脊髓損傷。摘自http://fsci.org.tw/modules/tinyd0/index.php?id=7
社團法人中華民國脊髓損傷者聯合會(2011)。脊髓損傷者概況分析．摘自http://www.fsci.org.tw/hurt.htm
胡月娟(1992)。殘障病人的心理評估。胡月娟、簡淑真、蔡麗絲編著，復健護理。台北：合記。
姚開屏(2000a)。台灣簡明版世界衛生組織生活品質問卷之發展及使用手冊（第一版）。台北：行政院國科會。
姚開屏(2000b)。台灣版世界衛生組織生活品質問卷之發展簡介。中華公共衛生雜誌，19，316-324。
姚開屏(2002a)。健康相關生活品質概念與測量原理之簡介。台灣醫學雜誌，6，183-192。
姚開屏(2002b)。台灣版世界衛生組織生活品質問卷之發展與應用。台灣醫學雜誌，6，193-200。
張彧、王顏和、游正芬、鍾智文、王榮德(2000)。以焦點團體方式探討影響脊髓損傷者生活品質之因素。中華復健醫學雜誌，28，87-95。
張彧、王顏和、姚開屏、王榮德(2002)。脊髓損傷生活品質問卷之發展。台灣醫學，6，209-214。
廖華芳、嚴嘉楓、黃靄雯、劉燦宏、張本聖、吳亭芳、呂淑真、紀彣宙、張光華(2013)。身心障礙鑑定功能量表之運用。台灣醫學，17，317-331。
廖華芳(主編)(2015)。身心障礙鑑定功能量表8.0版操作手冊。衛生福利部委託勞務計畫。台北市：社團法人台灣國際健康功能與身心障礙分類系統(ICF)研究協會。
黃子珍(2001)。探討脊髓損傷病患接受神經再生術後之生活品質與獨立性身體功能。國防醫學院護理研究所碩士論文，未出版，台北市。
陳姿怡(2003)。世界衛生組織生活品質問卷台灣簡明版、SF-36、標準賭博法、時間交換法以及評分量尺的比較-以創傷性脊髓損傷患者為例。臺北醫學大學傷害防治學研究所碩士論文，未出版，台北市。
莊月玲(2008)。台灣脊髓損傷者福利需求及其生活品質之研究。陽明大學衛生福利研究所碩士論文，未出版，台北市。
英文文獻
Anderson, C. J., Vogel, L. C., Klaas, S. J. L., & Lubicky, J. P. (1997). Long term psychosocial outcomes and life satisfaction of patients with pediatric spinal cord injuries. Jounal of Spinal Cord Medicine, 20, 155-162.
Anderson, C. J., & Vogel, L. C. (2003). Domain-specific satisfaction in adults with pediatric-onset spinal cord injuries. Spinal Cord, 41, 684-691.
Bach, J. R., & Tilton, M. C. (1994). Life satisfaction and well-being measures in ventilator assisted individuals with traumatic tetraplegia. Archives of Physical Medicine and Rehabilitation, 75, 626-632.
Berkowitz, M. (1998). Spinal Cord Injury : An Analysis of Medical and Social Costs. New York, NY: Demos Medical Publishing.
Blanes, L., Carmagnani, M. I., & Ferreira, L. M. (2007). Health-related quality of life of primary caregivers of persons with paraplegia. Spinal Cord, 45, 399-403.
Boswell, B. B., Dawson, M., & Heininger, E. (1998). Quality of life as defined by adults with spinal cord injuries. Journal of Rehabilitation, 64, 27-32.
Brolin, D. E. (1995). Career education: A functional life skills approach. Columbus, OH: Prentice-Hall.
Chapman, H. M., & Kewman, D. G. ( 2001). Factors affecting employment following spinal cord injury: A qualitative study, Rehabilitation Psychology, 46, 400-416.
Clayton, K. S., & Chubon, R. A. (1994). Factors associated with the quality of life of long-term spinal cord injured persons. Archives of Physical Medicine and Rehabilitation, 75, 633-638.
Conroy, L., & McKenna, K. (1999).Vocational outcome following spinal cord injury. Spinal Cord, 37, 624-633.
Cropanzano, R., Rupp, D. E., & Byrne, Z. S. (2003). The relationship to job performance ratings and organizational citizenship behavior. Journal of Applied Psychology, 88, 160-169.
Cushman, L., & Dijkers, M. (1990). Depressed mood in spinal cord injury patients: Staff perceptions and patient realities. Archives of Physical Medicine and Rehabilitation, 71, 191-196.
Cushman, L.A., & Hassett, J. (1992). Spinal cord injury: 10 and 15 years after. Paraplegia, 30, 690-696.
Diener, E. D., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The satisfaction with life scale. Journal of Personality Assessment, 49, 71-75.
Dijkers M. (1990). Correlates of life satisfaction among persons with spinal cord injury. Archives of Physical Medicine and Rehabilitation, 80, 867-876.
Dijkers, M. (1997). Quality of life after spinal cord injury: A meta analysis of the effects of disablement components. Spinal Cord, 35, 829-840.
DeVivo, M. J., Black, K. J., Richards, S., & Stover, S. L. (1991). Suicide following spinal cord injury. Paraplegia, 29, 620-627.
Dorsett, P., & Geraghty, t. (2008). Health- related outcomes of people with spinal cord injury- a 10 year longitudinal study. Spinal Cord, 46, 386-391.
Falvo, D. R. (2009). Condition of the nerve system: Part II spinal cord, Peripheral nervous system, and neuromuscular conditions. In D. R. Falvo (Ed.), Medical and psychosocial aspects of chronic illness and disability (4th ed., pp. 91-106). Boston: Jones and bartlett.
Fuhrer, M. j., Rintala, D. H., Hart, K. A., Clearmen, R., & Young, M. E. (1992). Relationship of life satisfaction to impairment, disability, and handicap among person with spinal cord injury living in the community. Archives of Physical Medicine and Rehabilitation, 73, 552-557.
Fuhrer, M. J. (1996). The subjective well-being of people with spinal cord injury: relationship to impairment, Disability and handicap. Top Spinal Cord Injury Rehabilitation, 19, 56-71.
Galvin, L. R., & Godfrey, H. P. D. (2001). The impact of coping on emotional adjustment to spinal cord injury (SCI): Review of the literature and application of a stress appraisal and coping formulation. Spinal Cord, 39, 615-627.
Gorzkowski, J. A., Kelly, E. H., Klaas, S. J., & Vogel, L. C. (2010). Girls with spinal cord injury: Social and job-related participation and psychosocial outcomes. Rehabilitation Psychology, 55, 58-67.
Jang, Y., Wang, Y. H. & Wang, J. D. (2005). Return to work after spinal cord injury in taiwan: The contribution of functional independence. Arches Physical and Medicine Rehabilitation. 86, 681-686.
James, M., DeVivo, M. J., & Richards, J. S. (1993). Postinjury employment outcomes among African-American and white person with spinal cord injury, Rehabilitation Psychology, 38, 151-164.
Kennedy, P., Lowe, R., Grey, N., & Short, E. (1995). Traumatic spinal cord injury and psychological impact: A cross-sectional analysis of coping strategies. British Journal Clinical Psychology, 34, 627-639.
Kennedy, P., & Rogers, B. A. (2000). Anxiety and depression after spinal cord injury: A longitudinal analysis. Archives of Physical Medicine and Rehabilitation, 81, 932-937.
Kennedy, P., Duff, J., Evans, M., & Beedie, A. (2003). Coping effectiveness training reduces depression and anxiety following traumatic spinal cord injuries. British Journal Clinical Psychological Medicine Settings, 12, 93-98.
Kennedy, P., Lude, P. & Taylor, N. (2006). Quality of life, social participation, appraisals and coping post spinal cord injury: A review of four community samples. Spinal cord, 44, 95-105.
Krause, J. S. (1992). Employment after spinal cord injury, Archives of Physical Medicine and Rehabilitation, 73, 163-169.
Krause, J. S., & Kjorsving, J. M. (1992). Mortality after spinal cord injury: A four year prospective study. Archives of Physical Medicine and Rehabilitation, 73, 558-563.
Krause, J. S. (1997). Adjustment after spinal cord injury: A 9 year longitudinal study. Archives of Physical Medicine and Rehabilitation, 78, 651-657.
Krause, J. S. (1998). Dimensions of subjective well-being after spinal cord injury: An empirical analysis by gender and race/ethnicity. Archives of Physical Medicine and Rehabilitation, 79, 900-909.
Krause, J. S., Sternberg, M., Maides, J., & Lottes, S. ( 1998). Employment after Spinal Cord Injury: Differences Related to Geographic Region, Gender, and Race. Archives of Physical Medicine and Rehabilitation, 79, 615-624
Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33, 159-174.
Lidal, I. B., Hjeltnes, N., Røislien, J., Stanghelle, J. K., & Biering-Sørensen, F. (2009). Employment of persons with spinal cord lesions injured more than 20 year ago. Disability and Rehabilitation, 31, 2174-2184.
Lin, M. R., Hwang, H. F., Yu, W. Y., & Chen, C. T. (2009). A prospective study of factors influencing return to work after traumatic spinal cord injury in taiwan. Arches Physical and Medicine Rehabilitation. 90, 1716-1722.
Livneh, H., & Antonak, R. F. (1997). Psychosocial adaptation to chronic illness and disability. Gaithersburg, MD: Aspen.
Manns, P. J., & Chad, K. E. (1999). Determining the relation between quality of life, handicap, fitness, and physical activity for persons with spinal cord injury. Archives of Physical Medicine and Rehabilitation, 80, 1566-1571.
May, L. A., & Warren, S. (2002). Measuring quality of life of persons with spinal cord injury: External and structural validity. Spinal Cord, 40, 341-350.
Meeberg, G. M. (2003). Quality of life: A concept analysis. Journal of Advanced Nursing, 18, 32-38.
Noreau, L., Dion, S. A., Vachon, J., Gervais, M., & Laramee, M. T. (1999). Productivity outcomes of individuals with spinal cord injury. Spinal Cord, 37, 730-736.
Post, M. W. M., Van Dijk, A. J., Van Asbeck, F. W. A., & Schrijvers, A. J. P. (1998). Life satisfaction of persons with spinal cord injury compared to a population group. Scandinavian Journal of Rehabilitation Medicine, 30, 23-30.
Putzke, J. D., & Richards, J. S. (2001). Nursing home residence Quality of life among individuals with spinal cord injury. American Journal of Physical and Medical Rehabilitation, 80, 404-409.
Putzke, J. D., Richards, J. S., Hicken, B. L., & DeVivo, M. J. (2002). Predictors of life satisfaction: A spinal cord injury cohort study. Archives of Physical Medicine and Rehabilitation, 83, 555-561.
Robnett, R. H., & Gliner, J. A. (1995). Qual-OT: A quality of life assessment tool. Occupational Therapy Journal of Research, 15, 198-214.
Targett, P. S., Wehman, P. H., McKinley, W. O., & Young, C. L. (2004). Successful work supports for persons with sci: Focus on job retention. Journal of Vocational Rehabilitation, 21, 19-26.
Tomassen, P. C. D., Post, M. W. M., & Asbeck, F. W. A. ( 2000). Return to work after spinal cord injury. Spinal Cord, 38, 51-55.
Trieschmann, R. B. (1988). Integration into the Community. In R. B. Trieschmann (Ed.), Spinal cord injury: Psychological, Social, and vocational rehabilitation (2nd ed., pp. 147-236). New York: Demos Publications.
Unalan, H., Gençosmanoğlu, B., Akgün, K., Karamehmetoğlu, S., Tuna, H., Ones, K., Rahimpenah, A., Uzun, E., & Tüzün, F. (2001). Quality of life of primary caregivers of spinal cord unjury survivors living in the community: Controlled study with short form-36 questionnaire. Spinal Cord, 39, 318-322.
Ville, I., & Ravaud, J. F. (1998). Work values: A comparison of non-disabled persons with paraplegia. Disability and Rehabilitation. 20, 127-137.
Vogel, L. C., Anderson, C. J., & Klaas, S. J. (1997). Life satisfaction and long-term outcomes of pediatric spinal cord injuries. Jounral of Spinal Cord Medicine, 20, 467-476.
Whiteneck, G. G. (1992). Outcome evaluation and spinal cord injury. Neurorehabilitation, 2, 31-41.
Whiteneck, G., (1994). Measuring what matters: Key rehabilitation outcomes. Archives of Physical Medicine and Rehabilitation, 75, 1073-1076.
Whiteneck, G., Meade, M. A., Dijkers, M. Tate, D. G., Bushnik, T., & Forchheimer, M. B. (2004). Environmental factors and their role in participation and life satisfaction after spinal cord injury. Archives of Physical Medicine and Rehabilitation, 85, 1793-803.
The WHOQOL Group (1994). Development of the WHOQOL: Rationale and current status. International Journal Mental Health, 23, 24-56.
The WHOQOL Group (1995). The world health organization quality of life assessment (WHOQOL): Position paper from the world health organization. Social Science Medicine, 41, 1403-1409.
The WHOQOL Group (1998). Development of the world health organization WHOQOL-BREF quality of life assessment (WHOQOL). Psychological Medicine, 28, 551-558.
World Health Organization. (2010). World Health Organization Disability Assessment Schedule II (WHODAS 2.0). Geneva: World Health Organization.
Wu, M. Y., & Chan, F. (2007). Psychosocial adjustment patterns of persons with spinal cord injury in Taiwan. Disability and Rehabilitation, 29, 1847–1857.
Yasuda, S., Wehman, P., Targett, P., Cifu, D. X., & West, M. (2002). Return to work after spinal cord injury: A review of recent research. Neurological Rehabilitation, 17, 177-186.
Zhan, L. (1992). Quality of life: Conceptual and measurement issues. Journal of Advanced Nursing, 17, 795-800.