手部外傷為最常見的一種意外事件，評估病患急性期的創傷後反應可作為其對疾 病適應的預測，而目前臨床上缺乏一簡短的創傷反應量表，故本研究目的為：(1) 發展「急 性創傷後反應量表」；(2) 檢測「急性創傷後反應量表」之信度及效度；(3) 探討手部外傷 病患之急性創傷後反應之現況；(4) 探討手部外傷病患之人口學特性及創傷特質與創傷反應 之相關性。本研究第一階段以訪談指引訪談五位病患，目的為修正訪談指引及探討手部外傷 病患創傷後反應的特質， 第二階段則依第一階段訪談內容分析及文獻查證資料， 發展 Likert 類型 1-5 分法的「急性創傷後反應量表」，共計十三題，並檢測量表之信效度及病 患受傷之創傷後反應的現況。 以立意取樣法於北部某醫學中心，針對 120 位手部外傷之住 院病患進行資料收集。 問卷以 Cronbach's alpha、專家效度、因素分析法檢測其信效度， 並以描述性統計、t 檢定及皮爾森積差相關法分析資料。研究結果顯示：(1) 量表之內在一 致性 Cronbach's alpha 係數為.89； (2) 量表之因素結構分析明顯呈現一個因素，因素負 荷值為.45 ∼.71，其解釋量為 39.8%； (3) 本研究之個案感受到中等程度之急性創傷後反 應；(4) 女性較男性感受到強烈的急性創傷後反應，創傷嚴重度與創傷後反應呈顯著之正相 關。本研究發展之急性創傷後反應量表初步具有良好的信度及效度，且題目內容精簡，可提 供臨床照護人員在簡短的時間內評估病人住院期間的急性創傷後反應，以提供適切之護理措 施改善創傷反應。

　　　　　Hand injury is one of the major accidents in Taiwan. Assessing the post-traumatic responses may predict the adaptation of illness. However, few validated assessment tool has been applied for assessing acute post-traumatic responses of patients with hand injury in clinical setting. The purposes of this study were to (1) develop the "Acute Post-Traumatic Response Scale (APTRS)", (2) test the reliability and validity of the scale, (3) explore the acute post-traumatic responses in patients with hand injury, and (4) explore the correlation of demographics characteristic and traumatic characteristics with acute post-traumatic responses in patients with hand injury. This study consisted of two steps. Step 1 was to interview five patients using an interview guide. The pruposes of step 1 were to revise interview guide and explore the characteristic of acute posttraumatic responses in patients with hand injury. According to the results of the content analysis on interriew data and literature review, "Acute Post-Traumatic Response Scale (APTRS)" was developed. Step 2 was to administrate Acute Post-Traumatic Response Scale to a latger sample. One hundred and twenty subjects were recruited from an plastic surgery inpatient ward in a medical center in Northern Taiwan by purposive sampling. The Cronbach's alpha coefficient of APTRS was.89. Based on the results of factor analysis the thirteen items of APTRS were grouped into one factor and accounted for 39.8% of the total variance. The results also indicated that patient with hand injury had moderate post-traumatic responses. Female patients had higher acute post-traumatic responses than male patients. There's a positive correlation between the severity of trauma and acute post-traumatic responses. In conclusion, the APTRS is useful, valid and reliable.