目的：創傷性腦傷（Traumatic Brain Injury, TBI）患者神經系統受損機制複雜，從較低認知層次的知覺與動作受損到較高統合層次的執行功能皆有可能存有暫時性或永久性之缺損。回顧過去文獻，慢性期TBI患者的主觀認知抱怨包含記憶力、注意力以及處理速度抱怨等，其抱怨會影響患者後續生活適應。過去研究多數研究以統計分析之相關法欲探討主客觀認知功能關係，多數研究顯示主客觀認知功能之相關性弱，然主觀抱怨與測驗表現之相關與否並不足以代表患者之主觀抱怨是否能反映在測驗表現上。目前國內外少有研究針對注意力與訊息處理速度能力，探討患者在主觀抱怨與是否能反映在其相對功能之客觀神經心理測驗表現，並逐項探討神經心理功能表現如何影響主觀抱怨。因此，本研究欲探討慢性期創傷性腦傷患者在注意力與處理速度抱怨和神經心理測驗表現之間的關係進行更深入之探討。
方法：採臨床樣本之立意取樣，於南部二教學醫院民國99至109年符合創傷性腦傷患者，共91位為本研究之受試者，平均32.58±11.85歲，平均教育年數13.81±2.48年，其中，輕度腦傷患者67位(73.63%)，含54位男性(59.34%)。研究工具方面，主觀抱怨以身心健康狀況量表評估，神經心理測驗以廣泛性非語文注意力測驗（CNAT）與Stroop 叫色測驗評估患者之注意力與處理速度能力。依其抱怨情形，將受試者分為高∕低主觀抱怨組，以獨立樣本t檢定分析高∕低主觀抱怨組在神經心理測驗表現是否有差異，另以敏感度、特異度、陽性預測值以及陰性預測值分析患者主觀抱怨與神經心理測驗之間之一致性。
結果：(1) 在注意力與處理速度抱怨中，輕度TBI患者與中重度TBI患者抱怨情形無顯著差異；而女性中重度TBI患者在處理速度抱怨的比率較男性患者高，且在集中與搜尋注意力之速度表現較男性差。(2)高注意力抱怨之輕度TBI患者雖對刺激能有正確反應，遲緩錯誤數較低抱怨者多；高處理速度抱怨之中重度TBI患者中，在需要抑制能力的測驗表現（CNAT之抑制與轉逆注意力之反應速度表現）較低抱怨者較差。(3)TBI患者主觀注意力抱怨之平均敏感度為33.78%、特異度79.36%、陽性預測值26.90%、陰性預測值86.11%。TBI患者主觀處理速度抱怨之平均敏感度52.47%、特異度63.76%、陽性預測值13.24%、陰性預測值94.00%。(4)在高注意力抱怨TBI患者中，CNAT之集中與搜尋注意力的遲緩錯誤以及Stroop 叫色測驗有高比率缺損(47.37%-63.16%)；低注意力抱怨患者中，患者在CNAT集中與搜尋注意力的遲緩錯誤、轉逆注意力分測驗之漏失錯誤、Stroop 叫色測驗中仍有高比率缺損(25.00%~69.44%)。在高處理速度抱怨TBI患者中，CNAT之集中注意力有20.59%達缺損，中重度患者CNAT之轉逆注意力有50.00%達缺損。
結論：依據本研究結果，女性中重度TBI患者在處理速度抱怨有較高程度的抱怨，且在簡單注意力任務上表現較差。在高注意力抱怨患者中，有高機率在簡單注意力任務中易分心、抑制習慣化反應的能力受損；然低抱怨患者仍有高機率在簡單注意力任務中易分心、彈性轉換能力受損以及抑制習慣化反應的能力受損。在高處理速度抱怨患者中，集中注意力與彈性轉換能力受損；而低抱怨患者有高機率在測驗上未顯示缺損。本研究了解高∕低主觀抱怨者可能受損之功能。然整體主觀抱怨與測驗一致性低，臨床工作者仍應留意患者主觀抱怨的局限性，並建議以神經心理衡鑑更精確地評估患者的功能受損，以利後續神經心理復健治療之計畫與執行。

Patients with chronic traumatic brain injury (TBI) suffer from neuropsychological deficits and complaints. This study investigated the consistency between subjective attention and processing speed complaints and neuropsychological test performance in patients with chronic TBI patients. The patients of the study taking a sample of the clinical samples from a medical center in the South, and total of 91 subjects completed the study. The research tool includes Physical and Mental Health Status Scale to assesses subjective attention and processing speed complaints; Comprehensive Non-verbal Attention Test Battery (CNAT) and Stroop task for assessing attention and processing speed test performance. Most subjective complaints were inconsistent with test performance in patients with chronic TBI in terms of attention and processing speed. Some TBI patients have difficulty to awareness the impairments in their attention and processing speed, and some patients complain about their self-symptoms excessively. Female patients with moderate to severe chronic TBI have a higher degree of complaints in processing speed complaints and performed poorly on simple attention tasks. Among patients with high attention complaints, there was a high rate of being easily distracted in simple attention tasks and the inhibition ability was impaired; however, patients with low complaints still have a high rate of being easily distracted in simple attention tasks, impaired cognitive flexibility, and inhibition ability. In patients with high processing speed complaints, the ability to concentrate and cognitive flexibility were impaired, while patients with low complaints have a high rate of not showing impairments on the test.

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