物理治療與長期照護

The Need and Benefit of Physical Therapy in Long-Term Care

胡名霞(Ming-Hsia Hu)

《中華民國物理治療學會雜誌》 23卷1期 (1998/01) Pp. 52-60

https://doi.org/10.29616/JPTAROC.199801.0006

摘要

對不同年齡層且患有慢性疾病及功能障礙的病患，以社會福利及醫療資源提供連續性的治療計畫與服務，是長期照護的基本精神。而物理治療的對象與具有長期照護需求的患者，多所重覆，因此物理治療除了在預防醫學、急性治療、與復健醫療等層次扮演重要角色以外，同時也在長期照護扮演影響病患癒後的良性角色。
本文修改自臺北市政府公務人員訓練中心八十七年度長期照護人員訓練講座之演講內容。主要敘述物理治療在長期照護所扮演的角色，包括物理治療與長期照護之定義、物理治療介入長期照護之需求、物理治療介入社區照護之優點、物理治療介入機構照護之利益等國內外的文獻回顧，以及國內相關法規的條文。雖然全民健保尚未將居家物理治療納入給付範圍，然而作者建議長期照護相關議題應加入物理治療之養成教育與繼續教育中，以提昇物理治療專業品質，並提供病患更佳的照顧。

關鍵字

物理治療 ； 居家照護 ； 機構式照護 ； 老人

並列摘要

Although long-term care (LTC) system is included in the National Health Insurance (NHI) plan in this country, physical therapists rarely provide services to patients at their homes or in LTC institutes. This is mainly the direct result of the non-reimbursement policy of the NHI and the shortage of physical therapists for LTC. The purpose of this article is to review and elucidate the need and benefits of physical therapy in LTC and hope to encourage more therapists to become involved in LTC. In 1990, approximately 55000 Taiwanese elderly had severe health problem and were unable to enjoy independent living. Eighty-eight percent of them live at home. Regardless of age groups, approximately 40% of these home nursing care recipients are stroke victims. Studies reported that care providers and nurses expressed a need for physical therapy involvement in home health care. In a survey of institutional residents, functional limitations resulted from multiple joint range limitations, pain, and weakness were reported. These problems are indications for physical therapy. Thus there is a need for physical therapy intervention for home-bound and institutionalized patients. Both home and institutional physical therapy involvement have been shown to be beneficial to the patients. Home physical therapy may decrease the length of hospital stay, improve motor function, and improve patient compliance to home exercises due to the awareness and participation of the family members. Physical therapy services provided in LTC institutions may increase the possibility of successful return of patients to their homes, decrease their dependence on wheel chairs or assistive devices. Furthermore, a higher therapist/patient ratio tends to enhance patient's functional performance and decreases the cost for each nursing home bed per year.

並列關鍵字

Physical Therapy ； Home Care ； Institutional Carep ； Elderly