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以周全性老年評估為核心的本土化中期照護社區醫院模式成效

Effectiveness of Comprehensive Geriatric Assessment-Based Intermediate Care in a Community Hospital

摘要


Objective: To evaluate the effectiveness of intermediate care (IC) for frail older patients managed by comprehensive geriatric assessment (CGA) and to provide a baseline profile of functional gain during IC services. Method: This is a prospective cohort study conducted in a community hospital. Elderly patients with post acute conditions were recruited and received interdisciplinary integrated care. CGA data were collected within 72 hours of admission and upon discharge so as to compare effectiveness of daily living, cognition, nutrition, emotion, pain control and ambulation. Results: Data of 137 recruited patients were collected during the period from April 2008 to March 2009; 27 of them were excluded due to incomplete data or unplanned readmission to acute ward. Mean age of the 110 eligible patients was 84.4±5.4 years old. Overall, clinical improvement was significant in various dimensions, including cognition (Mini-Mental State Examination from 18.0±6.8 to 20.9±6.8, p<.001), physical function (Barthel Index from 48.1±24.3 to 77.8±25.6, p<.001; Lawton-Brody Instrumental Activities of Daily Living from 1.9±1.7 to 3.7±2.5, p<.001), depression (Geriatric Depression Scale from 3.0±2.5 to 1.4±1.5, p<.001), ambulation (timed up-and-go test from 45.7±23.7 to 30.9±20.5, p<.001), nutrition (Mini Nutritional Assessment from 15.7±3.9 to 18.4±3.0, p<.001, Body Mass Index from 21.6±3.3 to 21.8±3.2, P=.001), and pain control (3.4±3.1 to 1.2±1.7, p<.001). Conclusion: A short-term inpatient physical re-enablement program conducted by an interdisciplinary geriatric team in a community hospital can successfully improve the physical and mental function, mood, ambulation, nutritional conditions, and pain control of postacute patients. Further studies are needed to evaluate long- term clinical outcomes.

並列摘要


Objective: To evaluate the effectiveness of intermediate care (IC) for frail older patients managed by comprehensive geriatric assessment (CGA) and to provide a baseline profile of functional gain during IC services. Method: This is a prospective cohort study conducted in a community hospital. Elderly patients with post acute conditions were recruited and received interdisciplinary integrated care. CGA data were collected within 72 hours of admission and upon discharge so as to compare effectiveness of daily living, cognition, nutrition, emotion, pain control and ambulation. Results: Data of 137 recruited patients were collected during the period from April 2008 to March 2009; 27 of them were excluded due to incomplete data or unplanned readmission to acute ward. Mean age of the 110 eligible patients was 84.4±5.4 years old. Overall, clinical improvement was significant in various dimensions, including cognition (Mini-Mental State Examination from 18.0±6.8 to 20.9±6.8, p<.001), physical function (Barthel Index from 48.1±24.3 to 77.8±25.6, p<.001; Lawton-Brody Instrumental Activities of Daily Living from 1.9±1.7 to 3.7±2.5, p<.001), depression (Geriatric Depression Scale from 3.0±2.5 to 1.4±1.5, p<.001), ambulation (timed up-and-go test from 45.7±23.7 to 30.9±20.5, p<.001), nutrition (Mini Nutritional Assessment from 15.7±3.9 to 18.4±3.0, p<.001, Body Mass Index from 21.6±3.3 to 21.8±3.2, P=.001), and pain control (3.4±3.1 to 1.2±1.7, p<.001). Conclusion: A short-term inpatient physical re-enablement program conducted by an interdisciplinary geriatric team in a community hospital can successfully improve the physical and mental function, mood, ambulation, nutritional conditions, and pain control of postacute patients. Further studies are needed to evaluate long- term clinical outcomes.

被引用紀錄


紀淑靜、葉莉莉、盧美秀、林珮宇(2015)。運用德菲法建構腦中風急性後期照顧護理人員應具備之核心能力護理雜誌62(6),35-47。https://doi.org/10.6224%2fJN.62.6.35
林淑惠(2016)。腦中風病患轉介急性後期照護後整體功能狀態之成效探討〔碩士論文,義守大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0074-2606201617344000

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