評估仁愛之家老年住民之營養狀況並分析其預測因子

目的：本研究之目的在評估仁愛之家住民的營養狀況並探討其預測因子。方法：本研究採立意取樣，以中部某公立安養機構（仁愛之家）109位住民為研究對象。研究方法以簡易營養評估台灣兩修訂版(Mini Nutritional Assessment, MNA-TI & MNA-TII)、食慾量表(Council on Nutrition Appetite Questionnaire, CNAQ)、老人精神抑鬱(Geriatric Depression Scale, GDS-15)、日常生活功能(Activity of Daily Living, ADL)、簡易智能評估(Mini-Mental State Examination, MMSE)等量表及體位測量與生化指標等評估個案的各種功能。以SPSS 12.0中文版統計軟體進行資料分析，以描述性資料分析基本資料，使用Wilcoxon Signed-Rank test進行事後檢定，比較兩版本評估結果之差異性，皮爾森相關分析了解兩種版本MNA總分與各項健康指標之相關性，以多元複回歸分析營養不良之預測因子。結果：MNA台灣修定一版本判定5.5%營養不良，33.9%有風險，60.6%營養良好，修定二版本判定6.4%營養不良，31.2%有風險，62.4%營養良好。相關分析顯示與MNA總分最具相關之指標為小腿圍、血清白蛋白、日常日生活功能及智能狀況(P<0.001)。線性複回歸分析則顯示日常生活功能及小腿圍為最能預測營養狀況之因子(P<0.001)，其次精神抑鬱及MMSE (P<0.01)，食慾狀況與年齡(P<0.05)又次之。其他因子皆不顯著(P>0.05)。這些結果顯示台灣修訂二版篩選安養機構老人營養狀況是更有效的量表。研究也顯示台灣兩修訂版本都能有效預測營養不良住民隨後六個月或一年的住院天數。結論：MNA台灣修訂二版可有效的預測老人營養不良風險。此一不具侵入性且簡易的量表，值得推廣至居家照護、社區關懷據點或日間照顧中心各種族群老人。針對有風險住民，計畫性提供個別化飲食以維護住民健康，提升照護品質。

關鍵字

營養評估；營養狀態；計畫性；相關性；侵入性；差異性；中文版；營養風險；老人

並列摘要

Background: The risk of malnutrition is high in low income elderly because of their prior exposure to disease risks and infections. Objective: The objective of this study was to gain an understanding of the risk of malnutrition in low income elderly residing in care homes and to analyze the potential impacting factors. Methods: By means of purposive sampling and with a structured questionnaire the study interviewed 109 residents of a low income care home in Central Taiwan. Key anthropometric indicators were measured. Serum biomarkers were obtained from routine checkups performed by the institution. The interview elicited personal basic information, health-related data and answers to questions in the modified MNA (Mini Nutritional Assessment, MNA-TI and TII), CNAQ (Council on Nutrition appetite questionnaire), Activities of Daily Living (ADL), GDS (Geriatric Depression Scale) and MMSE (Mini-Mental State Examination). Results were analyzed with SPSS 12.0 Statistical Software. Results: Two modified versions of the MNA produced comparable results in grading the nutritional status of the residents. The MNA-TI classified 5.5% of residents malnourished, 33.9% at risk of malnutrition and 60.6% normal whereas MNA-TII classified 6.4, 31.2 and 62.4%, respectively. Pearsons' correlation analysis showed that the MNA scores were significantly correlated with ADL, calf circumference, GDS, MMSE and CNAQ scores. These results suggest both versions of the modified MNA can effectively grade the nutritional status of the low income elderly. The MNA-TII would have certain advantages because it does not require the measurement of weight and height for computing BMI. Results also showed that the modified MNA can predict one-year follow-up hospital length of stay of these residents. Conclusion: The modified MNA, especially MNA-TII, is a useful tool for grading the nutritional status of elderly low income care-home residents. Routine assessment of nutritional status of the elderly is a key step in detecting emerging malnutrition. The process enables timely intervention to stop full bloom malnutrition and may improve the quality of life of the elderly and save the healthcare cost in the long run.

並列關鍵字

Nutritional assessment ； nutritional status ； AND ； nutritional risk ； elderly

參考文獻

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評估仁愛之家老年住民之營養狀況並分析其預測因子

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