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老人居家照護個案營養專業介入之成效探討

The Effectiveness of Home Visits by Registered Dietitians to the Elderly in Taiwan

摘要


Home health care is part of integrated medical care which has been paid for by the National Health Insurance since 1995. It is carried out by home care agencies which take care of subjects who are sick and are recuperating at home. Many studies have indicated that 50% of home care subjects are malnourished; however, home care agencies are not required to have a registered dietitian to provide nutrition services to their clients in Taiwan. In this study, we classified new home care subjects into three groups according to their nutritional status. Subjects in groups A and B were malnourished with serum albumin levels below 3.0 g/dL or serum cholesterol levels below 160 mg/dL, where group C consisted of subjects who were well-nourished. Subjects of group A were referred to a registered dietitian for home visits, and those of groups B and C were maintained on home nursing care. Results showed that after 4 months, the mean serum albumin level of group A (malnutrition-intervention group) had significantly increased from 3.2 ± 0.5 to 3.4 ± 0.5 g/dL (p < 0.005); that of group B (malnutrition-non0intervention group) showed no change (3.2 ± 0.6 vs. 3.2 ± 0.5 g/dL, p=0.97); while that of group C (normal nutrition-non-intervention group( had significantly decreased from 3.8 ± 0.4 to 3.7 ± 0.4 mg/dL (p < 0.002), that of group B showed no change (143 ± 25 vs. 141 ± 27 mg/dL, p =0.68), and that of group C decreased from 196 ± 34 to 185 ± 40 mg/dL (p < 0.05). These results indicate that nutritive and are necessary.

並列摘要


Home health care is part of integrated medical care which has been paid for by the National Health Insurance since 1995. It is carried out by home care agencies which take care of subjects who are sick and are recuperating at home. Many studies have indicated that 50% of home care subjects are malnourished; however, home care agencies are not required to have a registered dietitian to provide nutrition services to their clients in Taiwan. In this study, we classified new home care subjects into three groups according to their nutritional status. Subjects in groups A and B were malnourished with serum albumin levels below 3.0 g/dL or serum cholesterol levels below 160 mg/dL, where group C consisted of subjects who were well-nourished. Subjects of group A were referred to a registered dietitian for home visits, and those of groups B and C were maintained on home nursing care. Results showed that after 4 months, the mean serum albumin level of group A (malnutrition-intervention group) had significantly increased from 3.2 ± 0.5 to 3.4 ± 0.5 g/dL (p < 0.005); that of group B (malnutrition-non0intervention group) showed no change (3.2 ± 0.6 vs. 3.2 ± 0.5 g/dL, p=0.97); while that of group C (normal nutrition-non-intervention group( had significantly decreased from 3.8 ± 0.4 to 3.7 ± 0.4 mg/dL (p < 0.002), that of group B showed no change (143 ± 25 vs. 141 ± 27 mg/dL, p =0.68), and that of group C decreased from 196 ± 34 to 185 ± 40 mg/dL (p < 0.05). These results indicate that nutritive and are necessary.

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