運用多軸向手法提升高齡住院病人衰弱改善率

高齡長者隨年紀增長，易因疾病後出現體能及身體功能衰退進而產生衰弱，而衰弱更是造成失能的主因。本單位2019年1月至4月衰弱改善率23.1%，失能狀態改善率26.9%，引發改善動機，故本專案目的為提升高齡住院病人衰弱改善率，本專案執行期間自2019年5月1日至12月31日。經分析發現主因為護理師及家屬缺乏照護技巧，缺乏下床活動項目、設備及提醒機制，無衰弱照護流程，藉多軸向對策介入，強化在職教育、推動照護流程及衛教手冊、創新自助式認知刺激活動、高齡健康操及客製化活動項目以落實衰弱介入，專案實施後衰弱改善率提升為71.4%，失能狀態改善率為75%，達專案目標，成效良好。建議本專案提升高齡住院病人衰弱改善率及失能狀態改善，能推廣至全院高齡病房，增進長者身心健康，促進照護品質。

關鍵字

高齡；衰弱；失能；發生率

並列摘要

Elderly people are prone to frailty due to the decline in physical function after illness, and frailty is the main cause of disability. From January to April 2019, at the unit, the improvement rate of frailty was 23.1%, and the rate of improvement from a disability state was 26.9%, indicating overall improvement. Therefore, the purpose of this project was to increase the improvement rate of frailty in elderly inpatients. The project implementation period is from May 1, 2019 to December 31, 2019. The results revealed that the main reason for frailty was a lack of care skills among nurses and family members as well as a lack of out-of-bed activity, required equipment, reminder mechanisms, and a frailty care process. This project employed multiaxial intervention strategies to strengthen in-service education, promote care procedures and the use of health education manuals, innovate self-help cognitive stimulation activities, and implement elderly health exercises and customized activities. After implementation of this project, the improvement rate of frailty had increased to 71.4%, and the rate of improvement from disability status increased to 75%; thus, the goal of this project was attained. Through this project, the rate of frailty improvement was increased, the disability status of elderly inpatients was improved, and the physical health and mental health of elderly patients were enhanced, which in turn improved the quality of care.

並列關鍵字

advanced age ； frailty ； disability ； incidence

參考文獻

謝昌成、蕭雅尤、林妙秋、陳碧奇(2010)．老人衰弱症．家庭醫學與基層醫療，25 (11)，410-417。

Arai, H., Satake, S., & Kozaki, K. (2018). Cognitive frailty in geriatrics. Clinics in Geriatric Medicine, 34(4), 667-675.

Chen, L. -K., Hwang, A. -C., Lee, W. -J., Peng, L. -N., Lin, M. -H., Neil, D. -L., Shih, S. -F., Loh, C. -H., & Chiou, S. -T. (2020). Efficacy of multidomain interventions to improve physical frailty, depression and cognition: Data from cluster-randomized controlled trials. Journal of Cachexia, Sarcopenia and Muscle, 11(3), 650-662.

Church, S., Rogers, E., Rockwood, K., & Theou, O. (2020). A scoping review of the Clinical Frailty Scale. BMC Geriatrics, 20(1), 393.

Cunha, A., Veronese, N., de Melo Borges, S., & Ricci, N. A. (2019). Frailty as a predictor of adverse outcomes in hospitalized older adults: A systematic review and metaanalysis. Ageing Research Reviews, 56, 100960.

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運用多軸向手法提升高齡住院病人衰弱改善率

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