女性阿茲海默症病人之照護目標組合的研究：以中部某醫學中心為例

THE STUDY OF CARE TARGETS COMBINATION IN WOMEN WITH ALZHEIMER'S DISEASE: A CASE STUDY IN A MEDICAL CENTER IN CENTRAL TAIWAN

林雅嫻(Ya-Sian Lin) ； 王文甫(Wen-Fu Wang) ； 呂郁蕙(Yu-Huei Liu) ； 張凱茗(Kai-Ming Jhang) ； 陳富滿(Fu-Man Chen) ； 葉瓊鈺(Chiung-Yu Yeh) ； 林哲瑋(Che-Wei Lin) ； 康宜靜(Yi-Ching Kang) ； 張倩蜜(Chien-Mi Chang) ； 王釧如(Chuan-Ju Wang) ； 吳信宏(Hsin-Hung Wu)

《品質學報》 27卷1期 (2020/02) Pp. 1-25

https://doi.org/10.6220/joq.202002_27(1).0001

摘要

依據臺灣失智症協會2018年的統計，未來45年，臺灣失智人口數以平均每天增加36人，每40分鐘增加一位失智者的速度成長著。失智症類型中以阿茲海默症居多，且女性罹患失智症比率高於男性，經統計阿茲海默症病人以女性占大多數，因此本研究以中部某醫學中心的失智症病人為例，主要針對女性阿茲海默症的層面加以探討，進一步分析需要的照護目標有哪些，期望能在醫療管理上有所貢獻。收集對象為中部某醫學中心，於2014年1月至2018年5月失智症個案管理資料共計99筆有效資料。人口統計變數包含：病人性別（以女性為研究對象）、失智症類型（以阿茲海默症為研究類型）、病人年齡、失智症嚴重程度，以及15項照護目標。本研究的病人年齡、失智症嚴重程度變數均為前項，照護目標變數為前後項。在Apriori演算法提升度設定為大於1，支持度設定為10%，信賴度設定為90%，篩選過後得到405條規則。研究結果表明以五項照護目標為主，分別為適當的活動、定期門診追蹤治療、社會資源介紹及轉介、家屬支持團體與照顧技巧訓練轉介，以及追蹤病情及衛教（失智症及失智症的精神行為症狀[behavioral and psychological symptoms of dementia, BPSD]），視為一組執行在照護上的女性阿茲海默症病人基本照護需求組合。在醫療管理方面，可以提供給醫院管理階層、醫療照護人員、照護者以及女性失智症病人，具有實質上的相關建議與參考規劃，給女性阿茲海默症病人帶來更好的醫療照護品質，未來為醫療管理帶來更完善的整合性照護模式。

關鍵字

女性阿茲海默症 ； 失智症照護 ； 照護目標 ； 失智症照護者壓力

並列摘要

In the next 45 years, the number of dementia patients will be increased by 36 patients per day in Taiwan according to the report from Taiwan Alzheimers Disease Association in 2018. That is, a dementia patient is identified every 40 minutes. Among the types of dementia, Alzheimer's disease is the most common, the rate of women with dementia is higher than that of men, and the majority of patients with Alzheimer's disease are women. Therefore, this study based on the dementia patients of a medical center in central Taiwan focuses on female Alzheimer's disease, and further analysis of the need for care targets is performed in order to identify hidden knowledge to contribute to medical management. The patients are from a medical center in central Taiwan. From January 2014 to May 2018, there are 99 valid data sets from the database of dementia patients. Demographic variables include gender of the patient (women only), type of dementia (Alzheimer's disease only), age of the patient, severity of dementia, and 15 care targets. The study is to consider age of the patient and severity of dementia as input variables, whereas care target is considered as both input and output variables. In the Apriori algorithm, the degree of lift is set to be greater than 1. The support and confidence are set to 10% and 90%, respectively. There are 405 rules obtained. The results show that the five main care targets including appropriate activities, regular outpatient follow-up treatment, introduction and referral of social resources, referral to family support groups and care skills training, and behavioral and psychological symptoms of dementia (BPSD) treatment are considered as a group of basic care needs for women with Alzheimer's disease. Practically, the results can be a reference for hospital management, medical staff, caregivers, and female patients with Alzheimer's disease in order to provide a person-centered and integrated care for female patients with Alzheimer's disease.

並列關鍵字

women with Alzheimer's disease ； dementia care ； care target ； dementia caregiver stress

參考文獻

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