某醫學中心旅遊醫學門診老年病患特性之分析

The Characteristics of Elder Subjects Visiting the Travel Medicine Clinic in a Medical Center

謝孟芸(Meng-Yun Hsieh) ； 黃獻樑(Hsien-Liang Huang) ； 侯君穎(Chun-Yin Hou) ； 洪孜幸(Tzu-Hsing Hung) ； 雷永兆(Yung-Chao Lei) ； 陳如欣(Ju-Hsin Chen) ； 趙雁南(Yen-Nan Chao) ； 楊世仰(Shih-Yang Yang) ； 邱泰源(Tai-Yuan Chiu) ； 黃國晉(Kuo-Chin Huang)

《台灣老年醫學暨老年學雜誌》 4卷4期 (2009/11) Pp. 263-273

https://doi.org/10.29461/TGG.200911.0006

摘要

目的：近年來隨著旅遊的普及與國民健康意識的提升，旅遊對健康可能帶來的影響逐漸受到重視，老人族群其生理狀態及常見的慢性病，使其旅行前諮詢及預防注射等議題更受重視。本研究主要目的爲了解本土旅遊醫學門診之老年病人特性及需求，並比較老年與非老年旅行者的各項差異。
方法：以某醫學中心2008年至旅遊醫學門診就診的病人爲研究對象，使用病歷回溯分析方法，收集病人之年齡、性別、旅行地點、旅行目的、疫苗接種等臨床資料，選出年齡≧60歲之全部老年病患135位，並以性別配對方式，採用1:3的比例隨機取樣出405位＜60歲的病人作爲對照組，進行統計分析。
結果：全年就診人數中年齡≧60歲者佔5.6%；老年人最常去的旅遊地點爲非洲(31.6%)、中南美洲(27.4%)及歐洲(18%)等；不同年齡層的旅遊地點則有顯著差異性。老人最常見出國目的爲旅行團旅遊(64.3%)以及工作開會(21.4%)，不同年齡層的旅遊目的亦有統計顯著差異。此外老人在旅遊醫學門診接受的服務包括接種流行性腦脊髓膜炎疫苗(14.1%)、黃熱病疫苗(63.0%)、接受瘧疾預防用藥(32.6%)及急性高山症預防用藥(13.7%)。
結論：國內老年族群出國旅遊之旅遊地點、目的及其於旅遊醫學門診接受的服務有其特殊性。身爲臨床醫師應熟悉老人出國旅遊相關的知識與技能，同時具備評估其健康狀態並提供必要的藥物與預防注射等，才能個別化照顧老人的健康。

關鍵字

老人 ； 旅遊醫學 ； 旅遊疫苗接種 ； 瘧疾 ； 高山症

並列摘要

Objectives: In recent years, as international travel has become commonplace, more emphasis has been placed on the importance of travel on health. With regards to the unique physiological status combined with frequent concurrent comorbidities of the elderly population, pre-travel consultation and preventive vaccinations in this population are especially essential. This study was undertaken to understand the characteristics and needs of the elderly with respect to travel medicine, and to further analyze the differences between these findings and those of the non-geriatric population.
Methods: Retrospective analysis of patients coming to a travel medicine clinic in a medical center in Northern Taiwan in the year 2008 was performed. Patients’ data including age, gender, travel destination, travel aim, preventive vaccinations, medications received, and other clinical data were collected. In total, there were 135 patients whose age were over 60 years and thus classified into the geriatric group. Randomized sampling in a 1:3 ratio collected 405 gender-matched control cases (249 males, 156 females) ages less than 60-years-old for comparison.
Results: In the geriatric group, the most common travel destinations were Africa (31.6%), Central and South America (27.4%) and Europe (18%). For purposes of travel (travel aim), tour group travel ranked first in the geriatric group, and traveling for work or conferences (21.4%) ranked second. Of the elderly, 14.1% (n=19) underwent meninogococcal vaccinations, 63.0% (n=85) had yellow fever vaccinations, 32.6% (n=44) took prophylactic malarial medications, and 13.7% (n=18) were given preventive medicines for high altitude sickness. In comparison with the non-geriatric age group, statistically significant differences were noted in the patients undergoing meninogococcal, yellow fever, hepatitis A, and measles-mumps-rubella vaccinations, as well as administration of tetanus toxoid, prophylactic malarial and high altitude sickness medications.
Conclusions: This study was the first Taiwanese study to identify the unique characteristics of geriatric populations visiting the travel medicine clinic in a medical center. The overall destination and purposes of travel were statistically disparate from those of the non-geriatric population. Moreover, the results demonstrated that the geriatric population in general does not pay enough attention to the influence and effexts of travel on pre-existing co-morbidities. Further education for the elderly on the necessity of receiving pre-travel assessment and adequate preventive measures is strongly encouraged.

並列關鍵字

elderly ； travel medicine ； immunization ； malaria ； acute mountain syndrome