高齡患者出院後健康生活型態之探討

Change of Health-related Lifestyles in Elders after Discharge from Hospitalization

邱琪雯(Chi-Wen Chiu) ； 胡芳文(Fang-Wen Hu) ； 陳清惠(Ching-Huey Chen) ； 張家銘(Chia-Ming Chang)

《台灣老年醫學暨老年學雜誌》 8卷3期 (2013/08) Pp. 172-185

https://doi.org/10.29461/TGG.201308_8(3).0003

摘要

目的：探討高齡患者住院前後健康生活型態改變現況及影響出院後健康生活型態相關因素。方法：採前瞻性相關性研究，選取南部某醫學中心老年科及一般內科病房，以立意取樣方式邀請65位65歲以上個案，以結構式問卷進行面對面訪談收集資料。結果：實際完成資料收集者共60位，出院後整體健康生活型態較住院前顯著進步，其中以飲食控制、服藥安全與吸菸量達顯著改善。出院後的良好飲食控制以經濟足夠、年齡較輕者顯著居多；服藥安全方面，以無工作、慢性疾病數三種以上與住院天數較少者顯著執行良好。雖然，出院後規律運動與住院前無顯著差異，但以經濟足夠、疾病診斷數較少、慢性疾病數三種以上、疾病嚴重度較低、初次住院、三年內住院次數較少、距上次住院間隔較久與未再入院者較能維持規律運動。住院前後整體生活型態以有親友協助者表現顯著改善。結論：臨床醫療人員應運用住院機會，與高齡患者及其親友擬定健康生活型態維持或重建計劃，對於經濟狀況不佳、健康狀況較差或多次住院之高齡患者更應積極提供協助。

關鍵字

住院 ； 高齡者 ； 健康生活型態 ； 改變

並列摘要

Objectives: To investigate whether hospitalization is related to changes in health-related lifestyles among the elderly and identify the factors associated with the changes.Method: A prospective correlational design was adopted to select 65 patients aged 65 years and older in the geriatrics and general impatient wards at a medical center. A structured questionnaire was answered during a face-to-face interview upon admission and three months after discharge.Results: A total 60 elderly patients participated in the study. Total scores of health-related lifestyles were improved after hospitalization (19.4±1.8 vs 20.3±1.5, p≤.01), especially in good eating habits, safety of medicine usage, and smoking. Elderly patients who were younger and more financially secure performed better in good eating habits (77.4±6.7 vs 73.8±4.4, p≤.05; 69.2% vs 34%, p≤.05, respectively). Elderly patients who were unemployed and with three or more chronic diseases performed better in safety of medicine usage (84.4% vs 60%, p≤.05; 59.1% vs 33.3%, p≤.05; respectively). Although the amount of exercise was not significant, elderly patients who were more financially secure, with a lower number of diagnosed disease, with more than three chronic diseases, with a lower comorbidity score, hospitalized for the first time, with a lower frequency of hospitalization during the past three years, with a longer duration between last and current hospitalization, and with no readmission were more likely to maintain the habit of regular exercise after they were discharged from the hospital. Moreover, elderly patients with assistance and care from family members reported the most obvious improvement in health-related lifestyles after hospitalization.Conclusions: Clinical physicians, nurses and other medical professionals should grasp the opportunity of hospitalization to work with elderly patients and/or their family members to develop plans for maintaining or improving health-related lifestyles. Active assistance in particular should be provided to elderly patients who are less financially secure, frailer, and with a greater frequency of hospitalization.

並列關鍵字

hospitalization ； elderly ； health-related lifestyles ； change