長期照護機構住民功能性評估之研究

本研究採橫斷面調查，以中部某公部門養護機構住民為對象共收集346名住民資料，目的在瞭解住民的特性、身心機能狀況及照顧需求。內容有：基本資料、住民健康資料、日常生活獨立功能(ADL)、心智狀況(MMSE)、憂鬱狀況(GDS)等，研究結果住民平均年齡約80歲、女性多於男性、單身鰥寡為主，因為家人無能力及年老無人照顧才申請入住的為主，罹病方面以高血壓、中風為主要疾病診斷，而73.9%住民長期固定服藥且以服降血壓藥物者最多，而且45.5%住民有憂鬱傾向，日常生活中最困擾的身體問題為皮膚騷癢其次是便秘，視力模糊的問題排列第三，研究對象屬於日常生活依賴度偏高者(ADL平均分數27.88±31.40)，但公費住民的依賴度較自費住民低二者間有顯著差異(p＜0.05)，心智功能MMSE的分數從0—29分(平均分數16.27±6.33)，ADL與MMSE間呈顯著正相關(r=0.493，p＜0.001)，ADL與GDS間呈顯著負相關(r=0.-0.235，p＜0.01)，用藥總數與GDS間呈顯著正相關�� (r=0.240，p＜0.001)，意識狀態越差者其ADL及MMSE的評值分數越差且具統計上顯著差異(p＜0.01)，這結果將有助於提升長期照護機構生活品質的參考。

關鍵字

長期照護；機構住民；功能性評估

並列摘要

This study, conducted with pioneering cross-sectional investigation, adopted 346 residents in a certain public nursing home in central Taiwan as the subjects. Aiming at understanding their characteristics, physical and mental state, and care need, this study includes: basic data, residents' health data, Activity of Daily Living Scale (ADL) , Mini-Mental State Examination (MMSE) , Geriatric Depression Scale (GDS) and others. The results show that the residents' average age is 80 years old, more female than men, mainly single and widowed, and the main reason why they checked into the facility is due to either lack of family support or aging of their family. Most of them suffer from HTN, stroke, while 73.9% residents are long-term on mediation, which mainly reduces their blood pressure. In addition, 45.5% residents tend to be depressive. Among daily illness, the most disturbing for them is skin itching, the second disturbing is constipation, the third is vague eyesight. The subjects belong to the higher dependency category (the ADL ’s average score is 27.88±31.40) , while there is a significant difference between the residents on public payment and those on their own fee. The score of mental state function MMSE ranges from 0 to 29 points (average score is 16.27±6.33) . ADL and MMSE have significantly positive relevance (r=0.493，p＜0.001) . ADL and GDS have significant negative relevance (r=0.-0.235, p＜0.01) . The medication totality and GDS have a significantly positive relevance (r=0.240，p＜0.001) . The worse the residents' mental state gets, the worse the assessment score of their ADL and MMSE with a significant difference (p＜0.01) . The results work as a reference in promoting the living quality in long-term care facility.