士林區獨居長者對「送餐到家服務」之營養狀況及需求度評估

Impact of Meals-on-Wheels Program on Independent-living Elderly in Shih-Lin Area

楊宗蓉(Tzong-Rong Yang)

指導教授 ： 胡雪萍

臺北醫學大學/公共衛生暨營養學院/保健營養學研究所/碩士(2003年)

摘要

對獨居長者提供送餐到家是一種社會福利，自1997年起臺灣開始實施送餐服務，但相關之營養評估報告却闕如。本研究第一部分採人體測量、生化檢驗、血液學檢驗及NSI量表、MNA量表及自編滿意問卷，對23位接受送餐服務之臺北市士林區獨居長者予以為期四個月的送餐服務，以送餐前、後營養狀況及用餐滿意度作評估調查。結果：在四個月的送餐介入後，男性長者的體重、身體質量指數（BMI）及肌酸酐（creatinine）項目上呈現顯著性的下降（體重減輕1.57㎏、身體質量指數下降0.56㎏/㎡及肌酸酐下降0.12ml/dL），女性長者則無此差異。由NSI及MNA量表得知長者有43﹪及13﹪是為營養不良的高危險群；在介入後，得分有改善，但無統計上差異。長者對送餐到家服務之滿意度為72.17﹪，且此結果不受長者的人口背景影響。第二部分採NSI量表及自編需求問卷，對68位士林區獨居長者做營養狀況及送餐需求調查，結果需求度為33.85﹪，且與宗教信仰及自覺健康狀況有關。需要者中有71.4﹪認為應天天送餐、50﹪長者希望每天能提供2餐，並以選擇供應午、晚餐者最多。將需求度與NSI量表綜合分析後顯示『需要送餐的長者』在NSI營養評估上明顯比『不需要送餐』及『不確定要送餐』的長者差。

關鍵字

送餐到家 ； 獨居長者 ； 營養評估

並列摘要

Meals-on-wheels (MOW) program has been widely adopted in Taiwan since 1997. There has been a few survey investigating the nutritional status and satisfaction with this program. Firstly, we investigated the 23 independent -living elderly people who apply meals-on-wheels in Shih-Lin Area for four months. The assessment for nutritional status was determined using anthropometrics, laboratory data, and two methods－“DETERMINE Checklist” (NSI), and “Mini Nutritional Assessment” (MNA). After four months meals-on-wheels service elderly person improve their nutritional status that weight, BMI and creatinine were significantly decreased in male but not in female. Seventy-two percent subjects judged the meal as “good”. This effect did not influence by subjects demographic data. Secondary, we investigated the demands to 68 independent-living elderly person for meals-on-wheels program. Results showed that 33.85% of the subjects who needed this meals delivery services. These needs of services are correlated with religious belief and perception to their health status. There are 71.4% of the subjects want to receive meals every day, and 50% want two meals per day. Lunch and dinner is the most choice by subjects. The demand of meals delivery services group has a higher prevalence of malnutrition than the no demand / unsure groups based on the NSI.

並列關鍵字

meals-on-wheels ； independent-living elderly ； nutrition assessment

參考文獻

壹. 外文參考文獻 Allman RM, Laprade CA, Noel LB, et al.(1986)Pressure sores among hospitalized patients. Ann of Intern Med 105:337-342.

American Dietetic Association(1991)ADA’s testimony on reauthorization of the Older Americans Act. J Am Diet Assoc 91: 849-851.

Beitz R, Mensink GB, Fischer B(2003)Blood pressure and vitamin C and fruit and vegetable intake. Ann Nutr Metab 47:214-220.

Burr ML, Lennings CI and Milbank JE(1982) The prognostic significance of weight and of vitamin C status in the elderly. Age Ageing 11:249-255.

Chumlea WC and Baumgartner RN(1989)Status of anthropometry and body composition data in elderly subjects. Am J Clin Nutr 50: 1158-1166.