護理之家住民營養與液體攝取狀況及其相關因素之探討

Nutrition, fluid intake status and related factors for the residents in nursing homes

蘇淑芬(Shu-Fen Su)

指導教授 ： 葉淑惠

高雄醫學大學/護理學院/護理學系研究所/碩士(2006年)

摘要

本研究旨在探討護理之家住民營養與液體攝取狀況及其相關因素之探討。以南部地區四間護理之家111位住民為研究對象，採迷你營養評估量表 ( Mini Nutrition Assessment, MNA )、身體質量指數( Body Mass Index, BMI )、血液中之白蛋白( Albumin )、血色素( Hemoglobin )及膽固醇( Total cholesterol )作為營養狀況指標；實際液體攝取量及尿素氮與肌酸甘比值(脫水指標)為液體攝取指標，並與可能導致營養不良及脫水的相關危險因子進行分析。結果顯示，研究對象營養不良者(MNA＜17)為36.04%，體重過輕者(BMI＜18.5)為41.12%，脫水者(尿素氮與肌酸甘比值＞20)佔17.12%。就整體營養狀況而言，由口進食者較管灌者佳；液體攝取不足的現象以由口進食者為甚。經分析發現，住民認知狀態及每日活動情形對住民的迷你營養評估量表及身體質量指數呈統計顯著差異，與液體攝取指標未達統計差異。以logistic迴歸分析，住民認知狀態與每日活動情形為身體質量指數的預測因子，即中度認知功能障礙較認知功能正常者有19倍機率體重過輕；完全依賴者是功能獨立者的4.6倍機率體重過輕。本研究結果顯示護理之家住民營養不良與脫水是一嚴重問題，這個議題期能受到重視，以改善住民的健康狀態。

關鍵字

護理之家 ； 營養狀況 ； 液體攝取量 ； 營養不良

並列摘要

The purpose of this study was to explore the nutrition, fluid intake status and related factors for the residents in nursing homes. Subjects were sampled from four legal nursing homes in Kaohsiung city. 111 residents consented to participate in this study. The scores of Mini Nutrition Assessment (MNA), body mass index (BMI), serum albumin, hemoglobin and total cholesterol level were used as the major nutritional indicators. Actual fluid intake and BUN/Cr ratio (dehydration indicators) were measured as the major fluid intake indicators. The results revealed that 36.04% of the subjects had MNA scores of less than 17, which is a classification of malnutrition. According to the standards of BMI for Chinese adults, there were 41.12% subjects classified as thin. There were 17.12% subjects had a BUN/Cr ratio of more than 20. The nutritional status of subjects for oral intake was better than for N-G feeding. The fluid intake statistics indicated that subjects with inadequate fluid intake were more likely to have oral intake than N-G feeding. Mental status and activities of daily living (ADL) of subjects were significantly different between MNA scores and the BMI, but there were no significant differences concerning fluid intake indicators. According to the results of logistic regression analysis, mental status and ADL were significant predictors of BMI. This study found that for those residents whose BMI was less than 18.5, the residents with moderate mental status impairment had a 19 times greater odds ratio than the residents without mental status impairment, and the completely dependent residents had a 4.7 times higher odds ratio than the independent residents. This research indicates that malnutrition and dehydration are serious problems among nursing home residents, and these issues need to be dealt with in order to improve the health status of this vulnerable population.

並列關鍵字

nutritional status ； malnutrition ； fluid intake ； nursing home

參考文獻

參考文獻

一、 中文部分

Guyton, A. C.（1995）．蓋統生理學—生理及疾病機轉（傅祖慶、林富美、賴亮全譯）台北：華杏。（原著出版於1992）

行政院衛生署（2002）．國人營養素攝取參考量．2005年2月13日取自http://food.doh.gov.tw

李偉立（2000）．醫院附設與獨立型態護理之家住民特質與健康狀況之比較．未發表之碩士論文．高雄：高雄醫學大學公共衛生研究所。