老年髖部骨折病人接受手術治療後生活品質之探討

A Study on Quality of Life in Elderly Patients with Hip Fracture after Surgery

陳可旎(Ke-Ni Chen)

指導教授 ： 馬震中

義守大學/醫學院/醫務管理學系/碩士(2018年)

摘要

目的：全球人口快速老化，髖部骨折發生率和盛行率隨人口老化日益增加。本研究目的是探討老年髖部骨折病人手術治療後生活品質變化情形以及影響老年髖部骨折病人生活品質的相關因素。
方法：本研究是採用縱貫性研究設計，以南部某區域醫院中接受髖部骨折手術之60歲以上老年病人進行面對面訪談及電話訪談，訪談時間分成術後住院期間、術後一個月，共收62位個案，收集時間從2016年4月1日到2017年4月30日，本研究已經過義大醫院人體試驗委員會(EMRP-104-023)審核通過。資料採用成對樣本t檢定以評估老年髖部骨折病人住院期間及出院後一個月整體健康生活品質及自覺健康狀況之差異；使用重複測量變異數分析老年髖部骨折病人不同時間點上，以性別、年齡、骨折部位等變項能否影響之整體健康生活品質及自覺健康狀況。
結果：本研究結果男19人(30.6%)、女43人(69.4%)，男女比為1：3，平均年齡為78.97±7.6，病人年齡分布在70~79歲居多，骨折部位以股骨轉子間骨折(Intertrochanteric)的病人居多，手術方式使用Bipolar hemiarthroplasty居多，大部分髖部骨折病人會在家中進行復健，在住院期間，大多數髖部骨折病人的疼痛程度為中度(4 ~ 6分)；另外出院後一個月，髖部骨折病人的疼痛程度多數為輕度(1 ~ 3分)。在成對樣本t檢定髖部骨折病人住院期間與出院一個月自覺健康狀況有顯著差異；重複測量變異數統計分析顯示，出院一個月的疼痛程度、日常生活活動能力部分上廁所(住院期間)、上下床或椅子(出院一個月)、平地行走與整體健康相關生活品質有顯著差異；另外年齡、日常生活活動能力部分上廁所(出院一個月)、上下床或椅子(出院一個月)與自覺健康狀況有顯著差異。
結論：研究結果老年髖部骨折病人之日常生活活動能力部分會影響其整體健康相關生活品質及自覺健康狀況，出院一個月會比住院期間之自覺健康狀況好，因此建議醫護人員要加強對於老年人的健康照顧，防止病人再跌倒骨折，改善與提升其生活品質。

關鍵字

老年人 ； 髖部骨折 ； 生活品質 ； 歐洲生活品質量表五面向

並列摘要

Purpose: The rapid global population aging, hip fracture incidence and prevalence rate with the growing population aging. The aim of this study was to investigate the changes in the quality of life of elderly patients with hip fracture after surgery and the related factors that affect the quality of life of elderly patients with hip fracture.
Methods: This study was conducted in a longitudinal study designed to face-to-face interviews and telephone interviews with elderly patients over the age of 60 who underwent hip fracture surgery in a regional hospital in the South. The interview time was divided into postoperative hospitalization and postoperative month A total of 62 cases were collected from April 1, 2016 to April 30, 2017. The study was approved by the Human Experimental Committee of E-DA Hospital (EMRP-104-023). The data were analyzed using a paired sample t-test to assess differences in overall quality of life and health status among elderly hip fracture patients during hospitalization and one month after discharge from hospital. Using repeated measures of variation to analyze the elderly hip fracture patients at different time points, sex, Age, fracture site and other variables can affect the overall health quality of life and conscious health status.
Results: The results of this study were 19 males (30.6%) and 43 females (69.4%), with a ratio of 1: 3. The average age was 78.97 ± 7.6. The patients were mostly aged 70-79 years. The majority of Intertrochanteric patients are predominantly Bipolar hemiarthroplasty, and most patients with hip fracture are at home. Most patients with hip fracture have moderate pain(4 to 6 points ) during hospitalization; Another month after discharge, the majority of patients with hip fracture pain was mild (1 to 3 points). Significant differences were found in the health status of patients with hip fracture who were hospitalized in paired sample t and one month after discharge. Statistical analysis of repeated measures showed that the pain level was lower in the first month of hospitalization, The daily living activity of Bathing (one month after discharge) have significant differences in walking on level ground and overall health-related quality of life. In addition, age, the daily living activity of Bathing (discharged from hospital for one month), Mobility (one month from discharge) There are significant differences in status.
Conclusions: Results The daily living activity of elderly patients with hip fracture partially affects their overall health-related quality of life and conscious health. One month after discharge, they are better than the conscious health status during hospitalization. Therefore, it is suggested that health care workers should strengthen their ability to treat elderly patients Health care to prevent patients from falling off the fracture and improve and enhance their quality of life.

並列關鍵字

elderly ； hip fracture ； quality of life ； EQ-5D

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