高齡病人衰弱相關因素探討

Discussion on Related Factors of Elderly Patients’ Frailties

周美香(Mei-Hsiang Chou)

指導教授 ： 陳芬如

義守大學/醫學院/醫務管理學系/碩士(2017年)

摘要

背景：衰弱是高齡長者功能退化的前兆，嚴重影響生活功能和品質，若能了解衰弱相關因素，對衰弱老人及早介入措施，則有機會逆轉衰弱，預防或延緩失能的發生。
目的：本研究運用周全性老年評估探討高齡病人衰弱之相關因素。
方法：採用次級資料分析法，資料為經由個案管理師收集南部某醫學中心2015年5月至2016年9月住院之65歲以上病人周全性老年評估之資料，研究以Fried衰弱指標定義衰弱與非衰弱個案，資料以SPSS 18.0版進行卡方檢　　　定、獨立樣本t檢定和二元邏輯斯迴歸統計分析。
結果：符合研究者共有124人，住院老人的衰弱率為88.7%，非衰弱比率為11.3%，衰弱與非衰弱兩組之年齡(p=.026)、迷你營養評估簡式(MNA-SF)得分(p<.001)、老年憂鬱量表(GDS)得分(p=.043)、迷你心智狀態檢查(MMSE)得分(p<.001)、住院前及住院之日常生活功能巴氏量表得分 (p<.001)、住院之工具性日常生活量表得分(p=.002)、生活品質量表 (Euro Qol-5D-3L)得分(p<.001)，具顯著差異。日常生活功能巴氏量表(p=0.019,OR=0.946,95% CI=0.903-0.991)、迷你營養簡式評估結果(p=0.045, OR=0.707,95% CI=0.504-0.993)為預測衰弱的相關因子。
結論：研究結果提供照護團隊了解影響高齡住院病人衰弱的相關因素，進而擬定住院與出院後照護計畫，以加強返家後日常生活功能及營養照護，期預防及改善高齡病人衰弱的相關問題。

關鍵字

高齡 ； 衰弱 ； 周全性老人評估

並列摘要

Background: Frailty is a precursor to the functional deterioration of elderly people and seriously affects the function & quality of life. We could realize the frailty-related factors and early intervention measures for the elderly to reverse frailty, prevent and delay the occurrence of disability.
Purpose: This study employ the Comprehensive Geriatric Assessment to explore the related factors to the frailty of elderly patients.
Method: This study is secondary analysis design. The data was collected by case managers from patients who were over 65 years old and hospitalized at a southern medical center from 2015/05 to 2016/09. Case managers conducted comprehensive geriatric assessment for the hospitalized elder patients. This study defines frailty and non-frailty cases with the index of Fried frailty. The data was analyzed of chi-square test, the independent sample t-test and the binary logistic regression by SPSS.
Result: There were 124 elderly patients in this study. The rate of hospitalization for the frailty of Fried was 88.7% and the non- frailty ratio was 11.3%. The scores were significantly different in age (p=.026), MNA-SF (p<.001), Geriatric Depression Scale (p=.043), Mini Mental State Examination (p<.001), Barth index (p<.001), IADL (p=.002), Euro Qol-5D-3L (p<.001). In addition, the results of Barth index (p=0.019, OR=0.946,95% CI=0.903-0.991) and MNA-SF (p=0.045, OR=0.707, 95% CI=0.504-0.993) were the predictors for frailty of elderly patients.
Conclusion: These findings could provide the care team to understand the relative factors affecting frailty of elderly patients. Furthermore, we can develop related care programs including hospitalization and post-discharge to enhance daily life function & nutrition care for preventing and improving the related issues of frail elderly patients at home.

並列關鍵字

the elderly ； frailty ； comprehensive geriatric assessment

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