老人居家照護個案營養專業介入之成效探討

The Effectiveness of Home Visits by Registered Dietitians to the Elderly in Taiwan

10.6691/JCNS.200212_27(4).0005

金惠民(Huei-Min Linda Chin)；田玫(Mei Tyan)；廖英茵(Ying-Yin Liao)

居家照護 ； 營養不良 ； 營養介入 ； 血清白蛋白 ； 血清膽固醇 ； home health care ； malnutrition ； serum albumin ； serum cholesterol

中華民國營養學會雜誌

27卷4期（2002 / 12 / 01）

232 - 238

繁體中文

Home health care is part of integrated medical care which has been paid for by the National Health Insurance since 1995. It is carried out by home care agencies which take care of subjects who are sick and are recuperating at home. Many studies have indicated that 50% of home care subjects are malnourished; however, home care agencies are not required to have a registered dietitian to provide nutrition services to their clients in Taiwan. In this study, we classified new home care subjects into three groups according to their nutritional status. Subjects in groups A and B were malnourished with serum albumin levels below 3.0 g/dL or serum cholesterol levels below 160 mg/dL, where group C consisted of subjects who were well-nourished. Subjects of group A were referred to a registered dietitian for home visits, and those of groups B and C were maintained on home nursing care. Results showed that after 4 months, the mean serum albumin level of group A (malnutrition-intervention group) had significantly increased from 3.2 ± 0.5 to 3.4 ± 0.5 g/dL (p ＜ 0.005); that of group B (malnutrition-non0intervention group) showed no change (3.2 ± 0.6 vs. 3.2 ± 0.5 g/dL, p=0.97); while that of group C (normal nutrition-non-intervention group( had significantly decreased from 3.8 ± 0.4 to 3.7 ± 0.4 mg/dL (p ＜ 0.002), that of group B showed no change (143 ± 25 vs. 141 ± 27 mg/dL, p =0.68), and that of group C decreased from 196 ± 34 to 185 ± 40 mg/dL (p ＜ 0.05). These results indicate that nutritive and are necessary.

Home health care is part of integrated medical care which has been paid for by the National Health Insurance since 1995. It is carried out by home care agencies which take care of subjects who are sick and are recuperating at home. Many studies have indicated that 50% of home care subjects are malnourished; however, home care agencies are not required to have a registered dietitian to provide nutrition services to their clients in Taiwan. In this study, we classified new home care subjects into three groups according to their nutritional status. Subjects in groups A and B were malnourished with serum albumin levels below 3.0 g/dL or serum cholesterol levels below 160 mg/dL, where group C consisted of subjects who were well-nourished. Subjects of group A were referred to a registered dietitian for home visits, and those of groups B and C were maintained on home nursing care. Results showed that after 4 months, the mean serum albumin level of group A (malnutrition-intervention group) had significantly increased from 3.2 ± 0.5 to 3.4 ± 0.5 g/dL (p ＜ 0.005); that of group B (malnutrition-non0intervention group) showed no change (3.2 ± 0.6 vs. 3.2 ± 0.5 g/dL, p=0.97); while that of group C (normal nutrition-non-intervention group( had significantly decreased from 3.8 ± 0.4 to 3.7 ± 0.4 mg/dL (p ＜ 0.002), that of group B showed no change (143 ± 25 vs. 141 ± 27 mg/dL, p =0.68), and that of group C decreased from 196 ± 34 to 185 ± 40 mg/dL (p ＜ 0.05). These results indicate that nutritive and are necessary.

1. 謝昌成(2010)。探討居家照護服務與個案照護結果之間的相關性。成功大學老年學研究所學位論文。2010。1-135。 
2. 黃紹萱(2014)。含乳清蛋白及難消化麥芽糊精之管灌配方對長期照護住民營養改善之研究。中山醫學大學營養學研究所學位論文。2014。1-105。 
3. 黃荻坭(2008)。簡易營養評估量表之驗證及安養機構住民的營養風險評估。亞洲大學長期照護研究所學位論文。2008。1-42。
4. 陳淑婷(2008)。社區失能者長期照顧十年計畫服務使用情形相關研究。亞洲大學長期照護研究所學位論文。2008。1-97。
5. 柯玟玟(2008)。以簡易營養評估(MNA)台灣修訂版評估內科住院病人的營養狀況。亞洲大學長期照護研究所學位論文。2008。1-41。
6. 黃于殷(2013)。長期照顧十年計畫服務輸送之檢視—以照顧管理專員觀點為例。中正大學社會福利學系學位論文。2013。1-172。
7. 張佳樺(2014)。含大豆蛋白及乳清蛋白之管灌配方對長期照護住民營養改善之研究。中山醫學大學營養學研究所學位論文。2014。1-74。
8. 蔡宜珊(2017)。含高量牛乳蛋白及難消化性麥芽糊精之配方對長期照護住民營養改善之研究。中山醫學大學營養學系碩士班學位論文。2017。1-92。