預測住院老人功能下降評估工具

Assessment Tools for Prediction of Functional Decline in Hospitalized Elderly Patients

王美純(Mei-Chun Wang) ； 呂淑華(Shu-Hua Lu)

《台灣醫學》 23卷3期 (2019/05) Pp. 384-391

https://doi.org/10.6320/FJM.201905_23(3).0012

摘要

預防住院老人功能下降是高齡社會非常重要的議題，找出一個適合臨床使用之篩選工具對實務極為重要，因為若可及早鑑別得知，便能儘早提供介入措施，助於延緩或避免失能惡化，提升老年生活品質。本文介紹七個能運用於預測住院老人功能下降評估工具，包括：辨別老人風險篩檢的工具（Identification of Seniors at Risk Screening Tool, ISAR）、辨別住院老人風險篩檢的工具（Identification of Seniors at Risk-Hospitalized Patients, ISAR-HP）、入院風險剖析（Hospital Admission Risk Profile, HARP）、照護複雜性的預測工具（Care Complexity Prediction Instrument, COMPRI）、安置風險的指標變項（Variable indicative of Placement risk, VIP）、檢傷風險篩檢工具（Triage Risk Screening Tool, TRST）、住院而失去自主的風險評分（Hospital Score for the Evaluation of the Risk of loss of Autonomy, SHERPA）。並分析測量面向、題目、計分方式、效度、與優缺點。期望本文能提供臨床評估工具之選擇及未來發展本土性評估工具之參考。

關鍵字

住院老人 ； 功能下降 ； 評估工具

並列摘要

Preventing functional decline among hospitalized elderly patients is an issue of crucial importance in an aging society. Clinically effective assessment tools are therefore essential for early identification to help delay or prevent disability and improve quality of life in hospitalized elderly patients. The aim of this article is to introduce 7 assessment tools for predicting functional decline in hospitalized elderly patients, including Identification of Seniors at Risks Screening Tool (ISAR), Identification of Seniors at Risk-Hospitalized Patients (ISAR-HP), Hospital Admission Risk Profile (HARP), Care Complexity Prediction Instrument (COMPRI), Variable Indicative of Placement Risk (VIP), Triage Risk Screening Tool (TRST), and Hospital Score for the Evaluation of the Risk of Loss of Autonomy (SHERPA). In addition to describe these assessment tools including dimensions measured, questions, scoring, validity, their strengths and weakness. The article can help clinician to choose appropriate assessment tools for predicting functional decline among hospitalized elderly patients.

並列關鍵字

hospitalized elderly patients ； functional decline ； assessment tools

參考文獻

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McCusker J, Bellavance F, Cardin S, et al: Detection of Older People at Increased Risk of Adverse Health Outcomes After an Emergency Visit: The ISAR Screening Tool. J Am Geriatr Soc 1999;47:1229-37.

Hoogerduijn JG, Buurman BM, Korevaar JC, et al: The prediction of functional decline in older hospitalized patients. Age Ageing 2012;41:381-7.

Sager MA, Rudberg MA, Jalaluddin M, et al: Hospital Admission Risk Profile (HARP): Identifying Older Patients at Risk for Functional Decline Following Acute Medical Illness and Hospitalization. J Am Geriatr Soc 1996;44:251-7.