居家護理個案管理半年期間血清蛋白與血色素狀態探討

Albumin & Hemoglobin Status of Home Care Clients Within Half Year Service

葉莉莉(Lily Yeh) ； 溫敏杰(Miin-Jye Wen) ； 徐畢卿(Bih-Ching Shu) ； 彭巧珍(Cheau-Jane Peng)

《護理研究》 8卷4期 (2000/08) Pp. 447-458

https://doi.org/10.7081/NR.200008.0447

摘要

本前趨性研究目的擬探討接受居家護理服務之新個案於服務之第一、二、四及第六個月之血清白蛋白(以下稱Ab)及血色素(以下稱Hb)狀態，並分析個案之Ab與Hb是否因服務月數、年齡、性別、照護需求總數、胃管留置與否、照護地點是否固定、照護者是否固定及出院後多久收案等因素影響而有差異。以台南地區五居家護理機構，診斷爲非癌症之新收個案爲對象，共追蹤75案；其平均年齡71.7歲，84.0%由鼻管攝食。資料分析結果如下：以卡方趨勢檢定各時間點之Ab與男、女性Hb之數值分佈，結果顯示Ab確實隨居家護理服務時間的增長有改善趨勢，達統計顯著差異(P＝0.002)；男性Hb隨服務時間的增長，有改善趨勢(P＝0.055)；女性Hb測於各時間點皆有半數以上≥10g/dL，但卡方趨勢檢定則未達統計顯著差異。以GEE檢定個案之Ab、Hb和各變項間之關係，發現具下列特質者其Ab狀態較佳：服務之第二、四、六月齡越輕者；女性；照護需求總數越少者；而年齡越大者其Hb狀態越差。本研究對接受居家護理服務半年內個案之Ab、Hb及與此狀態有關之因素有初步認識，相關結果有助於居家護理營養照護之建立。

關鍵字

居家護理 ； 血清白蛋白 ； 血色素

並列摘要

Purposes of this prospective study were to explore the albumin and hemoglobin (Rb) of patients who were newly admitted to home care agencies. We wanted to identify the following: (1) the albumin and Hb status at the first, second, fourth, and sixth month; (2) factors (service month, age, sex, number of care needs, intake route, case location fixed or not, caregiver fixed or not, and registration for service from hospital discharge) which might influence albumin and Rb status. Seventy-five non-cancer clients from five home care agencies in the Tainan area were recruited for our study. Data were analyzed using the SAS computer program. The average age was 71.1 years old, with 84.0% of clients having NG tube. The results of Mental-Haenszel chi-squared analysis showed that as a group, when the number of months of home care service increased, the albumin condition and Hb in men were improved but not in women. GEE analysis showed the albumin levels were related to four factors including, duration of service, age, gender, and number of care needs. Thus, we found that those who were in the second, fourth, and sixth month of service, and who were younger, female, and had fewer care needs had better albumin condition. In addition, GEE analysis showed those who were younger, and had fewer care needs had better Rb condition. The results of this study can be used to develop nutritional care programs for home care clients.

並列關鍵字

home care ； albumin ； hemoglobin

參考文獻

American Dietetic Association(1996).Position of the American Dietetic Association: Nutrition, aging, and the continuum of care.Journal of the American Dietetic Association.96(10),1048-1052.

Arensberg, M. B.,Schiller, M. R.(1996).Dietitians in home care: A survey of current practice.Journal of the American Dietetic Associatign.96(4),347-353.

Boult, C.,Krinke, U. B.,Urdangarin, C. F.,Skarin, V.(1999).The validity of nutritional status as a marker for future disability and depressive symptoms among high-risk older adults.Journal of the American Geriatrics Society.47(8),995-999.

Coulston, A. M.(2000).Enteral nutrition in the patient with diabetes mellis.(Current Opinion in Clinical Nutrition & Metabolic Care).

Curtas, S.,Chapman, G.,Meguid, M. M.(1989).Evaluation of nutritional status.(Nursing Clinics of North America).