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中華職業醫學雜誌

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篇名 運用周全性評估於急性病房高齡患者功能性評估分析
卷期 21:4
並列篇名 Functional Assessment analysis on the acute hospital ward elderpatient by the Comprehensive Geriatric Assessment
作者 潘玉玲張耀文李忠興羅子評高東煒
頁次 215-226
關鍵字 住院老人老年周全性評估Hospitalized ElderlyComprehensive Geriatric AssessmentTSCI
出刊日期 201410

中文摘要

目的:於急性病房高齡病人接受老人周全性評估,了解其功能狀況及需求,探討其社會人口學、基本健康狀態與生活功能之相關性。
方法:本研究採用橫斷性研究,於102年1月1日至102年12月31日於北市某醫學中心內科病房65歲以上之病人為樣本,以老年醫學周全性評估量表為研究工具。
結果:活動評估有6人(33.3%)被歸類為五倍跌倒危險性;MNA以潛在營養不良者居多(16人,43.2%);MMSE重度障礙者達13人(35.1%);CDT計10名(27.8%)有認知功能缺失情形;GDS總分I測得13名(31.4%)屬於有憂鬱傾向者。功能性評估Barthel及IADL結果之預測因子,顯示顯著相關的變項包含年齡、失禁,當年齡越大時,其日常生活功能會越差;失禁患者之日常生活自理功能的表現也較差。功能性評估結果對住院天數之預測因子分析,表示CDT總分越高則住院天數越久;另外出院時跌倒危險因子的分數越高則住院天數也越久。
結論:本研究結果顯示與文獻所提老人功能衰退包括視力(老花)、聽力(重聽)、步態平衡、跌倒、失禁、營養不良、憂鬱及認知缺失等相符,故在未來照護急性病房老年病人建議進行周全性功能評估以及早發現個別性需求,規劃功能維持之照護計畫,讓老年生活能具有尊嚴及自我存在價值提升。

英文摘要

Objective: The aim of this study mainly focused on the comprehensive assessment of the elderlypatients in acute disease wards. It sought to understand their condition and needs, investigatethe relationship between population demography, basic health status and functional living.
Method: This investigation used the method of cross-sectional studies.At January 1 102 yearsto 102 years on December 31 at a medical center in Taipei City, Patient above 65 years old in amedical ward of the sample, In Geriatrics Comprehensive Assessment scale as a research tool.
Result: Independent function tended to be individually independent. 6 patients (33.3%) wereclassified as 5 times the risk of self-caused falls. MMSE indicated 13 patients (35.1%) with severeimpairment; CDT showed 10 patients (27.8%) with cognitive lost. GDS total for test I indicated 13patients (31.4%) were classified as depressed. the Barthel and IADL analysis for relatedness .Results pointed out that, as the age 、incontinence of the patient increased, their daily functionalability declined. Those who had incontinence would also have exhibited poorer daily functionalability to ones that had normal urinary function. With respect to the functional assessment result onthe prognostic factor hospitalization duration, the higher the CDT total, the longer the duration ofhospitalization. Higher risk factor score for falls after discharge also gives longer hospitalization.
Results from this study for comprehensive geriatric care showed concordance to the Literaturewith the cited references: elderly function deterioration includes eyesight (hyperopia), hearing (impairment),walking stature balance, fall, incontinence, malnutrition, depression and cognitive impairment.Therefore, it would be recommended that, in the future care for the elderly people, geriatriccomprehensive care assessments should be carried out to identify individual needs at an earlystage, in order for long term care plan for functional maintenance to carried out, leading to improvedelderly lifestyle and dign

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