進階搜尋


下載電子全文  
系統識別號 U0026-0702201409291100
論文名稱(中文) 出院時行走失能高齡病人返家後的恢復經驗
論文名稱(英文) The experience of recovery from ambulation disability among discharged elderly patients
校院名稱 成功大學
系所名稱(中) 護理學系
系所名稱(英) Department of Nursing
學年度 102
學期 1
出版年 103
研究生(中文) 黃璇如
研究生(英文) Hsuan-Ju Huang
學號 T26001055
學位類別 碩士
語文別 中文
論文頁數 116頁
口試委員 召集委員-張家銘
指導教授-陳清惠
口試委員-陳麗光
中文關鍵字 行走失能  出院老人  質性研究  恢復經驗 
英文關鍵字 ambulation disability  discharged elderly  qualitative research  recovery experience 
學科別分類
中文摘要 背景及目的
慢性病、住院、失能都是晚年極可能遭遇的生活情境。常發現住院老人因行走困難帶來身體功能衰退的問題,而且會將失能帶回到社區中。過去已有研究證實,出院時失能老人返家後有部分身體功能可恢復。但是,極少有研究從正面角度去探究,為何有一部份老人能克服疾病的衝擊,恢復最佳的功能狀態。再者,從現有的文獻可知動機是個人決定恢復行動的要素,但是對於當中影響的細節及對行動策略的影響尚未有研究探討。故本研究目的為瞭解出院時行走失能老人返家後,在動機驅使下恢復行動能力的歷程。
工具及方法
採用質性研究方法,於台南某醫學中心老年科門診進行,採取立意取樣(purposive sampling)獲得豐富的訪談資料,訪談對象為(1)年齡大於或等於65歲、(2)意識清楚、(3)住院期間未接受手術治療、(5)出院時較入院前有行走功能衰退並返家照護、(6)於門診進行追蹤,在返家照護後三個月內恢復行走、(7)經由詳細的研究說明後願意參加者;排除條件為中重度重聽者。資料收集採用半結構式訪談大綱,針對出院時行走功能衰退、現已恢復行走功能的感受及經驗,進行面對面深度訪談;資料收集過程,採錄音及逐字記錄方式進行;資料分析主要應用ATLAS.ti來進行資料持續比較。本研究共有四位參與者,一位男性,三位女性,參與者年齡分布為73歲至87歲。
結果
「順應」是在台灣文化下完成的研究結果,本研究是從台南市某教學醫院高齡科病房出院的老人進行研究參與者的招募,此結果僅能代表部分出院時行走失能老人返家後,從行走受限至恢復的經驗。透過本研究四位參與者的訪談資料,發現行走功能恢復經驗內含三個主題為順應治療、勿擾兒女、彈性調整行動,且受前置、阻力與助力因素影響。由本研究結果,可提供未來進行出院老人行走功能衰退恢復相關研究時,對此主題有一基礎概念。
結論
從研究結果得知老人返家後最常接受親友的協助,特別是家人的部分。而醫療資源的輔助卻是少被提及的部分,可以知悉目前整個醫療脈絡仍是以急性醫療為主軸,對於持續照護的概念仍需加以建構。
英文摘要 Chronic illness, hospitalization, and functional disability are common health issues among older adults. This study aims to discover the motivation and recovery of walking ability for the elderly with ambulation disabilities, after being discharged from the hospital. The study adopted the purposive sampling in an elderly clinic of a medical center in Tainan City to collect data. The inclusion criteria were: 1) age 65 or over; 2) mentally healthy; 3) without surgery during hospitalization; 5) decreasing in walking function during hospitalization and returning home for care; 6) continuing a follow-up in a clinic and walking again within 3 months after returning home. One-on-one interviews were conducted with the subjects who had a walking disability when leaving the hospital but currently recovered, in order to learn about their feels and experience. Both audio and verbatim recordings were used for collecting data. ATLAS.ti was employed for data analysis. There were four interviewees in total, including one male and three females, and their ages are between 73 and 87. “Adaptation” is the research result completed in the Taiwanese culture. This study found that the recovery of walking ability includes three factors such as adapting treatment, being independent, and agricultural adjustment act. The results suggest that the seniors, when returning home, often receive assistance from relatives and friends, especially from families.
論文目次 目 錄
中文摘要 I
英文摘要 III
誌 謝 VI
表目錄 X
圖目錄 XI
第壹章 緒論 1
第一節 研究背景 1
第二節 研究動機與重要性 3
一、 研究族群與住院的關係 3
二、 過去研究結果 4
三、 老人照護展望 5
第三節 研究目的 7
第四節 研究問題 7
第貳章 文獻查證 8
第一節 住院對老人身體功能的影響 8
第二節影響老人恢復行走功能的因子 10
第三節 與出院時行走失能老人恢復相關之經驗 19
第四節名詞界定 24
第叁章 研究方法 25
第一節 研究設計 25
第二節 研究參與者之選擇 27
第三節 研究工具之建立與運用 29
一、個人健康狀況 29
二、訪談大綱與訪談問題 33
第四節 研究者的個人準備 35
第五節 資料收集過程 39
第六節 資料整理與分析 42
一、文本資料整理 42
二、資料分析過程 43
第七節 研究嚴謹度 47
一、信賴性(credibility) 48
二、可轉換性(transferability) 49
三、可靠性(dependability) 50
四、可確認性(conformability) 50
五、解釋的有效性(interpretive validation) 51
第八節 倫理考量 52
一、自主權(Autonomy) 52
二、保密(Confidentiality) 52
三、好處及危險(Benefit-risk) 53
第肆章 研究發現 55
第一節 研究參與者背景資料簡介 55
第二節 核心概念「順應」 59
第三節 「順應」的主題 61
第四節「順應」的前置因素 67
第五節「順應」的助力與阻力 69
第五章討論 74
第一節與出院時行走失能老人恢復相關的文獻進行比較 74
第二節與相關理論進行比較 77
一、壓力因應理論(stress and coping theory) 77
二、賦權理論(empowerment theory) 77
第六章 研究結論與建議 79
第一節 研究結論 79
第二節 研究建議與研究限制 81
一、研究建議 81
二、研究限制 83
附錄一、人體試驗委員會上課時數證明 100
附錄二、訪談前基本資料收集內容 101
附錄三、訪談大綱及訪談問題 107
附錄四、觀察日記舉例 109
附錄五、人體試驗委員會通過同意書 111
附錄六、研究參與者逐字稿檢視回饋函 112
附錄七、研究參與者主題檢附回饋函回饋函 113
附錄八、中正大學質性資料分析方法課程時數證明 114
附錄九、質性資料電腦分析課程時數證明 115
附錄十、訪談回饋函 116
表目錄
表2-2住院失能老人出院後身體功能恢復因素之研究 16
表3-1個人健康狀況 32
表3-2代碼意義查詢表 42
表3-3 開放性編碼舉例 44
表3-4主軸性編碼舉例 45
表3-5選擇性編碼舉例 46
表3-6台南區老人心理輔導專線 52
表4-1研究參與者健康狀況 57
圖目錄
圖2-1影響出院老人身體功能恢復因素 23
圖3-1出院時行走失能高齡病人返家後的恢復經驗之研究過程甘特圖 26
圖3-2資料收集過程 41
圖4-1順應 60
參考文獻 王雲東、鄧志松(2009)。我國長期照護服務需求評估。行政院經濟建設委員會委託之研究報告。台北市:國立台灣大學。
內政部統計處(2011年3月12日)。98年台灣老人生活狀況調查。【內政統計通報】。取自http://www.moi.gov.tw/stat/news_Content.aspx?sn=5060
李玉春(2011年6月29日)。長期照護保險給付支付制度標準研習會。取自http://www.doh.gov.tw/ufile/doc/1000629%E9%95%B7%E4%BF%9D%E7%B5%A6%E4%BB%98%E6%94%AF%E4%BB%98%E5%88%B6%E5%BA%A6%E8%A6%8F%E5%8A%83%E7%A0%94%E8%A8%8E%E6%9C%83.pdf
行政院經濟建設委員會(2012年7月5日)。2012年至2060年臺灣人口推計。【中華民國2012年至2060年人口推計報告】取自http://www.cepd.gov.tw/m1.aspx?sNo=0000455
行政院衛生署(2012年8月9日)。99年度衛生統計-全民健保醫療統計。【99年度衛生統計動向】取自http://www.doh.gov.tw/CHT2006/DM/DM2_2.aspx?now_fod_list_no=12183&class_no=440&level_no=2
江佩紋(2011)。住院老人功能衰退與跌倒關係之探討(未出版之碩士論文)。國立成功大學,台南市。
李宜玲、胡名霞(2012)。居家物理治療對失能老人之介入與療效。物理治療,37(3), 277-289。
吳芝儀、廖梅花(譯)(2001)。質性研究法入門:紮根理論研究方法(原著A. Strauss & J. Corbin)。嘉義市:濤石。(原著出版年:1998)
高淑清(2008)。質性研究的18堂課-首航初探之旅(頁71)。高雄:麗文文化。
陳月枝、劉淑娟、穆佩芬、趙可、盧孳艷、徐亞瑛(2000)。質性護理研究方法。台北市:護望。
陳向明(2004)。社會科學質的研究。台北市:五南。
黃惠子、陳清惠(2009)。住院老人功能衰退的危險因素及照護。護理雜誌,56(1),85-90。
詹惠雅、曾建寧(2010)。從社會環境之觀點探討台灣出院準備服務。臺灣醫學,14(3),346-350。
劉淑娟(1998)。台灣社區老人的健康觀念與健康行為。護理雜誌,45(6),22-28。
羅大維、郭亮君、唐憶淨(2012)。髖關節骨折患者入住中期照護之成效探討。台灣老年醫學暨老年學雜誌,7(1),20-36。
魏玲玲、徐美玲、王佳惠、王淑怡(譯)(2007)。護理研究的倫理議題。護理研究概論(原著R. M. Nieswiadomy)(65-80頁)。台北市:五南。(原著出版年:2002)
Alarcon, T., Barcena, A., Gonzalez-Montalvo, J. I., Penalosa, C., & Salgado, A. (1999). Factors predictive of outcome on admission to an acute geriatric ward. Age Ageing, 28(5), 429-432.
Annells, M. (1997). Grounded theory method, part I:within the five moments of qualitative research. Nursing Inquiry, 4, 120-129.
Archibald, G. (2003). Patients' experiences of hip fracture. Journal of Advanced Nursing, 44(4), 385-392.
Ballard, C. G., Shaw, F., Lowery, K., McKeith, I., & Kenny, R. (1999). The prevalence, assessment and associations of falls in dementia with Lewy bodies and Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 10(2), 97-103.
Barry, L. C., Murphy, T. E., & Gill, T. M. (2011). Depression and functional recovery after a disabling hospitalization in older persons. Journal of the American Geriatrics Society, 59(7), 1320-1325. doi: 10.1111/j.1532-5415.2011.03453.x
Barnes, D. E., Mehta, K. M., Boscardin, W. J., Fortinsky, R. H., Palmer, R. M., Kirby, K. A., & Landefeld, C. S. (2013). Prediction of recovery, dependence or death in elders who become disabled during hospitalization. Journal of General Internal Medicine, 28(2), 261-268. doi: 10.1007/s11606-012-2226-y
Batavia, A. I. & Batavia, M. (2004). Disability, chronic condition, and iatrogenic illness. Archives of Physical Medicine and Rehabilitation, 85(1), 168-171.
Beers, M. H. (2004). Hospital care. In M. H. Beers & T. V. Jones (Eds.), The Merck manual of health & aging (pp. 123-135,175-185). Whitehouse Station, NJ: Merck Research Laboratories.
Bettger, J. A., Coster, W. J., Latham, N. K., & Keysor, J. J. (2008). Analyzing change in recovery patterns in the year after acute hospitalization. Archives of Physical Medicine and Rehabilitation, 89(7), 1267-1275. doi: 10.1016/j.apmr.2007.11.046
Bentler, S. E., Liu, L., Obrizan, M., Cook, E. A., Wright, K. B., Geweke, J. F., . . . Wolinsky, F. D. (2009). The aftermath of hip fracture: discharge placement, functional status change, and mortality. American Journal of Epidemiology, 170(10), 1290-1299. doi: 10.1093/aje/kwp266
Bowling, A., Gabriel, Z., Dykes, J., Dowding, L. M., Evans, O., Fleissig, A., . . . Sutton, S. (2003). Let's ask them: a national survey of definitions of quality of life and its enhancement among people aged 65 and over. Journal of Aging and Human Development, 56(4), 269-306.
Boyd, C. M., Xue, Q. L., Simpson, C. F., Guralnik, J. M., & Fried, L. P. (2005). Frailty, hospitalization, and progression of disability in a cohort of disabled older women. American Journal of Medicine, 118(11), 1225-1231. doi: 10.1016/j.amjmed.2005.01.062
Boyd, C. M., Landefeld, C. S., Counsell, S. R., Palmer, R. M., Fortinsky, R. H., Kresevic, D., & Covinsky, K. E. (2008). Recovery of activities of daily living in older adults after hospitalization for acute medical illness. Journal of the American Geriatrics Society, 56(12), 2171-2179. doi: 10.1111/j.1532-5415.2008.02023.x
Boyd, C. M., Ricks, M., Fried, L. P., Guralnik, J. M., Xue, Q. L., Xia, J., & Bandeen-Roche, K. (2009). Functional decline and recovery of activities of daily living in hospitalized, disabled older women: the Women's Health and Aging Study I. Journal of the American Geriatrics Society, 57(10), 1757-1766. doi: 10.1111/j.1532-5415.2009.02455.x
Brach, J. S., & Van-Swearingen, J. M. (2002). Physical impairment and disability: relationship to performance of activities of daily living in community-dwelling older men. Physical Therapy, 82(8), 752-761.
Buurman, B. M., Hoogerduijn, J. G., Haan, R. J., Hanna, A. A., Lagaay, A. M., Verhaar, H. J., & Rooij, S. E. (2011). Geriatric conditions in acutely hospitalized older patients: prevalence and one-year survival and functional decline. PLoS One, 6(11), e26951. doi: 10.1371/journal.pone.0026951
Charlson, M. E., Pompei, P., Ales, K. L., & MacKenzie, C. R. (1987). A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. Journal of Chronic Diseases, 40(5), 373-383.
Chaudhry, S. I., Friedkin, R. J., Horwitz, R. I., & Inouye, S. K. (2004). Educational disadvantage impairs functional recovery after hospitalization in older persons. American Journal of Medicine, 117(9), 650-656. doi: 10.1016/j.amjmed.2004.06.026
Chen, C. C., Wang, C., & Huang, G. H. (2008). Functional trajectory 6 months posthospitalization: a cohort study of older hospitalized patients in Taiwan. Nursing Research, 57(2), 93-100. doi: 10.1097/01.NNR.0000313485.18670.e2
Chen, C. C., Dai, Y. T., Yen, C. J., Huang, G. H., & Wang, C. (2010). Shared risk factors for distinct Geriatric Syndromes in older Taiwanese inpatients. Nursing Research, 59(5), 340-347. doi: 10.1097/NNR.0b013e3181eb31f6
Chen, C. C., Yen, C. J., Dai, Y. T., Wang, C., & Huang, G. H. (2011). Prevalence of geriatric conditions: a hospital-wide survey of 455 geriatric inpatients in a tertiary medical center. Arch Gerontol Geriatr, 53(1), 46-50. doi: 10.1016/j.archger.2010.06.003
Covinsky, K. E., Fortinsky, R. H., Palmer, R. M., Kresevic, D. M., & Landefeld, C. S. (1997). Relation between symptoms of depression and health status outcomes in acutely ill hospitalized older persons. Annals of Internal Medicine, 126, 417-425.
Covinsky, K. E., Pierluissi, E., & Johnston, C. B. (2011). Hospitalization-associated disability: "She was probably able to ambulate, but I'm not sure". Journal of the American Medical Association, 306(16), 1782-1793. doi: 10.1001/jama.2011.1556
Creditor, M. C. (1993). Hazards of hospitalization of the elderly. Annals of Internal Medicine, 118(3), 219-223.
De-Groot, V., Beckerman, H., Lankhorst, G., & Bouter, L. (2003). How to measure comorbiditya critical review of available methods. Journal of Clinical Epidemiology, 56(3), 221-229. doi:10.1016/S0895-4356(02)00585-1
Dwyer, D. (2011). Experiences of registered nurses as managers and leaders in residential aged care facilities: a systematic review. International Journal of Evidence-Based Healthcare, 9(4), 388-402. doi: 10.1111/j.1744-1609.2011.00239.x
Ettinger, W. H. (2011). Can hospitalization-associated disability be prevented. Journal of the American Medical Association, 306(16), 1800-1801. doi: 10.1001/jama.2011.1563
Fishbein, M., & Ajzen, I. (1975). Belief, Attitude, Intention, and Behavior: An Introduction to Theory and Research. Reading, MA: Addison-Wesley.
olkman, S. , & Lazarus, R. S. (1984). Stress, appraisal, and coping. New York : Springer Publishing Company.
Forster, A. J., Clark, H. D., Menard, A., Dupuis, N., Chernish, R., Chandok, N., . . . van Walraven, C. (2004). Adverse events among medical patients after discharge from hospital. Canadian Medical Association Journal, 170(3), 345-349.
Fried, L. P., Ferrucci, L., Darer, J., Williamson, J. D., & Anderson, G. (2004). Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. Journal of Gerontology: Medical Sciences, 59(3), 255-263.
Gibson, H. C. (1991). A concept analysis of empowerment. Journal of Advanced Nursing, 16, 354-361.
Gill, T. M., Allore, H. G., Holford, T. R., & Guo, Z. (2004). Hospitalization, restricted activity, and the development of disability among older persons. Journal of the American Medical Association, 292(17), 2115-2124. doi: 10.1001/jama.292.17.2115
Gill, T. M., Allore, H. G., Gahbauer, E. A., & Murphy, T. E. (2010). Change in disability after hospitalization or restricted activity in older persons. American Medical Association, 304(17), 1919-1928.
Glesne, C. (2005). The personal dimension: Rapport, subjectivity, and reflexivity. In C. Glesne (Eds.), Becoming qualitative research: An introduction. (pp. 109-128). New York, NY: Longman.
Graf, C. (2006). Functional decline in hospitalized older adults. American Journal of Nursing, 106(1), 58-67.
Grimmer, K., Moss, J., & Falco, J. (2004). Experiences of elderly patients regarding independent community living after discharge from hospital: a longitudinal study. International Journal for Quality in Health Care, 16(6), 465-472. doi: 10.1093/intqhc/mzh071
Guba, E. G., & Lincoln, Y. S. (2001). Guidelines and checklist for constructivist (a.k.a. Fourth generation) evaluation. Retrieved May 22, 2011, from http://www.wmich.edu/evalctr/archive_checklists/constructivisteval.pdf
Guralnik, J. M., Ferrucci, L., Simonsick, E. M., Salive, M. E., & Wallace, R. B. (1995). Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. New England Journal of Medicine, 332(9), 556-561. doi: 10.1056/nejm199503023320902
Guralnik, J. M., Ferrucci, L., Pieper, C. F., Leveille, S. G., Markides, K. S., Ostir, G. V., . . . Wallace, R. B. (2000). Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 55(4), 221-231.
Hall, S. F. (2006). A user's guide to selecting a comorbidity index for clinical research. Journal of Clinical Epidemiology 59(8), 849-855. doi: 10.1016/j.jclinepi.2005.11.013
Hall, M. J., DeFrances, C. J., Williams, S. N., Golosinskiy, A., & Schwartzman, A. (2010). National hospital discharge survey: 2007 summary. National Health Stat Report, 29, 1-20.
Hardy, S. E., & Gill, T. (2005). Factors associated with recovery of independence among newly disabled older persons. Archives of Internal Medicine 165, 106-112. doi: doi:10.1001/archinte.165.1.106
Hama, S., Yamashita, H., Kato, T., Shigenobu, M., Watanabe, A., Sawa, M., . . . Kitaoka, T. (2008). 'Insistence on recovery' as a positive prognostic factor in Japanese stroke patients. Psychiatry Clinical Neurosciences, 62(4), 386-395. doi: 10.1111/j.1440-1819.2008.01816.x
Hayward, R. D., & Krause, N. (2012). Trajectories of disability in older adulthood and social support from a religious congregation: a growth curve analysis. J Behav Med. doi: 10.1007/s10865-012-9430-4
Henry-Sanchez, J. T., Kurichi, J. E., Xie, D., Pan, Q., & Stineman, M. G. (2012). Do elderly people at more severe activity of daily living limitation stages fall more. American Journal of Physical Medicine & Rehabilitation, 91(7), 601-610. doi: 10.1097/PHM.0b013e31825596af
Hoogerduijn, J. G., Schuurmans, M. J., Duijnstee, M. S., Rooij, S. E., & Grypdonck, M. F. (2007). A systematic review of predictors and screening instruments to identify older hospitalized patients at risk for functional decline. Journal of Clinical Nursing, 16(1), 46-57. doi: 10.1111/j.1365-2702.2006.01579.x
Hoogerduijn, J. G., Buurman, B. M., Korevaar, J. C., Grobbee, D. E., de Rooij, S. E., & Schuurmans, M. J. (2012). The prediction of functional decline in older hospitalised patients. Age and ageing, 41(3), 381-387. doi: 10.1093/ageing/afs015
Huang, H. T., Chang, C. M., Liu, L. F., Lin, H. S., & Chen, C. H. (2013). Trajectories and predictors of functional decline of hospitalised older patients. Journal of Clinical Nursing. doi: 10.1111/jocn.12055
Inouye, S. K., Wagner, D. R., Acampora, D., Horwitz, R. I., Cooney, L. M., Jr., Hurst, L. D., & Tinetti, M. E. (1993). A predictive index for functional decline in hospitalized elderly medical patients. Journal of General Internal Medicine, 8(12), 645-652.
Inouye, S. K. (2006). Delirium in Older Persons. New England Journal of Medicine, 354(11), 1157-1165.
Inouye, S. K., Studenski, S., Tinetti, M. E., & Kuchel, G. A. (2007). Geriatric syndromes: clinical, research, and policy implications of a core geriatric concept. Journal of the American Geriatrics Society, 55(5), 780-791. doi: 10.1111/j.1532-5415.2007.01156.x
Jette, A. M. (2006). Toward a common language for function, disability, and health. Physical Therapy, 86(5), 726-734.
Kable, A. K., Gibberd, R. W., & Spigelman, A. D. (2002). Adverse events in surgical patients in Australia. International Journal of Health Care Quality Assurance, 14(4), 269-276.
Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A., & Jaffe, M. W. (1963). Studies of illness in the aged the index of ADL: A standardized measure of biological and psychosocial function. Journal of the American Medical Association, 185, 914-919.
King, B. G. (2006). Functional decline in hospitalized elders. Medsurg Nursing, 15(5), 265-271.
Koenig, H. G., George, L. K., & Titus, P. (2004). Religion, spirituality, and health in medically ill hospitalized older patients. Journal of the American Geriatrics Society, 52(4), 554-562. doi: 10.1111/j.1532-5415.2004.52161.x
Kortebein, P. (2009). Rehabilitation for hospital-associated deconditioning. American Journal of Physical Medicine & Rehabilitation, 88(1), 66-77. doi: 10.1097/PHM.0b013e3181838f70
Lafont, C., Gerard, S., Voisin, T., Pahor, M., & Vellas, B. (2011). Reducing "iatrogenic disability" in the hospitalized frail elderly. Journal of Nutrition Health & Aging, 15(8), 645-660.
Lang, P. O., Meyer, N., Heitz, D., Drame, M., Jovenin, N., Ankri, J., . . . Blanchard, F. (2007). Loss of independence in Katz's ADL ability in connection with an acute hospitalization: early clinical markers in French older people. European Journal of Epidemiology, 22(9), 621-630. doi: 10.1007/s10654-007-9150-1
Lawton, M. P., & Brody, E. M. (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist, 9(3), 179-186.
Lin, C. L., & Chang, S. Y. (2004). Functional Recovery Among Elderly People One Year After Hip Fracture Surgery. Journal of Nursing Research, 24(1), 72-82.
Magaziner, J., Fredman, L., Hawkes, W., Hebel, J. R., Zimmerman, S., Orwig, D. L., & Wehren, L. (2003). Changes in functional status attributable to hip fracture: a comparison of hip fracture patients to community-dwelling aged. American Journal of Epidemiolog, 157(11), 1023-1031.
Maggi, S., Siviero, P., Wetle, T., Besdine, R. W., Saugo, M., & Crepaldi, G. (2010). A multicenter survey on profile of care for hip fracture: predictors of mortality and disability. Osteoporosis International, 21(2), 223-231. doi: 10.1007/s00198-009-0936-8
Mahoney, J. E., Eisner, J., Havighurst, T., Gray, S., & Palta, M. (2000). Problems of older adults living alone after hospitalization. Journal of General Internal Medicine, 15(9), 611-619. doi: 10.1046/j.1525-1497.2000.06139.x
Mason, J. (2002). Sampling and selection in qualitative research. In J. Mason (Eds.), Qualitative Researching (pp. 125-144), London, England: SAGE Publications.
Matzen, L. E., Jepsen, D. B., Ryg, J., & Masud, T. (2012). Functional level at admission is a predictor of survival in older patients admitted to an acute geriatric unit. BioMed Central of Geriatrics, 12, 32. doi: 10.1186/1471-2318-12-32
McCusker, J., Kakuma, R., & Abrahamowicz, M. (2002). Predictors of functional decline in hospitalized elderly patients: a systematic review. Journal of Gerontology: Medical Sciences, 57(9), 569-577.
McAuley, E., Konopack, J. F., Morris, K. S., Motl, R. W., Hu, L., Doerksen, S. E., & Rosengren, K. (2006). Physical activity and functional limitations in older women: influence of self-efficacy. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 61(5), 270-277.
Merriam, S. B. (2009). Qualitative reserach: A guide to design and implementation. Sacramento, CA: Jossey-Bass.
Miller, E. A., & Weissert, W. G. (2000). Predicting elderly people's risk for nursing home placement, hospitalization, functional impairment, and mortality: a synthesis. Medical Care Research and Review, 57(3), 259-297.
Nakao, H., Yoshikawa, T., Hara, T., Wang, L., Suzuki, T., & Fujimoto, S. (2007). Thresholds of physical activities necessary for living a self-supporting life in elderly women [Abstract]. Osaka city medical journa, 53(2), 53-61.
Norman, K., Pichard, C., Lochs, H., & Pirlich, M. (2008). Prognostic impact of disease-related malnutrition. Clinical Nutrition, 27(1), 5-15.
Nyunt, M.S., Lim, M.L., Yap, K. B., & Ng, T. P. (2012). Changes in depressive symptoms and functional disability among community-dwelling depressive older adults. International Psychogeriatrics, 24(10), 1633-1641. doi:10.1017/S1041610212000890
Ortiz-Alonso, F. J., Vidan-Astiz, M., Alonso-Armesto, M., Toledano-Iglesias, M., Alvarez-Nebreda, L., Branas-Baztan, F., & Serra-Rexach, J. A. (2012). The pattern of recovery of ambulation after hip fracture differs with age in elderly patients. Journal of Gerontology: Medical Sciences, 67(6), 690-697. doi: 10.1093/gerona/glr231
Patton, M. Q. (2001). Qualitative interviewing. In M. Q. Patton (Eds.), Qualitative research & evaluation methods (pp. 405-418). California, CA: SAGE Publications.
Pedersen, M. M., Bodilsen, A. C., Petersen, J., Beyer, N., Andersen, O., Lawson-Smith, L., . . . Bandholm, T. (2013). Twenty-four-hour mobility during acute hospitalization in older medical patients. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 68(3), 331-337. doi: 10.1093/gerona/gls165
Ploit, D. F., & Beck, C. T. (2010). Nursing research: generating and assessing evidence for nursing practice. (8th ed.). Philadelphia: Wolters Kluwer Health.
Ponzetto, M., Zanocchi, M., Maero, B., Giona, E., Francisetti, F., Nicola, E., & Fabris, F. (2003). Post-hospitalization mortality in the elderly. Archives of Gerontology and Geriatrics, 36, 83-91.
Portegijs, E., Buurman, B. M., Essink-Bot, M. L., Zwinderman, A. H., & Rooij, S. E. (2012). Failure to regain function at 3 months after acute hospital admission predicts institutionalization within 12 months in older patients. Journal of the American Medical Directors Association, 13(6), 561-567. doi: 10.1016/j.jamda.2012.04.003
Randström, K. B., Asplund, K., Svedlund, M., & Paulson, M. (2012). Activity and participation in home rehabilitation: Older people’s and family members’ perspectives. Journal of Rehabilitation Medicine, 45(2). doi: 10.2340/16501977-1085
Rigby, H., Gubitz, G., Eskes, G., Reidy, Y., Christian, C., Grover, V., & Phillips, S. (2009). Caring for stroke survivors: baseline and 1-year determinants of caregiver burden. International Journal of Stroke 4(3), 152-158. doi: 10.1111/j.1747-4949.2009.00287.x
Saxena, S. K., Ng, T. P., Koh, G., Yong, D., & Fong, N. P. (2007). Is improvement in impaired cognition and depressive symptoms in post-stroke patients associated with recovery in activities of daily living. Acta Neurologica Scandinavica, 115(5), 339-346. doi: 10.1111/j.1600-0404.2006.00751.x
Schillerstrom, J. E., Royall, D.R., & Palmer, R. F. (2008). Depression, disability and intermediate pathways: A review of longitudinal studies in elders. Journal of Geriatric Psychiatry and Neurology, 21(3), 183-197. doi: 10.1177/0891988708320971
Sekaran, N. K., Choi, H., Hayward, R. A., & Langa, K. M. (2013). Fall-associated difficulty with activities of daily living in functionally independent individuals aged 65 to 69 in the United States: a cohort study. Journal of the American Geriatrics Society, 61(1), 96-100. doi: 10.1111/jgs.12071
Shepperd, S., McClaran, J., Phillips, C. O., Lannin, N. A., Clemson, L. M., McCluskey, A., . . . Barras, S. L. (2010). Discharge planning from hospital to home. Cochrane Database of Systematic Reviews, 1, CD000313. doi: 10.1002/14651858.CD000313.pub3
Sonn, U. (1996). Longitudinal studies of dependence in daily life activities among elderly persons. Scandinavian Journal of Rehabilitation Medicine rehabilitation. 34, 1-35.
Spector, W. D., & Fleishman, J. A. (1998). Combining Activities of Daily Living with Instrumental Activities of Daily Living to measure functional disability. Journal of Gerontology: Social sciences, 53(1), 46-57.
Stel, V. S., Pluijm, S. M., Deeg, D. J., Smit, J. H., Bouter, L. M., & Lips, P. (2004). Functional limitations and poor physical performance as independent risk factors for self-reported fractures in older persons. Osteoporosis International, 15(9), 742-750. doi: 10.1007/s00198-004-1604-7
Strauss, A. & Corbin, J. (1990). Basics of Qualitative Research. California, CA: SAGE Publications.
Suchy, Y., Williams, P. G., Kraybill, M.L., Franchow, E., & Butner, J. (2010). Instrumental Activities of Daily Living among community-dwelling older adults: Personality associations with self-report, performance, and awareness of functional difficulties. Journal of Gerontology: Psychological Sciences, 65(5), 542-550. doi: 10.1093/geronb/gbq037
Sylliaas, H., Thingstad, P., Wyller, T. B., Helbostad, J., Sletvold, O., & Bergland, A. (2012). Prognostic factors for self-rated function and perceived health in patient living at home three months after a hip fracture. Disability & Rehabilitation, 34(14), 1225-1231. doi: 10.3109/09638288.2011.643333
Tollen, A., Fredriksson, C., & Kamwendo, K. (2008). Elderly persons with disabilities in Sweden: their experiences of everyday life. Occupational Therapy International, 15(3), 133-149. doi: 10.1002/oti.254
Tollen, A., Kamwendo, K., & Ivarsson, A. B. (2011). Changes in everyday life after discharge from day care rehabilitation. International Journal of Qualitative Studies onHealth and Well-being, 6(1). doi: 10.3402/qhw.v6i1.5753
Tucker, D., Molsberger, S. C., & Clark, A. (2004). Walking for wellness: a collaborative program to maintain mobility in hospitalized older adults. Geriatric Nursing, 25(4), 242-245. doi: 10.1016/j.gerinurse.2004.06.009
United States Census Bureau. (2011, July 26). Latest U.S. Disability Statistics and Facts [Disabled World towards tomorrow about disability information]. Retrieved from http://www.disabled-world.com/disability/statistics/census-figures.php
Ween, J. E., Mernoff, S. T., & Alexander, M. P. (2000). Recovery rates after stroke and their impact on outcome prediction. Neurorehabilitation & Neural Repair, 14(3), 229-235.
Wenger, G. C. (2001). Interviewing older people. In J. F. Gubrium & J. A. Holstein (Eds.), Handbook of interview research: Content & method (pp. 259-278). California, CA: SAGE Publications.
World Health Organization (WHO). (2013.1.). Disabilitis. Retrieved from http://www.who.int/topics/disabilities/en/
Wu, H. Y., Sahadevan, S., & Ding, Y. Y. (2006). Factors associated with functional decline of hospitalised older persons following discharge from an acute geriatric unit. Ann Acad Med Singapore, 35(1), 17-23.
Ziden, L., Scherman, M. H., & Wenestam, C. G. (2010). The break remains – elderly people's experiences of a hip fracture 1 year after discharge. Disability & Rehabilitation, 32(2), 103-113. doi: 10.3109/09638280903009263
Zisberg, A., Shadmi, E., Sinoff, G., Yaish, N. G., Srulovici, E., & Admi, H. (2011). Low mobility during hospitalization and functional decline in older adults. Journal of the American Geriatrics Society, 59(2), 266-273. doi: 10.1111/j.1532-5415.2010.03276.x
論文全文使用權限
  • 同意授權校內瀏覽/列印電子全文服務,於2017-02-10起公開。
  • 同意授權校外瀏覽/列印電子全文服務,於2017-02-10起公開。


  • 如您有疑問,請聯絡圖書館
    聯絡電話:(06)2757575#65773
    聯絡E-mail:etds@email.ncku.edu.tw