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系統識別號 U0026-0812200915052509
論文名稱(中文) 出院後老年患者健康生活型態之探討
論文名稱(英文) Healthy lifestyle in elders after discharge
校院名稱 成功大學
系所名稱(中) 護理學系碩博士班
系所名稱(英) Department of Nursing
學年度 97
學期 1
出版年 98
研究生(中文) 邱琪雯
研究生(英文) Chi-Wen Chiou
電子信箱 t2694403@mail.ncku.edu.tw
學號 t2694403
學位類別 碩士
語文別 中文
論文頁數 123頁
口試委員 指導教授-陳清惠
口試委員-王靜枝
口試委員-劉立凡
中文關鍵字 改變  健康生活型態  住院老人 
英文關鍵字 hospitalization elderly  change  healthy lifestyle 
學科別分類
中文摘要 執行健康生活型態可減少老年患者慢性疾病罹病率、死亡率及減少住院與再入院機率,然而探討住院前後健康生活型態改變研究甚少,且影響因素仍不明確。故本研究目的為探討老年患者於住院前後健康生活型態(飲食、運動、休閒暨社會活動參與、抽菸、喝酒、吃檳榔、服藥安全及預防性健康照護)改變現況及相關影響因素。採前瞻性相關性研究,使用質量性合併資料,自民國97年5月12日至9月3日選取南部某醫學中心一般內科病房65歲以上患者,以立意取樣方式邀請60位符合條件者參與研究,於住院及返家後3個月使用結構式問卷訪談收集資料,並於返家後一星期收集開放性問卷資料。利用SPSS14.0 for Windows套裝電腦統計軟體進行描述性及推論性統計。
研究結果顯示,歷經住院後,整體健康生活型態、飲食型態、運動執行、活動參與、無抽菸、無喝酒及服藥安全較住院前好。抽菸、喝酒、吃檳榔方面,返家後有4人戒菸或減量,2人反而加重菸量,住院前有喝酒習慣者,返家後皆戒酒或減量,所有個案皆不吃或已戒檳榔。預防性健康照護方面,定期量血壓與施打流感疫苗為較常執行的項目。飲食型態為改善最多的面向,經濟足夠者、年齡較輕者的飲食控制較良好。運動方面,返家後有70%患者運動,有運動比率增加10%,但整體運動量較住院前少,金錢足夠、疾病診斷數較少、慢性疾病數三種以上、疾病嚴重度較低、初次住院、三年內住院次數較少、距上次住院間隔年數較久及未再入院者較會去運動。休閒暨社會活動參與方面,有66.7%患者返家後有參與活動,以外出休閒娛樂居多,與人口學、健康狀況變項無顯著關係。服藥安全方面,返家後單項平均得分為3.92分,表示大部分患者在服藥安全執行偏良好,無工作者、慢性疾病數三種以上者及住院天數低者的服藥安全良好。開放式問句結果分析,親友協助是改善健康生活型態的主要原因,其次是醫護人員提示。此結果將可提供臨床醫療人員參考,運用住院機會,與親友討論擬定健康生活型態重建或維持計畫,以減少老年患者再入院機率。
英文摘要 The adoption of healthy lifestyle was essential to reduce the likelihood of morbidity, mortality, hospitalization and readmission. However, only few studies explored the healthy lifestyle and its related factors in elders after discharge. The research purpose was to explore healthy lifestyle (diet, exercise, leisure and social activity, smoking, drinking, eating betel nut, medication taking habits, and preventive healthy care ) change after hospitalization and its related factors in elders. Prospective design was used in the study. Both qualitative and quantitative data were collected. A purposive sample of 60 subjects who aged over 65 in one medical center of south Taiwan had been conduct to recruit from May 12 to September 3, 2008. A structured questionnaire was used to collect data by face to face interview from admission and three month after discharge. The open-question was used in one week after discharge. Descriptive and inferential statistics was applied to analyze the data by using SPSS for Windows 14.0 statistical software.
The results showed that all healthy lifestyle improved after hospital admission. There were 4 persons quit or decreased to tobacco after discharge, but 2 persons were not. The patients who had drink habits would quit or decrease amount of drink after discharge. Taking blood pressure and influenza vaccine on regular time schedule were often executing in preventive healthy care. Diet was the most improve dimension of healthy lifestyle. Subjects who were young and had enough money were good performance of diet. Results showed that 70% of subjects engaged in exercise. The rate of exercise was increased 10% after discharge. However, the amount of exercise was less than pre-test. Subjects who had enough money, less diagnosis, more than tree chronic diseases, less co-morbidity score, first admission experience, less frequency of admission during three years, long years that during last admission and no readmission were more than others to exercise. There were 66.7% of subjects took part in leisure and social activity. Recreation was the most activity that subjects attended. There were no significance difference in demographic data and health status with leisure and social activity. The mean of drug adherence after discharge was 3.92 that indicated most of subjects were good performance in taking medicines. Subjects who had on job, more than tree chronic diseases and less duration of hospitalization were good performance of drug adherence. Results of open-question showed that the assistance of family was the most improve reason of healthy lifestyle, and then was clinicians. The result of this study may provide information for clinicians and discussed with their family to improve healthy lifestyle of elderly after hospitalization.
論文目次 摘要......................................................I
致謝......................................................V
目錄....................................................VII
表目錄...................................................IX
圖目錄...................................................XI
附件目錄.................................................XI
第一章 緒論.............................................1
第一節 研究動機與重要性.................................1
第二節 研究目的.........................................4
第二章 文獻查證.........................................5
第一節 健康生活型態定義.................................5
第二節 老年健康生活型態.................................6
第三節 住院前後健康生活型態改變現況與相關因素..........20
第三章 研究問題與研究架構..............................25
第一節 研究問題........................................25
第二節 研究架構........................................26
第四章 研究方法與過程..................................27
第一節 名詞界定........................................27
第二節 研究設計與對象..................................29
第三節 研究工具的測量與信效度..........................30
第四節 資料收集過程及研究對象之倫理考量................36
第五節 資料分析與解釋..................................39
第五章 研究結果........................................41
第一節 人口學屬性、健康狀況、健康生活型態之現況........41
第二節 住院前後健康生活型態改變之現況..................59
第三節 返家後三個月健康生活型態執行現況與人口學變項、健康
狀況之相關分析..................................64
第四節 健康資源結果分析................................73
第六章 討論............................................76
第一節 住院前後健康生活型態執行現況....................76
第二節 老年患者返家後健康生活型態與人口學變項、健康狀況之
關係............................................81
第三節 健康資源與健康生活型態改變之關係................86
第七章 結論與建議......................................88
第一節 結論............................................88
第二節 研究結果之應用與建議............................90
第三節 研究限制及未來研究建議..........................92
參考文獻.................................................94

圖表目錄
表2-1 老年健康生活型態內容................................7
表2-2 老年人的健康生活型態量表整理.......................11
表2-3 生活型態量表與文獻整合相關項目的評估比較...........13
表3-1 工具施測時間.......................................35
表3-2 健康生活型態量表專家效度CVI值......................35
表4-1 資料分析整理表.....................................40
表5-1 人口學變項.........................................43
表5-2 健康狀況...........................................46
表5-3-1 住院前後飲食控制.................................49
表5-3-2 住院前後身體運動.................................52
表5-3-3 住院前後休閒暨社會活動參與.......................53
表5-3-4 住院前後抽菸、喝酒、吃檳榔.......................55
表5-3-5 住院前後服藥安全.................................57
表5-3-6 住院前預防性健康照護.............................58
表5-4-1 住院前後健康生活型態改變情形.....................61
表5-4-2 住院前後各健康生活型態比較.......................62
表5-5 返家後整體健康生活型態在人口學變項、健康狀況間之關
係.................................................67
表5-6-1 返家後三個月飲食控制、服藥安全與人口學變項、健康狀
況之相關分析.....................................69
表5-6-2 返家後三個月活動參與、身體運動與人口學變項、健康狀
況之相關分析.....................................70
表5-7-1 返家後三個月飲食控制/服藥安全執行良好與較差兩組在年
齡、住院天數、疾病診斷數、距上次住院間隔年數、疾病
嚴重度及日常生活活動之差異分析...................71
表5-7-2 返家後三個月有無參與休閒暨社會活動/身體運動兩組在年
齡、住院天數、疾病診斷數、距上次住院間隔年數、疾病
嚴重度及日常生活活動之差異分析...................72
表5-8-1 整體健康生活型態平均值總合有無改善與有無健康資源之
關係.............................................75
表5-8-2 返家後整體健康生活型態平均值總合有改善者在有無健康
資源之得分差異分析...............................75
表6-1 各變項與返家後健康生活型態之相關分析總整理.........87
圖一 研究架構圖..........................................26
圖二 研究流程............................................38

附件目錄
附件一 同意書...........................................102
附件二 凱茲日常生活活動量表.............................104
附件三 人口學基本資料量表...............................105
附件四 健康生活型態量表.................................106
附件五 疾病嚴重量表.....................................109
附件六 成大醫院人體試驗委員會審核通過證明...............110
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