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系統識別號 U0026-2512201213104300
論文名稱(中文) 探討身體功能衰退老人出院後三個月功能恢復情形及其影響因素
論文名稱(英文) Determinants of physical function recovery in elderly during three‐months post-hospitalization
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 101
學期 1
出版年 101
研究生(中文) 張巧玟
研究生(英文) Chiao-Wen Chang
電子信箱 pipi0503@gmail.com
學號 T26991072
學位類別 碩士
語文別 中文
論文頁數 54頁
口試委員 召集委員-張家銘
口試委員-顏妙芬
指導教授-陳清惠
中文關鍵字 功能衰退  功能恢復  住院老人 
英文關鍵字 Functional decline  Functional recovery  Hospitalization elderly 
學科別分類
中文摘要 背景:老人住院常因疾病或活動受限導致功能衰退,過去研究顯示超過30%的住院老人有功能衰退的現象,台灣甚至高達70%。且在出院三個月後,恢復至住院前身體功能的機率不到75%。功能衰退不僅能影響老人生活品質更甚至造成死亡率的提升。目的:本研究旨在探討身體功能衰退老人出院後三個月功能恢復情形及其影響因素。方法:研究採橫斷性相關性研究,藉2008年「探討住院老人功能衰退的危險因子」國科會研究計畫資料進行次級資料分析。該研究於台南市某醫學中心之8個內科病房,針對65歲以上且能以國台語溝通的住院老人為對象,依方便取樣篩選符合收案之住院老人,並進行結構性問卷調查。筆者擷取原始資料中之個案基本資料、入院診斷、查爾森共病症指標、迷你智能狀態測驗、凱茲日常生活活動量表、住院前之平日活動情形等,並使用SPSS17.0 for windows進行描述性及推論性統計分析。結果:住院老人於出院後三個月仍有54.22% 尚未恢復至其原有的身體功能狀態。是否有規律活動為住院老人身體功能恢復的獨立影響因素(p = 0.027 < 0.01)。臨床運用:規律活動與否可作為預測老人出院後功能恢復的參考指標。未恢復功能之老人於三個月後發生尿失禁的比例較高,這表示未恢復的老人續發其他老人症候群比例較高。此研究結果可提供臨床人員或社區照護團隊,在進行照護時,針對已發生或易發生功能衰退的老人族群給予指導,以期能維護住院老人獨立生活能力。
英文摘要 Background: For many older adults, hospitalization can lead to functional decline because of diseases or activity restriction. Previous studies found that 70% hospitalized older adults experienced functional decline in Taiwan. Less than 75% of them could regain their previous physical function, three months post-hospitalization. The experience functional decline may not only affect the quality of life but else increase the mortality rate. Objective: The aim of this study was to describe functional recovery and its determinants among elderly patient three months post-hospitalization. Method: This was a cross-sectional study, using secondary data analysis. The data originated from a research project, functional decline among hospitalized elderly. Subjects of the original project were recruited through convenience sampling from eight medical units at a university hospital in southern Taiwan. Inclusion criteria were patients aged ≥ 65 years and were capable of communication. For the purpose of this study, the demographic information, Charlson comorbidity index, Mini-mental state examination, Katz ADL and associated information were retrieved from original data. Results: More than half (54.22%) elderly had persistent functional impairment 3 months post-hospitalization. Regular physical activity (p = 0.027 < 0.01) is the only independent factor associated with functional recovery. Implications for Practice: Regular physical activity can be used as reference indicators predicting functional recovery of the elderly after discharge. Those elderly who didn't to regain baseline ADL function, experience higher risk of other Geriatric syndrome. This resultsmay be used for planning future clinical care or community interventions.
論文目次 摘要 I
Abstract III
致謝 V
目錄 VII
表目錄 X
圖目錄 XI
第一章緒論 1
第一節研究動機及背景 1
第二節研究目的 3
第三節研究問題 3
第二章文獻查證 3
第一節老人身體功能衰退 3
第二節住院與老人身體功能衰退 4
第三節老人身體功能恢復及其影響因素 8
第三章 研究架構與假設 13
第一節 研究架構 13
第二節 名詞界定 14
第三節 研究假設 16
第四章 研究方法與研究過程 16
第一節 研究設計 16
第二節 資料來源與內容 17
第三節 研究對象 18
第四節 研究過程 18
第五節 研究工具 19
第六節 統計分析 22
第七節 倫理考量 23
第五章研究結果 24
第一節 研究對象之基本資料 24
第二節 出院三個月後老人身體功能恢復及其相關因素 31
第六章 討論 33
第一節 老人出院後三個月內的身體功能恢復狀況 33
第二節 影響老人出院後身體功能恢復之相關因素 34
第七章 結論與建議 40
第一節 結論 40
第二節 研究限制與未來研究的建議 41
第三節 臨床運用與未來實務建議 41
參考文獻 42
附件 50
附件一 查爾森共病症指標(Charlson comorbidity index;CCI): 50
附件二 簡易智能狀態測驗(Mini-Mental State Examination;MMSE) 51
附件三 凱茲日常生活活動量表(Katz Index of Independence in Activities of Daily Living;Katz ADL) 52
附件四 勞頓工具性日常生活功能量表(Lawton IADL): 53
附件五 出院後身體活動紀錄表: 54

表目錄
表2-1「住院對老人之不良影響」 7
表2-2「文獻提出相關出院老人身體功能恢復影響因素之彙整」 11
表4-1「描述性統計分析整理表」 23
表5-1 「兩組間住院時各變項之比較」 26
表5-1 「兩組間住院時各變項之比較」(續) 27
表5-2 「兩組間出院時各變項之比較」 28
表5-3 「兩組間3個月時各變項之比較」 29
表5-2 「使用羅吉斯迴歸探討研究個案中影響身體功能恢復狀況之獨立影響因素」 32

圖目錄
圖3-1 「研究架構圖」 13
圖4-1 「原始資料收案流程圖」 18
圖5-1「兩組於不同時間點Katz ADL得分」 30
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