高齡住院病人衰弱現況及其影響因子

Factors Influencing Frailty in Elderly Hospitalized Patients

10.6142/VGHN.201903_36(1).0003

周美香(Mei-Hsiang Chou)；陳芬如(Fen-Ju Chen)；邱群芳(Chun-Fang Chiu)；林育德(Yu-Te Lin)

高齡 ； 衰弱 ； 周全性老年評估 ； elderly people ； frailty ； comprehensive geriatric assessment

榮總護理

36卷1期（2019 / 03 / 01）

27 - 38

繁體中文

衰弱是高齡長者功能退化的前兆，了解衰弱相關因素及早介入措施，則有機會逆轉衰弱，預防或延緩失能的發生。本研究利用周全性老年評估探討影響高齡病人衰弱之相關因素。採用次級資料分析法，資料為個案管理師收集南部某醫學中心2015年5月至2016年9月住院之65歲以上病人住院3天內周全性老年評估之資料，再以Fried衰弱指標定義衰弱與非衰弱個案，資料以SPSS 18.0版進行卡方檢定、獨立樣本t檢定和二元邏輯式迴歸統計分析。符合研究個案共有124人，住院老人的衰弱比率為88.7%，非衰弱比率為11.3%。衰弱與非衰弱兩組之年齡、迷你營養評估簡式（MNA-SF）得分、老年憂鬱量表（GDS）得分、迷你心智狀態檢查（MMSE）得分、住院前及住院之日常生活功能巴氏量表得分、住院之工具性日常生活量表得分與生活品質量表（Euro Qol-5D-3L）得分，具顯著差異。日常生活功能巴氏量表、迷你營養簡式評估結果為預測衰弱的相關因子。研究結果提供照護團隊了解影響高齡住院病人衰弱的相關因素，進而擬定住院與出院後照護計畫，以加強返家後日常生活功能及營養照護，期預防及改善高齡病人衰弱的相關問題。

Frailty is a precursor to the functional deterioration of health in elderly people. Recognizing frailty-related factors and potential early intervention measures for elderly people could help to reverse frailty and to prevent and delay the onset of disability. This study employed the comprehensive geriatric assessment to explore factors related to the frailty of elderly patients. This study had a secondary analysis design. Data were collected by case managers from patients who were over 65 years of age and hospitalized for up to 3 days at a medical center in southern Taiwan from May 2015 to September 2016. Case managers conducted the comprehensive geriatric assessment for older hospitalized patients. This study defines frailty and nonfrailty using the Fried frailty index. Data were analyzed using the chi-square test, the independent sample t-test, and binary logistic regression by SPSS. The study included 124 elderly patients. The hospitalization rate for the frailty of Fried was 88.7% and that for nonfrailty was 11.3%. Frailty scores differed significantly for age, Mini Nutritional Assessment Short-Form (MNA-SF) scores, Geriatric Depression Scale scores, Mini Mental State Examination scores, Barth index scores, IADL scores, and EuroQol-5D-3L scores. In addition, results for the Barth index and the MNA-SF served as predictors for frailty of the elderly patients. These findings could inform care teams regarding relative factors affecting frailty of elderly patients. Furthermore, appropriate care programs may be developed, including hospitalization and postdischarge aid to improve daily routines and nutrition and subsequently prevent or alleviate issues affecting frail elderly patients at home.

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