Effectiveness of Family Care Intervention Program on Activity of Daily Living Among

家庭照護介入計劃對失能病患日常生活活動之成效

洪麗珍(Li-Chen Hung)；郭憲文(Hsien-Wen Kuo)

成效 ； 家庭照護介入計劃 ； 日常生活活動 ； 失能病患 ； Effectiveness ； family care intervention program ； activity of daily living (ADL) ； disabled patients

The Journal of Nursing Research

9卷5期（2001 / 12 / 01）

191 - 202

英文

The objective of this prospective study was to compare the improvement of activity of daily living (ADL) scores between two groups of disabled patients who participated in a family care intervention program. 137 patients were selected from health stations and Activity of Daily Living (ADL) scores were assessed eight times over a period of 22 weeks. Family caregivers were trained to provide home nursing care for the disabled. The patients were divided into two groups: early-stage (intervention started less than 6 months from diagnosis) and late-stage (intervention started 7-24 months from diagnosis). Over the duration of the intervention program, the results, using ANCOVA test, showed that the ADL score of the early-stage had group increased by 12.9, compared to the later-stage group, which increased by 3.0 (p ＜ .000). At one-year follow-up, the ADL score of the early-stage group increased by a greater extent (6.2) than the later-stage group (1.3). The factors that affected ADL scores of the survivals were as follows: age, baseline ADL score and duration of disability. The authors conclude that the intervention program was most effective in improving ADL score when intervention was implemented early.

The objective of this prospective study was to compare the improvement of activity of daily living (ADL) scores between two groups of disabled patients who participated in a family care intervention program. 137 patients were selected from health stations and Activity of Daily Living (ADL) scores were assessed eight times over a period of 22 weeks. Family caregivers were trained to provide home nursing care for the disabled. The patients were divided into two groups: early-stage (intervention started less than 6 months from diagnosis) and late-stage (intervention started 7-24 months from diagnosis). Over the duration of the intervention program, the results, using ANCOVA test, showed that the ADL score of the early-stage had group increased by 12.9, compared to the later-stage group, which increased by 3.0 (p ＜ .000). At one-year follow-up, the ADL score of the early-stage group increased by a greater extent (6.2) than the later-stage group (1.3). The factors that affected ADL scores of the survivals were as follows: age, baseline ADL score and duration of disability. The authors conclude that the intervention program was most effective in improving ADL score when intervention was implemented early.

1. Boult, C., Dowd, B., McCaffrey, D., Boult, L., Hernandez, R., Krulewitch, H.(1993).Screening Elders for Risk of Hospital Admission.Journal of the American Geriatrics Society,41(8)
2. Cowley, S.(1999).Early Interventions: Evidence for Implementing Sure Start.Community Practitioner,72(6)
3. Epstein, C. F.(1992).A System Consultation Approach in Later-Stage Care.Boston:Mosby Year Book.
4. Harris, M. R., Warren, J. J.(1995).Patient Outcomes: Assessment Issues for the CNS.Clinical Nurse Specialist,9(2)
5. Jorgensen, H. S., Nakayama, H., Raaschou, H., Vive-Laesen, J., Stier, M., Olsen, T.(1995).Outcome and Time Course of Recovery in Stroke, Part I: Outcome: The Copenhagen Stroke Study.Archives of Physical Medicine ＆ Rehabilitation,76(5)
6. Kono, A., Kanagawa, K.(1998).Daily Life Patterns Associated With 18-Months Changes of Disability Ability Among Frail Elderly Living at Home.Japanese Journal of Public Health,45(8)
7. Peters, D. A.(1995).Outcomes: The Mainstay of a Framework for Quality of Care.Journal of Nursing Care Quality,10(1)
8. Phillips, L. R., Morrison, E., Steffl, B., Chae, Y. M., Cromwell, S. L., Russell, C. K.(1995).Effects of the Situational Context and Interactional Process on the Quality of Family Caregiving.Research in Nursing and Health,18(3)
9. Reuben, D. B., Rubenstein, L. V., Hirsch, S. H., Hays, R. D.(1992).Value of Functional Status as a Predictor of Mortality: Results of a Prospective Study.American Journal of Medicine,93(6)
10. Rice, D. P., Laplante, M. P.(1992).Medical Expenditures for Disability and Disabling Comorbidity.American Journal of Public Health,82(5)
11. Travers, A. F.(1996).Caring for Older People: Carers.British Medical Journal,313(7055)
12. Verbrugge, L. M., Patrick, D. L.(1995).Seven Chronic Conditions: Their Impact on US Adults' Activity Levels and use of Medical Services.American Journal of Public Health,85(2)
13. Wade, D.(1992).Measurement in Neurological Rehabilitation.Current Opinion in Neurology and Neurosurgery,5(5)
14. Wolinsky, F. D., Callahan, C. M., Fitzgerald, J. F., Johnson, R. J.(1993).Changes in Functional Status and the Risks of Subsequent Nursing Home Placement and Death.Journal of Gerontology,48(3)
15. World Health Organization(1980).International Classification of Impairments, Disability, and Handicaps.Geneva:World Health Organization.
16. Yamashita, K., Araki, S., Murata, K., Tamiya, N., Sasaki, K.(1996).Factors Affecting ADL Improvement and QOL in Stroke Patients: A Community-Based Study.Japanese of Public Health,43(6)
17. 吳淑如 Wu, Shu-Zu、 邱啟潤 Chiou, Chii-Jun(1997)。居家照護病患照護問題相關因素之探討 The Exploration of Related Factors of Nursing Care Problems in Home Health Care Patients。護理研究 The Journal of Nursing Research，5(3)
18. 杜明勳 Tu, Ming-Shium、 王復維 Wang, Fu-Wei(1998)。影響居家照護病患巴氏活動量表功能改變之因素探討 An Analysis of Factors that Influence On Patients' Bathel Score in A Home Health Care Setting。中華民國家庭醫學雜誌 Chinese Journal of Family Medicine，8(1)
19. 林美娜 、 邱啟潤 Chiou, Chii-Jun(1995)。居家中風老人之家庭照護品質 The Quality of Family Care For the Elderly Homebound Stroke Victim。護理研究 The Journal of Nursing Research，2(2)
20. 洪麗珍 Hung, Li-Chen、 劉千琪 Liu, Chien-Chi、 郭憲文 Kuo, Hsien-Wen、 黃美娜 Hwang, Mei-Nah、 張麗華 Zhang, Li-Hua、 林菊枝 Lin, Jyur-Jy(1999)。主照顧者接受照護指導對居家長期臥床患照護之影響 Effectiveness of Nursing Instructions Given to Caregivers of Long-Term Bedridden Patients。護理研究 The Journal of Nursing Research，7(4)
21. 胡幼慧 Hu, Yow-Hwey、 王孝仙 Wang, Shaw-Shain、 郭淑珍 Kuo, Shu-Chen(1995)。家人照護失能老人的困境：一項質化與量化整合的研究 Home Care for Disabled Elderly: An Integration of Qualitative and Quantitative Research。公共衛生 Public Health Quarterly，22(2)
22. 曾建寧 Tseng, Chien-Ning(1998)。臺北，國立陽明大學臨床護理研究所。

1. 曹昭懿、胡名霞、李宜玲、李世代(2015)。長短期失能個案居家物理治療服務利用與療效─以台北都會區為例。臺灣公共衛生雜誌，34(6)，657-669。
2. 溫千慧、楊仲棋、陳佳鳳、卓妙如(2007)。運用巴氏量表於出血性腦中風患者復健治療三個月成效追蹤。臺灣家庭醫學雜誌，17(4)，250-299。