頁籤選單縮合
題 名 | 以周全性老年評估為核心的本土化中期照護社區醫院模式成效=Effectiveness of Comprehensive Geriatric Assessment-Based Intermediate Care in a Community Hospital |
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作 者 | 李威儒; 劉謹儀; 程遠揚; 劉力幗; 陳亮恭; 鄭紹宇; | 書刊名 | 臺灣老年醫學暨老年學雜誌 |
卷 期 | 5:4 2010.11[民99.11] |
頁 次 | 頁248-256 |
分類號 | 419.76 |
關鍵詞 | 周全性老年評估; 老年; 急性後期照護; 中期照護; Comprehensive geriatric assessment; Elderly; Postacute care; Intermediate care; |
語 文 | 中文(Chinese) |
中文摘要 | 目的:評估以周全性老年評估為基礎的本土化中期照護社區醫院模式成效。 方法:本研究係在某社區醫院進行,針對急性疾病治療完成之老年病患,進行跨領域團隊整合性照護,並於入住72小時內與離院前完成兩次周全性老年評估,藉以比較在日常生活、認知、營養、情緒、疼痛與行動力各面向之介入成效。 結果: 2008年4月至2009年3月一年間共收集137例,排除 27例因資料不全或轉介急性醫療之個案後,共有 110例參與本研究,其平均年齡達 84.4±5.4歲。整體而言,進入中期照護服務前後各個面向均有顯著的臨床進步。巴氏量表由 48.1±24.3 進步到 77.8±25(p<0.001)、Lawton及Brody量表由 1.9±1.7 進步到 3.7±2.5(p<0.001)、迷你心智檢查 (mini-mental status examination, MMSE) 分數由 18.0 ± 6.8進步至 20.9 ± 6.8(p<0.001)、簡式老年憂鬱量表(geriatric depression scale, GDS)由 3.0±2.5 進步到 1.4±1.5(p<0.001)、計時起立行走試驗(timed up and go test, TUG)由 45.7±23.7 秒進步到 30.9±20.5秒(p<0.001)、迷你營養評估( mini nutritional assessment, MNA)由 15.7±3.9進步到 18.4±3.0(p<0.001)、數字疼痛評估表( numerical rating scale, NRS)由 3.4±3.1 進步到 1.2±1.7(p<0.001)。 結論:社區醫院模式的中期照護針對急性疾病治療完成之老年病患藉由跨領域醫療的短期整合介入治療後,日常生活、認知、情緒、營養、疼痛與行動力均有明顯的進步,確為一具有明顯成效的服務模式,而中期照護所提升身心功能的長期成效尚待進一步研究加以評估。 |
英文摘要 | Objective: To evaluate the effectiveness of intermediate care (IC) for frail older patients managed by comprehensive geriatric assessment (CGA) and to provide a baseline profile of functional gain during IC services. Method: This is a prospective cohort study conducted in a community hospital. Elderly patients with post acute conditions were recruited and received interdisciplinary integrated care. CGA data were collected within 72 hours of admission and upon discharge so as to compare effectiveness of daily living, cognition, nutrition, emotion, pain control and ambulation. Results: Data of 137 recruited patients were collected during the period from April 2008 to March 2009; 27 of them were excluded due to incomplete data or unplanned readmission to acute ward. Mean age of the 110 eligible patients was 84.4±5.4 years old. Overall, clinical improvement was significant in various dimensions, including cognition (Mini-Mental State Examination from 18.0±6.8 to 20.9±6.8, p <.001), physical function (Barthel Index from 48.1±24.3 to 77.8±25.6, p < .001; Lawton-Brody Instrumental Activities of Daily Living from 1.9±1.7 to 3.7±2.5, p <.001), depression (Geriatric Depression Scale from 3.0±2.5 to 1.4±1.5, p <.001), ambulation (timed up-and-go test from 45.7±23.7 to 30.9±20.5, p < .001), nutrition (Mini Nutritional Assessment from 15.7±3.9 to 18.4±3.0, p <.001, Body Mass Index from 21.6±3.3 to 21.8±3.2, P=.001), and pain control (3.4±3.1to 1.2±1.7, p <.001). Conclusion: A short-term inpatient physical re-enablement program conducted by an interdisciplinary geriatric team in a community hospital can successfully improve the physical and mental function, mood, ambulation, nutritional conditions, and pain control of postacute patients. Further studies are needed to evaluate long- term clinical outcomes. |
本系統中英文摘要資訊取自各篇刊載內容。