臺灣博碩士論文加值系統

本研究旨在比較居家活動功能正常及失能老人營養狀況之差異，並探討影響營養狀況之可能因子。以175位年齡大於65歲，居住於家中之活動功能正常與失能老人為受試者，藉由血液檢查及體位測量評估其營養狀況，另以問卷調查其人口學特性、健康狀況、日常生活活動功能、營養知識及營養素攝取量。研究結果顯示，與活動功能正常老人相比，失能老人之年齡較大，與家人同住之比例較高，三頭肌皮脂厚度、舒張壓、收縮壓及日常生活活動功能指數較低。在營養素攝取量方面，失能老人之熱量及醣類攝取量皆較活動功能正常老人低，且其紅血球、血紅素、血清鐵、總鐵結合量、運鐵飽和度及轉運鐵蛋白、白蛋白及總蛋白亦顯著性低於活動功能正常老人。而失能老人之熱量、蛋白質及醣類攝取量低於RDNA，且有高貧血及蛋白質營養不足現象。另由兩組之高密度脂蛋白膽固醇≦35 mg/dL及總膽固醇/高密度脂蛋白膽固醇比、腰臀比高於正常值的比例均有偏高的現象，顯示居家老人為心血管疾病高危險群。經相關性分析發現，活動功能正常老人之高密度脂蛋白膽固醇與三頭肌皮脂厚度及腰臀比呈負相關。失能老人之血紅素與三頭肌皮脂厚度呈正向關，與蛋白質攝取量呈負相關。而女性失能老人之白蛋白與日常生活活動功能呈現正性相關。綜合上述結果顯示，失能老人有營養不良的現象，居家老人三頭肌皮脂厚度、腰臀比、日常生活活動功能及營養素攝取量之適當維持，或許為促進其營養狀況之重要因子。

The purpose of this study was to compare the nutritional status between normal activity and disable elderly in Taichung County. One hundred and seventy-five subjects age over 65 years and living in home were included in this study. Demographic characteristics, activities of daily living, health status, nutritional knowledge and nutrient intakes of homebound elderly were investigated by interview method. Anthropometric, hematological and biochemical parameters were also measured. The results showed the disable elderly had higher average age and percentage living with families. The triceps skinfold valus, diastolic pressure, systolic pressure, activities of daily living, energy and carbohydrate intakes, RBC, hemoglobin, serum iron, TIBC, transferrin saturation, transferring, albumin, total protein of disable group were lower than the normal activity group. The intakes of energy, protein and carbohydrate in disable elderly were lower than Taiwanese RDNA, and this group had high ratio of anemia and protein malnutrition. However, the percentages of abnormal HDL-cholesterol value, total cholesterol/ HDL-cholesterol ratio and Waist/Hip ratio were high in both normal and disable elderly showed the homebound elderly had high risk of cardiac-vascular disease. Correlation analysis found there were significantly negative correlations between HDL-cholesterol with triceps skinfold and waist / hip ratio in normal activity elderly. Hemoglobin was positively related to triceps skinfold and negatively related to protein intake in disable elderly, and the significant positive correlations between albumin and activities of daily living in female disable elderly were also found. In summary, we conclude that the disable homebound elderly was malnutrition, the maintenance of triceps skinfold, waist / hip ratio, activities of daily living and the proper nutrient intakes may be the important factors to the nutritional status of homebound elderly.

中文摘要 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I
英文摘要 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .III
目 錄 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . V
表 目 錄 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . VII
圖 目 錄 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X
附表目錄 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XI
第 一 章 前 言 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
第 二 章 文 獻 回 顧 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
第一節 老人之定義 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
第二節 老化之定義及理論 . . . . . . . . . . . . . . . . . . . . . . . . 4
第三節 老年人口指標 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
第四節 老年人營養狀況之相關探討 . . . . . . . . . . . . . . . . 8
第五節 慢性病及失能之相關探討 . . . . . . . . . . . . . . . . . 12
第 三 章 材 料 與 方 法 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
第一節 研究架構 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
第二節 研究設計與研究流程圖 . . . . . . . . . . . . . . . . . . . 19
第三節 研究對象 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
第四節 問卷效度評估及預試 . . . . . . . . . . . . . . . . . . . . . 23
第五節 訪員訓練 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
第六節 問卷調查表之內容 . . . . . . . . . . . . . . . . . . . . . . . 25
第七節 體位測量之方法 . . . . . . . . . . . . . . . . . . . . . . . . . 29
第八節 血液生化值測量之方法 . . . . . . . . . . . . . . . . . . . 30
第九節 資料統計分析 . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
第 四 章 結 果 與 討 論 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
第一節 人口學特性分析 . . . . . . . . . . . . . . . . . . . . . . . . . 40
第二節 體位測量值 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
第三節 健康狀況 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
第四節 日常活動評估 . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
第五節 營養知識 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
第六節 熱量及營養素攝取 . . . . . . . . . . . . . . . . . . . . . . . 56
第七節 血液生化值 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
第八節 血液生化值與人口學特性、體位測量
值、日常活動評估、營養知識、熱量
及營養素攝取之相關性分析 . . . . . . . . . . . . . . . 71
第 五 章 結 論 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .82
參考文獻 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..83

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