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研究生:黃敬淳
研究生(外文):Ching-Chun Huang
論文名稱:罹患失智症對其接受居家/機構護理照護品質之影響
論文名稱(外文):The Effect of Patient with Dementia on Quality of Home and Institutional Health Care
指導教授:吳肖琪吳肖琪引用關係
指導教授(外文):Shiao-Chi Wu
學位類別:碩士
校院名稱:國立陽明大學
系所名稱:衛生福利研究所
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2016
畢業學年度:104
語文別:中文
論文頁數:120
中文關鍵詞:失智症照護品質居家照護機構照護
外文關鍵詞:dementiaquality of carehome health careinstitutional health care
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背景:失智者在病程初期,尚擁有自我照顧能力,然而至晚期生活上幾乎完全依賴他人,甚至有攻擊行為的產生,使其照顧比起一般人困難。過去國外研究發現失智者與非失智者在照護品質上存在差異,國內目前尚未有全國性研究,探討失智者與非失智者在居家或機構照護之照護品質,是否存在差異。

目的:探討罹患失智症是否影響居家或機構照護品質

方法:採回溯性世代研究,以全民健康保險次級資料庫進行分析;研究對象為2008-2012年首次申請健保居家照護65歲以上個案,依照護場域進行分層,以性別、年齡、共病症程度計算傾向分數後,以1:1方式配對出失智組和非失智組,追蹤收案日後一年內呼吸道感染、泌尿道感染、壓瘡、骨折及髖部骨折發生情形;以Stepwise Cox proportional hazard model控制人口學特質、疾病特質、服務機構特質後,分析失智組和非失智組間收案後一年內照護品質差異。

結果:居家照護中失智組呼吸道感染(HR=1.11)、壓瘡(HR=1.43)風險顯著較高,泌尿道感染、骨折與髖部骨折發生風險在居家照護和機構照護場域中兩組間無顯著差異。

結論:本研究發現失智者及非失智者間照護品質仍存在差異,居家照護失智者呼吸道感染及壓瘡風險顯著較高,泌尿道感染、骨折與髖部骨折發生風險不論照護場域兩組間皆無顯著差異。建議衛生主管機關:(1)持續透過人員繼續教育及機構評鑑增進機構照護品質、(2)提升民眾失智症照護素養;建議服務提供者:(1)加強失智症照護技巧、(2)協助轉介長期照顧資源、(3)給予家庭照顧者照顧指導。

Background: Patients with dementia in the early stage of disease still have self-care ability, but they become totally disable and have aggressive behavior in the later period, making it more difficult to take care of them. Several Studies found that there are differences on quality of care between people with and without dementia. However, in Taiwan there has not been a national population-based study identifying whether the quality of care is different between people with and without dementia in home and institutional care.

Objectives: To explore the effect of dementia on quality of care in home and institutional health care.

Methods: The study adopted a retrospective cohort study design, data were derived from the National Health Insurance Research Database, and the subjects were elders who use National Health Insurance Home Health Care at the first time during 2008-2012. Patients were divided into two groups-dementia and non-dementia group by using propensity score with sex, age and comobidity to match subject in each care site. Each case was monitored from the patient’ s entry day until the respiratory tract infection, urinary tract infection, pressure ulcer, fracture and hip fracture occurred or to the end of one year follow-up. Stepwise Cox proportional-
hazards regression was used to analyze the outcome, after controlling demographic, disease and institutional characteristics.

Results: In home health care, dementia group have higher respiratory tract infection risk(AHR=1.11)and pressure ulcer risk(AHR=1.43)than non-dementia group, however there were no difference in urinary tract infection, fracture and hip fracture between two groups during one year after they use services.

Conclusions: Dementia patients have higher risks in respiratory tract infection and pressure ulcer than people without dementia in home health care site. Medical institutions should keep going continuous education courses and monitoring the quality of care in institutional setting and enhance the caring skill of informal caregiver. Formal caregiver should strengthen the skill of dementia care, pass the long-term care information to patients who need it, and teach informal caregiver the skill of caring dementia patients.

目錄
中文摘要 i
Abstract ii
目錄 iii
表目錄 iv
圖目錄 v
第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的 3
第三節 研究問題 3
第四節 研究重要性 4
第五節 重要名詞解釋 4
第二章 文獻探討 5
第一節 失智症與感染之相關研究 5
第二節 失智症與壓瘡之相關研究 13
第三節 失智症與骨折之相關研究 19
第三章 材料與方法 25
第一節 研究設計與架構 25
第二節 研究假設 26
第三節 研究對象 27
第四節 研究變項及其測量 28
第五節 研究資料來源及處理流程 33
第六節 統計分析 36
第四章 研究結果 37
第一節 首次申請健保居家護理老年人之基本特質 37
第二節 罹患失智症對居家/機構照護老年人一年內呼吸道感染之影響 48
第三節 罹患失智症對居家/機構照護老年人一年內泌尿道感染之影響 56
第四節 罹患失智症對居家/機構照護老年人一年內壓瘡之影響 64
第五節 罹患失智症對居家/機構照護老年人一年內骨折及髖部骨折之影響 72
第五章 討論 88
第一節 居家/機構照護的失智與非失智老人呼吸道感染情形 88
第二節 居家/機構照護的失智與非失智老人泌尿道感染情形 91
第三節 居家/機構照護的失智與非失智老人壓瘡情形 93
第四節 居家/機構照護的失智與非失智老人骨折及髖部骨折情形 95
第五節 研究限制 98
第六章 結論與建議 99
第一節 結論 99
第二節 建議 101
參考文獻 102
附錄 111


表目錄
表4-1-1居家照護老年人配對前後基本資料 38
表4-1-2機構照護老年人配對前後基本資料 39
表4-1-3居家照護失智者和非失智者之老年人基本特質比較(配對後) 41
表4-1-4機構照護失智者和非失智者之老年人基本特質比較(配對後) 42
表4-1-5居家/機構照護老年人一年內不良照護結果發生率 46
表4-1-6居家/機構照護老年人罹患失智症對一年內照護品質之影響 47
表4-2-1 居家/機構照護老年人罹患失智症對一年內呼吸道感染之影響分布 52
表4-2-2居家/機構照護老年人罹患失智症對一年內呼吸道感染之影響 53
表4-2-3居家/機構照護老年人罹患失智症對一年內呼吸道感染之影響(續) 54
表4-3-1居家與機構照護老年人罹患失智症對一年內泌尿道感染之影響分布 60
表4-3-2居家/機構照護老年人罹患失智症對一年內泌尿道感染之影響 61
表4-4-2居家/機構照護老年人罹患失智症對一年內壓瘡之影響 69
表4-4-3居家/機構照護老年人罹患失智症對一年內壓瘡之影響(續) 70
表4-5-1 居家/機構照護老年人罹患失智症對一年內骨折之影響分布 76
表4-5-2居家/機構照護老年人罹患失智症對一年內骨折之影響 77
表4-5-3居家/機構照護老年人罹患失智症對一年內骨折之影響(續) 78
表4-5-4 居家/機構照護老年人罹患失智症對一年內髖部骨折之影響分布 83
表4-5-5居家/機構照護老年人罹患失智症對一年內髖部骨折之影響 84
表4-5-6居家/機構照護老年人罹患失智症對一年內髖部骨折之影響(續) 85

圖目錄
圖3-1-1研究架構 25
圖3-5-1 資料處理流程 35
圖4-2-1 居家照護失智者和非失智者之呼吸道感染情形 55
圖4-2-2 機構照護失智者和非失智者之呼吸道感染情形 55
圖4-3-1 居家照護失智者和非失智者之泌尿道感染情形 63
圖4-3-2 機構照護失智者和非失智者之泌尿道感染情形 63
圖4-4-1 居家照護失智者和非失智者之壓瘡情形 71
圖4-4-2 機構照護失智者和非失智者之壓瘡情形 71
圖4-5-1 居家照護失智者和非失智者之骨折情形 86
圖4-5-2 機構照護失智者和非失智者之骨折情形 86
圖4-5-3 居家照護失智組和非失智組之髖部骨折情形 87
圖4-3-4 機構照護失智組和非失智組之髖部骨折情形 87


中文文獻
曲佩芬、李聰明(2002)。長期照護機構之重要一環-院內感染管制。感染控制雜誌,12(2),118-127。
吳仁光、惠群(2013)。護理之家肺炎的臨床特性。內科學誌,24,107-117。
宋怡慧(2011)。台灣失智症患者髖關節骨折發生率之研究。台南:國立成功大學公共衛生研究所碩士論文。
李果鴻(2015)。居家與機構間照護品質之探討-長照十年計劃實施後。台北:國立陽明大學衛生福利研究所碩士論文。
李愛誠、葉玲玲、黃光華、朱僑麗(2012)。居家護理與護理之家照護品質之探討。澄清醫護管理雜誌,8(3),38-46
林民浩、楊安琪、溫在弘(2011)。利用地區差異與人口學特徵評估全民健保資料庫人口居住地變項之推估原則。臺灣公共衛生雜誌,30(4),347-361。
林念璁、繆偉傑、蔡爵任、蘇迎士、黃瑞明、韓玉玲、侯佳弦(2011)。建立台灣長期照護機構之機構內感染之監測指標與現況初探。衛生福利部疾病管制署科技研究發展計劃(編號:DOH100-DC-1021)。
邱咨華、徐盈真、林麗芬、王雅香(2015)。降低內科加護病房泌尿道感染率之改善專案。志為護理,14(1),62-73。
邱照華(2010)。精神科實習手冊。台北市,華杏出版社股份有限公司。
邱銘章、湯麗玉(2009)。失智症照護指南。台北市,原水文化。
施至遠、陳人豪(2008)。老年人吞嚥障礙之評估與處置。長期照護雜誌,12(4),
337-346。
紀美滿、陳瑛瑛(2008)。泌尿道感染之相關危險因素及感染管制政策。榮總護理,25(3),294-299。
唐嘉宏(2014)。失智症患者跌倒與髖部骨折之多重死因分析。台南:國立成功大學公共衛生研究所碩士論文。
高潔純、林麗蟬(2005)。從安全概念探討失智者遊走行為的處置。長期照護雜誌,9(3),223-232。
張淑卿(2013)。從實證資料探討失能老人在居家與機構間移轉情形及照護品質。台北:國立陽明大學衛生福利研究所博士論文
梁家欣、程蘊菁、陳人豪(2014)。失智症之重點回顧。內科學誌,25,151-157。
許貴英(2014)。機構照顧者被失智症患者攻擊之經驗探討。台北:國立台北護理健康大學護理研究所碩士論文。
陳欣(2007)。我國失智症盛行率及其病患醫療利用和死亡情形之探討。台北:國立陽明大學衛生福利研究所博士論文
陳家容、蘇慧芳、謝碧晴(2003)。護理之家機構特性與照護品質相關性研究。護理雜誌,50(3),62-70。doi: 10.6224/jn.50.3.62
陳麗華(2013)。失智症整合照顧。社區發展季刊,104,343-353。
黃惠璣、林季宜、王寶英(2007)。老人或失智老人跌倒危險因子之初探。台灣老人保健學刊,3(1),1-13。
楊榮森(2008)。老年人的跌倒與骨折預防。台灣老年醫學寄老年學雜誌,3(2),78-90。
廖英茵(2008)。長期照護個案之吞嚥困難營養照護。長期照護雜誌,12(4),361-375。
臧麗琳、張憶如(2000)。美國長期照護機構感染管制之發展。感染控制雜誌,10,
342-347。
衛生福利部疾病管制署(2015)。105年度長照機構感染管制查核作業手冊。
賴致淵(2011)。傾向分數配對與確切配對之合併使用:蒙地卡羅模擬研究與實證分析。台北:國立政治大學統計研究所碩士論文。
顏慕庸、顏兆熊(2011)。老人之肺炎。當代醫學,38(2),87-94。

英文文獻
Albrecht, J. S., McGregor, J. C., Fromme, E. K., Bearden, D. T., & Furuno, J. P. (2013). A nationwide analysis of antibiotic use in hospice care in the final week of life. J Pain Symptom Manage, 46(4), 483-490. doi: 10.1016/j.jpainsymman.2012.09.010
Baker, N. L., Cook, M. N., Arrighi, H. M., & Bullock, R. (2011). Hip fracture risk and subsequent mortality among Alzheimer's disease patients in the United Kingdom, 1988-2007. Age Ageing, 40(1), 49-54. doi: 10.1093/ageing/afq146
Beerens, H. C., Sutcliffe, C., Renom-Guiteras, A., Soto, M. E., Suhonen, R., Zabalegui, A. (2014). Quality of life and quality of care for people with dementia receiving long term institutional care or professional home care: the European RightTimePlaceCare study. J Am Med Dir Assoc, 15(1), 54-61. doi: 10.1016/j.jamda.2013.09.010
Burton, L. C., German, P. S., Gruber-Baldini, A. L., Richard Hebel, J., Zimmerman, S., & Magaziner, J. (2001). Medical Care for Nursing Home Residents:Differences by Dementia Status. J Am Geriatr Soc, 49, 142–147.
Cadigan, R. O., Grabowski, D. C., Givens, J. L., & Mitchell, S. L. (2012). The quality of advanced dementia care in the nursing home- the role of special care units. Medical Care, 50, 856–862.
Carol van Doorn, Ann L. Gruber-Baldini, Sheryl Zimmerman, J. Richard Hebel, Cynthia L. Port, Mona Baumgarten, . . . Jay Magaziner. (2003). Dementia as a risk factor for falls and fall injuries among nursing home residents. journal of American Geriatrics Society, 51, 1213–1218.
Castle, N. G., & Ferguson, J. C. (2010). What is nursing home quality and how is it measured? Gerontologist, 50(4), 426-442. doi: 10.1093/geront/gnq052
Chang, S. C., Shiu, M. N., Chen, H. T., Ng, Y. Y., Lin, L. C., & Wu, S. C. (2015). Evaluation of care quality for disabled older patients living at home and in institutions. J Clin Nurs. doi: 10.1111/jocn.12946
Chen, J. S., Sambrook, P. N., Simpson, J. M., Cameron, I. D., Cumming, R. G., Seibel, M. J., Lord, S. R., March, L. M. (2009). Risk factors for hip fracture among institutionalised older people. Age Ageing, 38(4), 429-434. doi: 10.1093/ageing/afp051
Conway, P. H., & Keren, R. (2009). Factors associated with variability in outcomes for children hospitalized with urinary tract infection. J Pediatr, 154, 789-796.
D'Agata, E., Loeb, M. B., & Mitchell, S. L. (2013). Challenges in assessing nursing home residents with advanced dementia for suspected urinary tract infections. J Am Geriatr Soc, 61(1), 62-66. doi: 10.1111/jgs.12070
D'Agata, E., & Mitchell, S. L. (2008). Patterns of antimicrobial use among nursing home residents with advanced dementia. Arch Intern Med, 168(4), 357-362. doi: 10.1001/archinternmed.2007.104

Doupe, M., Brownell, M., St John, P., Strang, D. G., Chateau, D., & Dik, N. (2011). Nursing home adverse events: further insight into highest risk periods. J Am Med Dir Assoc, 12(6), 467-474. doi: 10.1016/j.jamda.2011.02.002
Dufour, A. B., Shaffer, M. L., D'Agata, E. M., Habtemariam, D., & Mitchell, S. L. (2015). Survival After Suspected Urinary Tract Infection in Individuals with Advanced Dementia. J Am Geriatr Soc. doi: 10.1111/jgs.13833
Escott-Stump, S. (2008). Nutrition and Diagnosis-Related Care. 6th ed. Philadelphia: Lippincott Williams & Wilkins
Frank, C., Hodgetts, G., & Puxty, J. (1996). Safety and effcacy of physical restraints for the elderly. Canadian Famiy Physician, 42, 2402-2409.
Friedman, S. M., Menzies, I. B., Bukata, S. V., Mendelson, D. A., & Kates, S. L. (2010). Dementia and hip fractures: development of a pathogenic framework for understanding and studying risk. Geriatr Orthop Surg Rehabil, 1(2), 52-62. doi: 10.1177/2151458510389463
Frytak, J. R., Henk, H. J., Zhao, Y., Bowman, L., Flynn, J. A., & Nelson, M. (2008). Health service utilization among Alzheimer's disease patients: evidence from managed care. Alzheimers Dement, 4(5), 361-367. doi: 10.1016/j.jalz.2008.02.007
Givens, J. L., Kiely, D. K., Carey, K., & Mitchell, S. L. (2009). Healthcare proxies of nursing home residents with advanced dementia: decisions they confront and their satisfaction with decision-making. J Am Geriatr Soc, 57(7), 1149-1155. doi: 10.1111/j.1532-5415.2009.02304.x
Givens, J. L., Selby, K., Goldfeld, K. S., & Mitchell, S. L. (2012). Hospital transfers of nursing home residents with advanced dementia. J Am Geriatr Soc, 60(5), 905-909. doi: 10.1111/j.1532-5415.2012.03919.x
Givens, J. L., Spinella, S., Ankuda, C. K., D'Agata, E., Shaffer, M. L., Habtemariam, D., & Mitchell, S. L. (2015). Healthcare Proxy Awareness of Suspected Infections in Nursing Home Residents with Advanced Dementia. J Am Geriatr Soc, 63(6), 1084-1090. doi: 10.1111/jgs.13435
Hamers, J. P. H., Gulpers, M. J. M., & Strik, W. (2004). Use of physical restraints with cognitively impaired nursing home. J Adv Nurs, 45(3), 246–251.
Hirdes, J. P., FRIES, B. E., MORRIS, J. N., Ikegami, N., Zimmerman, D., Dalby, D. M., . . . and Jones, R. ( 2004). Home Care Quality Indicators (HCQIs) Based on the MDS-HC. The Gerontologist, 44,(5), 665–679.
Hjaltadottir, I., Ekwall, A. K., Nyberg, P., & Hallberg, I. R. (2012). Quality of care in Icelandic nursing homes measured with Minimum Data Set quality indicators: retrospective analysis of nursing home data over 7 years. Int J Nurs Stud, 49(11), 1342-1353. doi: 10.1016/j.ijnurstu.2012.06.004

Holmberg, S. K.(1997).A walking program for wanderers:Volunteer training and development of anevening walker’s group. Geriatric Nursing,18(4),160-165.
Huang, S. W., Lin, J. W., Liou, T. H., & Lin, H. W. (2015). Cohort study evaluating the risk of hip fracture among patients with dementia in Taiwan. Int J Geriatr Psychiatry, 30(7), 695-701. doi: 10.1002/gps.4209
Hutchinson, A. M., Milke, D. L., Maisey, S., Johnson, C., Squires, J. E., Teare, G., & Estabrooks, C. A. (2010). The Resident Assessment Instrument-Minimum Data Set 2.0 quality indicators: a systematic review. BMC Health Serv Res, 10, 166. doi: 10.1186/1472-6963-10-166
Jalbert, J. J., Eaton, C. B., Miller, S. C., & Lapane, K. L. (2010). Antipsychotic use and the risk of hip fracture among older adults afflicted with dementia. J Am Med Dir Assoc, 11(2), 120-127. doi: 10.1016/j.jamda.2009.10.001
Kahan, N. R., Friedman, N. L., Lomnicky, Y., Hemo, B., Heymann, A. D., Shapiro, M., & Kokia, E. (2005). Physician speciality and adherence to guidelines for the treatment of unsubstantiated uncomplicated urinary tract infection among women. Pharmacoepidemiol Drug Saf, 14(5), 357-361. doi: 10.1002/pds.1044
Katherine, B., Vincent, M., John, M., Murphy, K. M., Terry, M., & Yael, H. (2002). Identification and Evaluation of Existing Nursing Homes Quality Indicator. HEALTH CARE FINANCING REVIEW, 23, (4).
Kwong, E. W., Pang, S. M., Aboo, G. H., & Law, S. S. (2009). Pressure ulcer development in older residents in nursing homes: influencing factors. J Adv Nurs, 65(12), 2608-2620. doi: 10.1111/j.1365-2648.2009.05117.x
Lazarus, R., Kleinman, K. P., Dashevsky, I., DeMaria, A., & Platt, R. (2001). Using automated medical records for rapid identification of illness (syndromes syndromic surveillance)-the example of lower respiratory infection. BMC Public Health, 1(1), 9.
Lo, J. C., Pressman, A. R., Chandra, M., & Ettinger, B. (2011). Fracture Risk Tool Validation in an Integrated Healthcare Delivery System. Am J Manag Care, 17(3), 188-194.
Logemann, J., Kahrilas, P., Kovara, M., & Vakil,N. (1989). The benefit of head rotation on pharyngoesophageal dysphagia. Archives of physical and Medical Rehavilitation, 70, 767-771.
Luk,K. H. & Chan, K.Y.(2014). Preventing aspiration pneumonia in older people:do we have the ‘know-how’? Hong Kong Med J, 20, 421–427.
Magaziner, J., Zimmerman, S., Gruber-Baldini, A. L., van Doorn, C., Hebel, J. R., German, P. (2005). Mortality and adverse health events in newly admitted nursing home residents with and without dementia. J Am Geriatr Soc, 53(11), 1858-1866. doi: 10.1111/j.1532-5415.2005.53551.x
Mannix, R., Monuteaux, M. C., Schutzman, S. A., Meehan, W. P., Nigrovic, L. E., & Neuman, M. I. (2013). Isolated Skull Fractures: Trends in Management in US Pediatric Emergency Departments. Annals of Emergency Medicine, 62(4), 327-331. doi: 10.1016/j.annemergmed.2013.02.027
Margolis, D. J., Knauss, J., Bilker, W., & Baumgarten, M. (2003). Medical conditions as risk factors for pressure ulcers in an outpatient setting. Age Ageing, 32( 3), 259–264.
McCloskey, R.M.(2004). Caring for patients with dementia in the acute care environment. Geriatric Nursing, 25(3),139-144.
Mitchell, S. L., Morris, J. N., Park, P. S., & Fries, B. E. (2004). Terminal Care for Persons with Advanced Dementia in the Nursing Home and Home Care Settings. JOURNAL OF PALLIATIVE MEDICINE, 7 (6), 808-816.
Mitchell, S. L., Shaffer, M. L., Kiely, D. K., Givens, J. L., & D'Agata, E. (2013). The study of pathogen resistance and antimicrobial use in dementia: study design and methodology. Arch Gerontol Geriatr, 56(1), 16-22. doi: 10.1016/j.archger.2012.08.001
Mitchell, S. L., Shaffer, M. L., Loeb, M. B., Givens, J. L., Habtemariam, D., Kiely, D. K., & D'Agata, E. (2014). Infection management and multidrug-resistant organisms in nursing home residents with advanced dementia. JAMA Intern Med, 174(10), 1660-1667. doi: 10.1001/jamainternmed.2014.3918
Mitchell, S. L., Teno, J. M., Kiely, D. K., Shaffer, M. L., Jones, R. N., Prigerson, H. G., . . . Hamel, M. B. (2009). The clinical course of advanced dementia. N Engl J Med, 361(16), 1529-1538. doi: 10.1056/NEJMoa0902234
Moïse, P., Schwarzinger, M., & Um, M. (2004). Dementia Care in 9 OECD Countries: A Compara-tive Analysis. OECD Health Working Papers, 13.
Morin, S., Lix, L. M., Azimaee, M., Metge, C., Majumdar, S. R., & Leslie, W. D. (2012). Institutionalization following incident non-traumatic fractures in community-dwelling men and women. Osteoporosis International, 23(9), 2381-2386. doi: 10.1007/s00198-011-1815-7
Myer, L., Womack, J. A., Goulet, J. L., Gibert, C., Brandt, C., Chang, C. C., . . . Justice, A. C. (2011). Increased Risk of Fragility Fractures among HIV Infected Compared to Uninfected Male Veterans. PLoS One, 6(2), e17217. doi: 10.1371/journal.pone.
0017217
Nakrem, S., Vinsnes, A. G., Harkless, G. E., Paulsen, B., & Seim, A. (2009). Nursing sensitive quality indicators for nursing home care: international review of literature, policy and practice. Int J Nurs Stud, 46(6), 848-857. doi: 0.1016/j.ijnurstu.2008.11.005
Pop-Vicas, A., Mitchell, S. L., Kandel, R., Schreiber, R., & D'Agata, E. M. (2008). Multidrug-resistant gram-negative bacteria in a long-term care facility: prevalence and risk factors. J Am Geriatr Soc, 56(7), 1276-1280. doi: 10.1111/j.1532-5415.2008.01787.x
Perls T.T. & Herget M. (1995) Higher respiratory infection rates on an Alzheimer's special care unit and successful intervention. JAGS,43,1341-1344.
Rosenbaum, P. R., & Rubin, D. B. (1983). The central role of the propensity score in observational studies for causal effects. Biometrika, 70(1), 41-55.
Sato, Y., Kanoko, T., Satoh, K., & Iwamoto, J. (2004). Risk factors for hip fracture among elderly patients with Alzheimer's disease. J Neurol Sci, 223(2), 107-112. doi: 10.1016/j.jns.2004.03.033
Silvestre, J. H., Bowers, B. J., & Gaard, S. (2015). Improving the Quality of Long-Term Care. Journal of Nursing Regulation, 6(2), 52-56. doi: 10.1016/s2155-8256(15)30389-6
Singleton, R. J., Holman, R. C., Folkema, A. M., Wenger, J. D., Steiner, C. A., & Redd, J. T. (2012). Trends in lower respiratory tract infection hospitalizations among American Indian/Alaska Native children and the general US child population. J Pediatr, 161(2), 296-302 e292. doi: 10.1016/j.jpeds.2012.02.004
Smith PW, Bennett G, Bradley S, Drinka P, Lautenbach E, Marx J, Mody L, Nicolle L, Stevenson K. (2008).SHEA/APIC Guideline: Infection prevention and control in the long-term care facility. Am J Infect Control, 36(7), 504-535.
Sugarman, J. R., Helgerson, S. D., Connell, F. A., Hansen, A., Jessup, M. C., & Lee, H. (2002). Hip fracture incidence in nursing home residents and community-dwelling older people, Washington State, 1993-1995. JAGS, 50, 1638–1643.
Su H. P., Tseng L. R., Chou C. Y., Chung T. C., Pan T. M.(2005). Legionella pneumophila infection in the Taiwan area. J Infect Chemother 11, 244-249.
Tolppanen, A. M., Lavikainen, P., Soininen, H., & Hartikainen, S. (2013). Incident hip fractures among community dwelling persons with Alzheimer's disease in a Finnish nationwide register-based cohort. PLoS One, 8(3), e59124. doi: 10.1371/journal.pone.0059124
Toscani, F., van der Steen, J. T., Finetti, S., Giunco, F., Pettenati, F., Villani, D., . . . End of Life Observatory-Prospective Study on, D. P. C. E.-P. R. G. (2015). Critical decisions for older people with advanced dementia: a prospective study in long-term institutions and district home care. J Am Med Dir Assoc, 16(6), 535 e513-520. doi: 10.1016/j.jamda.2015.02.012
van der Steen, J. T., Lane, P., Kowall, N. W., Knol, D. L., & Volicer, L. (2012). Antibiotics and Mortality in Patients with Lower Respiratory Infection and Advanced Dementia. J Am Med Dir Assoc, 13(2), 156-161. doi: 10.1016/j.jamda.2010.07.00
Vandervoort, A., Van den Block, L., van der Steen, J. T., Volicer, L., Vander Stichele, R., Houttekier, D., & Deliens, L. (2013). Nursing home residents dying with dementia in Flanders, Belgium: a nationwide postmortem study on clinical characteristics and quality of dying. J Am Med Dir Assoc, 14(7), 485-492. doi: 10.1016/j.jamda.2013.01.016
Verdel, B. M., Souverein, P. C., Egberts, T. C. G., van Staa, T. P., Leufkens, H. G. M., & de Vries, F. (2010). Use of antidepressant drugs and risk of osteoporotic and non-osteoporotic fractures. Bone, 47(3), 604-609. doi: 10.1016/j.bone.2010.06.006
Vincent, M., Berg, K., Joseph, A., David, G., Morris, J., & Moore, T. (2003). The Quality of Quality Measurement in US Nursing Homes. The Gerontologist, 43(Special Issue II), 37–46.
Wang, H. K., Hung, C. M., Lin, C. W., Tai, Y. C., Lu, K., Liliang, P. C., . . . Li, Y. C. (2014). Increased risk of hip fractures in patients with dementia-a nationwide population-based study. BMC Neurology, 14(175).
Wang, W. W., & Moyie, W. (2005). Physical Restraint Use on People With Dementia-a review of the literature. Australian Journal of Advanced Nursing, 22(4), 46-52.
Weller, I., & Schatzker, J. (2004). Hip fractures and Alzheimer's disease in elderly institutionalized Canadians. Ann Epidemiol, 14(5), 319-324. doi: 10.1016/
j.annepidem.2003.08.005
Yates, E., Mitchell, S. L., Habtemariam, D., Dufour, A. B., & Givens, J. L. (2015). Interventions Associated with the Management of Suspected Infections in Advanced Dementia. J Pain Symptom Manage. doi: 10.1016/j.jpainsymman.2015.06.011
Zhao, Y., Kuo, T. C., Weir, S., Kramer, M. S., & Ash, A. S. (2008). Healthcare costs and utilization for Medicare beneficiaries with Alzheimer's. BMC Health Serv Res, 8, 108. doi: 10.1186/1472-6963-8-108
Zimmerman, S., Gruber‐Baldini, A. L., Hebel, J. R., Sloane, P. D., & Magaziner, J. (2002). Nursing home facility risk factors for infection and hospitalization: importance of registered nurse turnover, administration, and social factors. Journal of the American Geriatrics Society, 50(12), 1987-1995.

網路資料
台灣失智症協會(2015)。認識失智症。2015年11月7日,取自http://www.tada2002.
org.tw/tada_know_02.html
台灣泌尿科醫學會(2012)。泌尿道感染保健手冊[第九版]。2016年6月22日,取自
http://www.ntuh.gov.tw/urology/DocLib4/疾病手冊/01泌尿道感染保健手冊[第九
版].pdf
衛生福利部中央健康保險署(2015)。全民健康保險醫療服務給付項目及支付標準。2015
年12月3日,取自http://www.nhi.gov.tw/webdata/webdata.aspx?menu=20&menu_id
=710&webdata_id=3633\
衛生福利部中央健康保險署(2016)。健保新紀元-健保以人為本貼心守護全民健康。
2016年7月5日,取自http://www.nhi.gov.tw/webdata/webdata.aspx?menu=17&
menu_id=659&WD_ID=897&webdata_id=4882
衛生福利部國民健康署(2015)。菸害防制資訊網-成年人吸菸行為調查。2016年6月22日,取自http://tobacco.hpa.gov.tw/Show.aspx?MenuId=581
衛生福利部國民健康署(2011)。骨質疏鬆症臨床治療指引。2016年6月25日,取自http://www.hpa.gov.tw/Bhpnet/Web/Books/Files/005/骨質疏鬆症治療指引.pdf
Alzheimer's Disease International(2015)。About dementia。2015年11月7日,取自
http://www.alz.co.uk/about-dementia
World Health Organization(2015)。Dementia。2015年12月16日,取自http://www.who
int/mediacentre/factsheets/fs362/en/


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