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研究生:陳碧雲
研究生(外文):CHEN,PI-YUN
論文名稱:臺北市某社區老人多元預防衰弱介入方案成效評估
論文名稱(外文):Effects of Multicomponent Preventing Frailty Intervention Program among Community-dwelling Elders in Taipei City
指導教授:高森永高森永引用關係
指導教授(外文):KAO, SENYEONG
口試委員:高森永張耀文陳雪芬
口試委員(外文):KAO, SENYEONGCHANG, YAW-WENCHEN,SHUEH-FEN
口試日期:2021-05-19
學位類別:碩士
校院名稱:國防醫學院
系所名稱:公共衛生學研究所
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:2021
畢業學年度:109
語文別:中文
論文頁數:116
中文關鍵詞:社區長者多元預防衰弱介入Kihon Checklist
外文關鍵詞:community-dwelling eldersmulticomponent preventing frailty intervention programKihon Checklist (KCL)
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背景與目的:長者隨著壽命的延長導致身體機能變差進而影響生活品質,因此需要實施肌力強化運動、生活功能重建訓練、社會參與、口腔保健、膳食營養及認知促進的多元預防衰弱介入方案,以促進、維持或恢復長者自我照顧功能,並得延長健康餘命,縮短臥床時間來提升長者生活品質。本研究目的為初步探討社區實施長者多元預防衰弱介入方案的成效及其影響因子。
研究方法:本研究為回溯性研究,研究對象為臺北市某社區2018年3月至2020年6月間,參與長照C據點辦理每期12週預防衰弱介入方案之65歲(含)以上長者,共343位。資料來源為衛生福利部預防及延緩失能照護服務資源管理平台資料庫,資料包含長者之基本特質、評估狀態、參加次數及介入前後評估Kihon Checklist (KCL)之整體總分及獨立生活、運動、營養、口腔、社交、失智、綜合性、憂鬱各面向分數,KCL總分介於0-25分,得分愈低表示健康狀況愈佳。
研究結果:衰弱前期長者參與介入方案在憂鬱面向之變化(ß=-0.368, 95% CI=-0.699~-0.037)呈現統計學上顯著改善;衰弱長者參與介入方案在營養面向變化(ß=-0.436, 95%CI=-0.688~-0.183)、口腔面向變化(ß=-0.602, 95%CI=-1.194~-0.009)、憂鬱面向變化(ß=-1.249, 95%CI=-2.074~-0.423)及KCL整體總分變化(ß=-2.205, 95%CI=-4.150~-0.259)呈現統計學上顯著改善。
結論:結果顯示多元預防衰弱介入方案有助於改善衰弱長者的營養面向變化、口腔面向變化、憂鬱面向變化及KCL整體總分。本研究結果支持多元預防衰弱介入方案,可達到改善長者的衰弱,促進社區長者健康之成效。本研究結果具跨年度和地區性,可提供日後應用於長照C據點、社區關懷據點對衰弱長者成效評估之參考。
關鍵字:社區長者、多元預防衰弱介入、Kihon Checklist
Background and purpose: The deterioration of physical functions of the elderly with the extension of life span, the quality of life is greatly affected. Therefore, it is necessary to implement multiple intervention programs for the prevention of weakness including muscle strengthening exercises, life function reconstruction training, social participation, oral health care, dietary nutrition, and cognitive promotion to promote, maintain or restore the self-care function of the elderly, prolong the health of life, shorten bed rest to improve the quality of life of the elderly. This study preliminarily explores the effectiveness of multiple intervention programs for the elderly to prevent frailty in the community.
Methods: This research is a retrospective design. From March 2018 to June 2020, 343 elderly people participated in the long-term care C base to handle the 12-week prevention intervention program for debilitating, use data base management system of the Ministry of Health and Welfare for the prevention and delay of disability care services. The data includes elders’ age, gender, education level, health status, number of participations and use Kihon Checklist for pre- and post-intervention assessments. The lower of the score means the better of the health.
Results: The results show that the prefrail elderly participated the intervention program, showing a statistically significant improvement in the depression aspect (ß= -0.368, 95 % CI= -0.699- -0.037); the frail elderly participated the intervention program, the nutritional orientation changes (ß: -0.436, 95 % CI= -0.688- -0.183), the oral orientation changes (ß: -0.602, 95 % CI= -1.194- -0.009), and the depression aspect changes (ß: - 1.249, 95 % CI= -2.074- -0.423) and the overall KCL total score change (ß: -2.205, 95 % CI=-4.150- -0.259) showed a statistically significant improvement.
Conclusions: The results show that the multicomponent preventing frailty program may improve oral health care, dietary nutrition, depression and overall KCL scores in community elderly. Findings of this study indicate that the multiple intervention programs may improve the frailty and promote the health of the elderly in the community as well as served as a reference to evaluate of the effectiveness of the frailty prevention programme for the elderly in long-term care and community care.
Keywords: community-dwelling elders, multicomponent preventing frailty intervention program, Kihon Checklist (KCL)
目錄
表目錄 II
圖目錄 III
附錄 目錄 IV
中文摘要 V
Abstract VI
第一章 緒論 1
第一節 研究背景 1
第二節 研究動機 5
第三節 研究重要性與必要性 8
第四節 研究目的 10
第五節 名詞解釋 11
第二章 文獻探討 13
第一節 衰弱 13
第二節 多元預防衰弱介入方案 20
第三節 多元預防衰弱介入方案成效評估與相關因素 26
第三章 研究方法 36
第一節 研究設計與對象 36
第二節 研究架構與假設 38
第三節 研究工具 39
第四節 變項操作型定義 43
第五節 統計分析 45
第四章 研究結果 46
第一節 研究對象特質與 KCL整體總分及各面向 整體總分及各面向分數之布情形 46
第二節 研究對象 KCL整體總分及各面向數變化之影響因子 56
第五章 討論 . 75
第一節 多元預防衰弱介入方案特質與 KCL整體總分及各面向之布情形 75
第二節 老人參與多元預防衰弱介入方案成效 79
第三節 研究限制 83
第六章 結論與建議 84
第一節 結論 84
第二節 建議 85
參考文獻 87
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