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研究生:李志濤
研究生(外文):Li, Chi-To
論文名稱:某護理之家住民骨質疏鬆症盛行率及相關危險因子探討: 一項先驅性研究
論文名稱(外文):Prevalence and Associated Risk Factors of Osteoporosis among Residents Living in a Nursing Home: A Pilot Study
指導教授:吳至行吳至行引用關係
指導教授(外文):Wu, Chih-Hsing
口試委員:張秦松張尹凡
口試委員(外文):Chang, Chin-SungChang, Yi-Fan
口試日期:2023-07-10
學位類別:碩士
校院名稱:國立成功大學
系所名稱:老年學研究所
學門:其他學門
學類:其他不能歸類之各學類
論文種類:學術論文
論文出版年:2023
畢業學年度:111
語文別:中文
論文頁數:78
中文關鍵詞:護理之家骨質疏鬆症骨折風險評估維他命D濃度白蛋白濃度
外文關鍵詞:Nursing homeOsteoporosisFRAX25(OH)DAlbumin
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研究背景與動機:全球骨質疏鬆症日益嚴重,人口老化和生活方式是主要因素。台灣老化速度居全球之冠,65歲以上高齡者人口比例不斷上升,骨質疏鬆症患者也隨之增多。預計2025年將有500萬人受此困擾,護理之家的住戶也呈現上升趨勢。這對社會和醫療系統造成沉重負擔,值得深入探討。
研究目的:本研究的目的是調查護理之家住民的骨質疏鬆症盛行率和相關危險因子,並評估FRAX評估工具的有效性,以提供健康照護措施和建議。
研究方法:本研究的取樣護理之家為國欣護理之家,收案52人。採用結構式問卷包括人口學變項、疾病史、跌倒史、生化值檢驗、FRAX分數和骨密度檢測等資料。
研究結果:骨質疏鬆症的盛行率為86.5%,其中女性比例高達90.3%,男性比例為81.0%,主要的骨質疏鬆症危險因素包括女性、維他命D濃度低,此外在ROC曲線分析發現FRAX(Major)在沒有BMD輸入的情況下AUC有0.7以上,預測效果屬於中等,可作爲護理之家的骨質疏鬆症初步篩選工具。
討論與總結:護理之家住民是特殊人群,其骨質疏鬆症盛行率甚高,他們需強化骨質疏鬆的預防和診治,如補充維他命D、運動、使用抗骨質疏鬆症藥物等,以促進骨骼健康和生活品質。本研究結果可作爲護理之家住民骨質疏鬆症健康管理的參考依據,也可作爲未來相關研究的基礎。
This study aimed to investigate the prevalence and risk factors of osteoporosis among nursing home residents in Taiwan, and to evaluate the effectiveness of the FRAX assessment tool. A pilot study was conducted with 52 residents from Guo-Xin Nursing Home. Data were collected by a structured questionnaire, biochemical tests, FRAX score, and bone density test. The results showed that the prevalence of osteoporosis was 86.5%, with 90.3% in women and 81.0% in men. The risk factors for osteoporosis included being female and having low vitamin D level. Moreover, we found that FRAX(Major) (Without BMD) had a near-significant predictive ability, with an AUC of over 0.7, indicating a moderate predictive effect. It can be used as a preliminary screening tool for osteoporosis in nursing homes. The conclusion of this study was that nursing home residents are a special population with a high prevalence of osteoporosis. They need to strengthen the prevention and diagnosis of osteoporosis, such as supplementing vitamin D, exercising, using anti-osteoporosis drugs, etc., to promote bone health and quality of life. The results of this study can serve as a reference for the health management of osteoporosis among nursing home residents, and as a basis for future related research.
中文摘要I
English Abstract II
誌謝 IV
表目錄 VIII
縮寫表 IX
第一章 研究背景與動機 1
第一節 骨質疏鬆症的背景發展 1
第二節 台灣護理之家入住情況 2
第三節 生化值在身體作用機制 5
第四節 FRAX的發展 6
第二章 文獻回顧 7
第一節 護理之家住民的骨質疏鬆症盛行率 7
第二節 護理之家的骨鬆性骨折危險因子 9
第三節 維他命D對骨質疏鬆症的影響 10
第四節 FRAX評估工具的使用 11
第五節 骨質疏鬆症診斷方式 12
第六節 研究文獻缺口 13
第七節 研究動機與目的 14
第三章 研究方法 15
第一節 研究假設 15
第二節 研究架構 15
第三節 研究流程 16
第四節 研究變項 22
第五節 分析方法 24
第四章 研究結果 25
第五章 結論 52
第六章 討論 54
第七章 總結 56
第八章 研究限制與建議 57
第九章 未來研究方向 57
第十章 參考文獻 58
第十一章 附件一(研究問卷) 62
第十二章 附件二(IRB) 75
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