|a英文題名:Comparison Of The Nutritional Status Of The Nursing Home Residents And The Elderly People Living Alone - Studies Of Taipei City, Wenshan Distinct
|a背景與目的：由於全球經濟提昇、醫療技術進步、生育率降低以及人口老化快速，老年問題已成為各國重視的議題。文獻指出不論是獨居或入住機構的老年人，多屬於營養不良的高危險群。本研究目的為瞭解獨居老人與安養護中心住民之營養狀況，並探討在機構專業團隊照護之下，能否提供老人較佳的營養支持。方法：研究個案分別由台北市文山區已列冊之獨居老人及台北市文山區某老人安養護中心之住民中隨機挑選，總收案人數安養老人有66人、養護老人有132人、獨居老人為44人，經個案同意後收集其基本資料、體位測量、迷你營養評估量表、日常生活活動功能量表及老人健檢中血液生化值等數據進行統計分析。結果：在日常生活活動功能方面，養護老人依賴程度明顯較安養及獨居老人高，且養護老人因受疾病與身體活動功能較差之影響，其營養狀況亦比安養與獨居老人差。若將安養與獨居老人做比較，在體位測量方面，獨居老人身高明顯高於安養老人(p<0.05)，而臂中圍及小腿圍兩者則無顯著差異。在迷你營養評估得分方面，安養及獨居老人平均得分雖無顯著差異，但在飲食評估項目中，獨居老人在「乳製品攝取量」、「液體攝取量」及「一天可吃的完整餐食」項目中，明顯低於安養老人。在血液生化檢測方面，安養老人血清白蛋白及血紅素平均值顯著高於獨居老人，且獨居老人血清白蛋白異常及血紅素異常的比例(11.6%；62.8%)顯著高於安養老人(6.1%；19.7%)。以65-74歲為基準，75-84歲老人營養不良的風險為其2.7倍，85歲以上老人營養不良風險則高達4.7倍；缺牙或無牙者營養不良的風險為配戴假牙者之1.1倍；罹患3種以上疾病者營養不良的風險是未罹患任何疾病者之15.9倍；服用3種以上藥物者營養不良風險為未服用任何藥物者之4.9倍。結論：安養老人不論在體位測量、營養評估或血液生化檢測上，其營養狀況較養護或獨居老人佳，而影響營養狀況的因子可能與年齡、ADL、牙齒狀況、疾病罹患與服用藥物有關，因此建議藉由加強養護機構的專業照護品質、對於獨居老人能提供完善的安養護機構轉介服務，並重視營養師介入獨居與機構老人營養狀況之必要性，以達到改善老人營養狀況之目的。|uBackground and Purpose: As to the increasing of the global economy, the progress of medical technology, the reductions in fertility and the rapid aging of the population, the seniors’ problems have become the very important issues. The literature indicates that no matter the seniors living alone or staying in rehabilitation, they are mostly at high risk of malnutrition. The purposes of this study are to understand the nutritional status of seniors living alone and staying in rehabilitation, and to explore if the elders under the professional care can provide seniors with better nutritional supports or not. Methods: The cases were chosen from the list of seniors who living alone, and the residents in one of the Rehabilitation in Wenshan District, Taipei City at random. There are 66 residents living in retirement home,132 in nursing home in that rehabilitation, and 44 living alone in Wenshan District. Collecting and statistical analysis the basic data, anthropometry, Mini Nutritional Assessment Scale, activities of daily living Scale (ADL) and biochemical data in the elderly health examination data under their personal permit. Results: In activities of daily living function, the seniors living in nursing home were significantly dependent than and elderly people living alone. And due to diseases and worse physical functions, the nutritional status of seniors living in nursing home were worse than those in retirement home and living alone. In terms of anthropometric measurements, the heights of the seniors living alone were significantly higher than those in the retirement home (p <0.05), but there is no significant difference on arm circumference and calf circumference. In the Mini Nutritional Assessment, although there is no significant differences between the average scores of the seniors in nursing homes and living alone, the seniors living alone in the “dairy intake”, “liquid intake” and “the complete meals project in one day” are obviously lower than those seniors living alone in dietary assessment project. In the blood biochemical detection, the human serum albumin and hemoglobin of the seniors in retirement home were significantly higher than living alone. And the abnormalities percentage of serum albumin and hemoglobin (11.6%; 62.8%) of the seniors living alone was significantly higher than those in retirement home(6.1%; 19.7%). Base on the age of 65-74, the risk of lacking malnutrition at the age of 75-84 is 2.7 times, and 4.7 times at the age of 85 and up, and seniors missing or without teeth is 1.1 times the wearing dentures. Suffering from more than three kinds of malnutrition diseases is 15.9 times not suffering from any disease. Taking more than three kinds of medicines is 4.9 times without taking any medicines. Conclusion: Whether in anthropometry, nutrition assessment or blood biochemical testing, nutritional status, the retirement home seniors’ are better than the nursing home and living alone. The age, ADL, dental status, disease, suffering and taking medications are the factors may affect the nutritional status and therefore recommended that strengthen the quality of care by professionals, provide the retirement and nursing home referral services for the seniors living alone, and attach the importance to the dietitians involved those seniors’ nutritional status in order to achieve the purpose of improving their nutritional status.
|aComparison Of The Nutritional Status Of The Nursing Home Residents And The Elderly People Living Alone - Studies Of Taipei City, Wenshan Distinct