| 摘要: | 失能老人的照護在全世界先進國家皆為重視議題，而失能老人在照顧需求更為複雜。本研究旨在瞭解居家失能老人之健康狀況及照護需求及進而預測照護需求之因子。
本研究採橫斷研究設計，以立意取樣在新北市某醫學中心附設居家護理所收案的老人作為研究對象，共收案139位，由研究者以MDS-HC 2.0居家照護評估工具進行訪視收案。
結果發現居家失能老人照護需求前五名為健康促進（99.3%）、需要機構照護之風險（99.3%）、工具性（社會性）日常生活功能（IADLs）（98.6%）、壓瘡（85.6%）、口腔衛生（80.6%）。居家失能老人照護需求預測因子為：健康狀況及預防保健處理（B=0.516; p<0.001）、口腔衛生（B=1,102; p<0.001）、工具性（社會性）日常生活功能（IADLs）（B=0.173; p<0.001）、社會功能（B=0.418; p<0.001）及藥物治療（B=0.538; p<0.001）。
居家失能老人可藉由提升老人健康狀況及預防保健處理、有效增加口腔牙齒照顧、改善工具性（社會性）日常生活功能（IADLs）需求、增加失能老人社會參與、藥物遵從性及重複用藥等方法來降低照顧需求。未來健康政策應該更關注預防保健、口腔衛生教育，並建立正確口腔照護行為、研發科技維持失能老人每天IADLs的功能、增加失能老人社會參與機會、整合失能老人用藥，減少重複用藥情形，以提升失能老人生活品質減少照護需求。
The care of elderly with disable is a major public health problem in advanced countries. The elderly with disable are more complicated in caring for their needs. This study aimed to explore the health status and care needs of the elderly with disable, and to examine predictor variables of the care needs.
This cross-sectional study used Minimum Data Set-Home Care (MDS-HC) 2.0 for data collection. One hundred and thirty-nine elderly participants were selected from the home care clinic attached to a medical center in New Taipei City.
The results showed that the top five care needs of the elderly with disable were health promotion (99.3%), the risk of institutional care (99.3%), instrumental (social) daily life function (IADLs) (98.6), pressure ulcer (85.6%), and oral hygiene (80.6%). The predictive factors of home care needs for the elderly with disable were health status and preventive health care (B=0.516, p<0.001), oral hygiene (B=1,102, p<0.001), instrumental (social) daily life function (IADLs) (B=0.173, p<0.001), social function (B=0.418, p<0.001), and medical treatment (B=0.538, p<0.001).
The health status and preventive health care of home-dwelling elderly with disable can be enhanced by promoting oral hygiene, satisfying the needs of instrumental (social) daily life function (IADLs), increasing social participation, improving medication adherence and avoiding duplicated medication, and thus reducing the care needs. Future health policies should pay more attention to preventive health care, oral hygiene education by setting up a correct oral care behavior, research and development technology to maintain the function of IADLs, social participation opportunities, and proper medications prescriptions for elderly with disable. These efforts can improve the quality of life and reduce the care needs of the elderly with disable. |
