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http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/43843完整後設資料紀錄
| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 陳佳慧(Chia-hui Chen) | |
| dc.contributor.author | Man-Shan Wang | en |
| dc.contributor.author | 王曼珊 | zh_TW |
| dc.date.accessioned | 2021-06-15T02:30:18Z | - |
| dc.date.available | 2010-09-15 | |
| dc.date.copyright | 2009-09-15 | |
| dc.date.issued | 2009 | |
| dc.date.submitted | 2009-08-15 | |
| dc.identifier.citation | 中文部分
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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/43843 | - |
| dc.description.abstract | 營養不良是腸胃道術後老人常見的現象，其不僅會影響生理，對於心理、社會、經濟各層面亦有所影響，嚴重者甚至會死亡。經由臨床實證研究得知，口腔健康功能喪失、營養照護知識缺乏及臥床，是引發腸胃道術後老人營養不良、功能下降之重要危險因子，因此本研究目的主要在探討經腸胃道手術老人接受個別化營養策略後之營養及功能狀態改善成效。研究設計採前、後測之臨床控制試驗（Controlled Clinical Trial, CCT），於北部某醫學中心，選取65歲以上老人，經醫師診斷需接受腸胃道手術者，控制組自96年8月至97年4月止；實驗組自97年5月至97年12月止，各82名個案。控制組接受醫院常規照護，實驗組於術後第一天接受個別化營養策略介入措施，包括口腔護理及訓練、飲食護理指導及早期活動直到出院。兩組分別於術前、出院前、術後一個月及出院後三個月，測量營養狀況﹙迷你營養評估量表、體重變化、身體質量指數﹚，及功能狀態﹙巴氏量表、握力﹚。研究結果以獨立樣本t檢定、卡方檢定、費雪精確度檢定，呈現兩組之間是否有差異，並以p＜0.05定為統計上顯著差異水準。結果顯示（1）營養狀態方面，出院前，控制組迷你營養評估總分顯著低於實驗組（p＜0.001），身體質量指數控制組平均下降顯著多於實驗組（p=0.001），且控制組體重減輕百分比顯著多於實驗組（p=0.001）。（2）功能狀態方面，出院前，控制組平均巴氏總分顯著低於實驗組（p＜0.001），且控制組握力顯著低於實驗組（p＜0.05）。﹙3﹚縮短住院日數方面，控制組平均總住院天數及術後住院天數顯著多於實驗組﹙p＜0.05﹚。整體而言，透過個別化營養策略介入後，顯見護理獨特功能之臨床效益，不僅預防腸胃道術後老人營養不良，亦有效改善術後老人營養狀態、減緩功能下降、縮短患者住院日數，因此值得將此策略提供給臨床護理人員做為未來照護腸胃道術後老人之指引方針。 | zh_TW |
| dc.description.abstract | The prevalence of malnutrition is high among the elderly who underwent gastrointestinal surgery. The aim of this study was to evaluate the effects of nutritional protocol on nutritional status in postoperative elderly patients underwent an elective gastrointestinal surgery. A pre- and post controlled clinical trial design was employed to enroll subjects aged 65 years and older who scheduled for an elective gastrointestinal surgery at a 2000-bed medical center in Taipei. Subjects enrolled during 8/07 to 4/08 were served as the controls (n=82) and subjects enrolled since 5/08 to 12/08 were served as the experimental group (n=82). For the experimental group, a daily nutritional protocol including oral care, diet education and early mobilization were implemented. Educational pamphlet on overcoming malnutrition was also provided. Subjects in the control group received usual care. Mini-Nutritional Assessment (MNA), body weight, body mass index, Barthel index, and hand grip strength were taken at four points: before surgery, at discharge, 1and 3 months after surgery.
Analyses were performed to examine the group differences using SPSS. Preliminary results shown that, at discharge, patients at experimental group had significant better MNA scores (21.3±3.0 vs. 13.1±3.4 points, p < 0.001), less body weight loss percentage (2.8%±3.6% vs. 5.0%±4.2%, p= 0.001), better hand grip strength (23.7±8.0 vs. 20.9±8.2 kg, p < 0.05), better in Barthel Index (86.7±9.3 vs. 64.3±13.6 points, p < 0.001), and shorten length of stay (16.9±10.4 vs. 21.8±18.8 days, p < 0.05) compared to the controls. The findings support effects of this nurse-led nutritional protocol in preventing malnutrition for the elderly who underwent gastrointestinal surgery. | en |
| dc.description.provenance | Made available in DSpace on 2021-06-15T02:30:18Z (GMT). No. of bitstreams: 1 ntu-98-R96426015-1.pdf: 644208 bytes, checksum: 334a9c18ae8f3824c9cb03e74862753d (MD5) Previous issue date: 2009 | en |
| dc.description.tableofcontents | 目 錄
口試委員會審定書……………………………………………………i 誌謝……………………………………………………………………ii 中文摘要………………………………………………………………iii 英文摘要………………………………………………………………iv 第一章 緒論…………………………………………………………1 第一節 研究動機及重要性…………………………………………1 第二節 研究目的..…………………………………………………3 第三節 研究假設..…………………………………………………3 第四節 名詞界定..…………………………………………………4 第二章 文獻查證……………………………………………………5 第一節 營養不良的影響……………………………………………5 第二節 腸胃道手術對老人營養狀況的影響………………………11 第三節 經腸胃道手術後常見的營養困擾及合併症………………14 第四節 臨床上常見的營養指標及評估方式………………………18 第五節 營養介入對營養狀況及功能狀態成效的相關探討………20 第三章 研究方法……………………………………………………29 第一節 研究設計……………………………………………………29 第二節 研究概念架構………………………………………………30 第三節 研究對象及場所……………………………………………31 第四節 研究工具……………………………………………………32 第五節 資料收集流程………………………………………………34 第六節 營養策略……………………………………………………36 第七節 資料處理及分析……………………………………………42 第八節 研究倫理考量………………………………………………43 第四章 研究結果……………………………………………………44 第一節 研究對象之基本屬性………………………………………44 第二節 營養策略介入對營養狀況成效……………………………50 第三節 營養策略介入對減緩功能下降成效………………………58 第四節 營養策略介入對縮短住院日數成效………………………61 第五章 討論…………………………………………………………62 第一節 營養狀況的成效……………………………………………62 第二節 功能狀態的成效……………………………………………66 第三節 縮短住院日數的成效………………………………………67 第六章 結論與建議…………………………………………………68 第一節 研究限制與建議……………………………………………68 第二節 結論…………………………………………………………70 參考文獻………………………………………………………………71 附錄一 基本資料表…………………………………………………89 附錄二 迷你營養評估量表…………………………………………91 附錄三 巴氏量表……………………………………………………94 圖目錄 圖一 研究概念架構…………………………………………………30 圖二 資料收集流程…………………………………………………35 圖三 收案流程………………………………………………………45 圖四 控制組與實驗組MNA趨勢圖……………………………………52 圖五 控制組與實驗組體重減輕趨勢圖……………………………55 圖六 控制組與實驗組體重減輕百分比趨勢圖……………………56 圖七 控制組與實驗組巴氏分數比較趨勢圖………………………59 圖八 控制組與實驗組握力比較趨勢………………………………60 表目錄 表一 研究設計………………………………………………………29 表二 基本資料………………………………………………………46 表三 手術與疾病屬性………………………………………………48 表四 術前控制組及實驗組MNA、BMI與檢驗值狀況………………53 表五 出院前控制組及實驗組MNA、BMI與檢驗值狀況……………53 表六 控制組及實驗組術後禁食及排氣天數比較…………………57 表七 控制組及實驗組住院天數之比較……………………………61 | |
| dc.language.iso | zh-TW | |
| dc.subject | 營養策略 | zh_TW |
| dc.subject | 腸胃道手術 | zh_TW |
| dc.subject | 口腔護理 | zh_TW |
| dc.subject | 護理指導 | zh_TW |
| dc.subject | 早期活動 | zh_TW |
| dc.subject | nutritional protocol | en |
| dc.subject | gastrointestinal surgery | en |
| dc.subject | early mobilization | en |
| dc.subject | nursing education | en |
| dc.subject | oral care | en |
| dc.title | 經腸胃道術後老人接受個別化營養策略之成效探討 | zh_TW |
| dc.title | Effects of Individualized Nutritional Strategies in Postoperative Elderly Patients Undergoing Gastrointestinal Surgery | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 97-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.coadvisor | 尹祚芊(Teresa J. C. Yin),田郁文(Yu-Wen Tien) | |
| dc.contributor.oralexamcommittee | #VALUE! | |
| dc.subject.keyword | 腸胃道手術,營養策略,口腔護理,護理指導,早期活動, | zh_TW |
| dc.subject.keyword | gastrointestinal surgery,nutritional protocol,oral care,nursing education,early mobilization, | en |
| dc.relation.page | 95 | |
| dc.rights.note | 有償授權 | |
| dc.date.accepted | 2009-08-17 | |
| dc.contributor.author-college | 醫學院 | zh_TW |
| dc.contributor.author-dept | 護理學研究所 | zh_TW |
| 顯示於系所單位： | 護理學系所 | |
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