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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 陳佳慧(Cheryl Chia-Hui Chen) | |
dc.contributor.author | Ssu-Ying Chen | en |
dc.contributor.author | 陳思穎 | zh_TW |
dc.date.accessioned | 2021-06-16T07:10:57Z | - |
dc.date.available | 2014-10-09 | |
dc.date.copyright | 2014-10-09 | |
dc.date.issued | 2014 | |
dc.date.submitted | 2014-07-07 | |
dc.identifier.citation | 行政院衛生署(2011)•死因結果統計分析•2013年11月21日取自
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Mulero, J., Zafrilla, P., & Martinez-Cacha, A. (2011). Oxidative stress, frailty and cognitive decline. The journal of nutrition, health & aging, 15(9), 756-760. Opasich, C., Feo, D. S., Pinna, G.D., Furgi, G., Pedretti, R., Scrutinio, D., Tramarin, R. (2004). Distance Walked in the 6‐Minute Test Soon After Cardiac Surgery Toward an Efficient Use in the Individual Patient. CHEST Journal, 126(6), 1796‐1801. Partridge, J. S., Harari, D., & Dhesi, J. K. (2012). Frailty in the older surgical patient: a review. Age and ageing, 41(2), 142-147. Pieper, C. F., Rao, K. M. K., Currie, M. S., Harris, T. B., & Cohen, H. J. (2000). Age, functional status, and racial differences in plasma D-dimer levels in community-dwelling elderly persons. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 55(11), 649-657. Robinson, T. N., Wu, D. S., Stiegmann, G. V., & Moss, M. (2011). 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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/57908 | - |
dc.description.abstract | 衰弱及心臟血管疾病,為健康老化重要的威脅之一。衰弱指的是身體儲存能量或抗壓力下降,無法有效因應外在壓力源,而對健康產生不良結果。越來越多文獻指出,衰弱與心臟血管疾病有著共同的病理機轉,主要以神經-內分泌失調、慢性炎症反應以及凝血路徑-促血栓狀態三個路徑呈現,衰弱在心臟血管疾病患者,盛行率可達25-50%,接受心臟手術的患者也高達42%,衰弱的發生常加速疾病惡化、術後失能以相關不良結果發生。
本研究為觀察性研究,以接受心臟手術病患為收案對象,在術前、術後一、三、六個月評估衰弱、握力、六分鐘行走距離以及身體組成之變化,以測量術後衰弱發生率及身體活動功能改變與恢復的情形。資料分析以變異數分析(ANOVA)檢定其多重比較測定,比較非衰弱組、衰弱傾向組與衰弱組在基本及工具性日常活動功能、六分鐘走路及握力的差異,檢定之顯著差異水準訂為p<0.05。 根據100位平均年齡為62.3±13.2歲的個案其資料分析結果顯示:(1)術後六個月內衰弱的盛行率分別為:術前19%、術後一個月35%、術後三個月9.9%、術後六個月8.8%。(2) 在衰弱轉變趨勢上,以「衰弱型態持平不變」為主,而「衰弱型態進步」,以術後三個月開始上升,在術後六個月時達高峰,在「衰弱型態退步」中,以術後一個月時為高峰,術後三個月時驟降。(3)術前有衰弱者在術前、術後第一個月時的基本日常活動功能皆顯著的偏低於前衰弱及非衰弱者(p<0.05)。(4)術前有衰弱者在術前、術後第一、六個月時的工具性活動功能皆顯著偏低於前衰弱及非衰弱者(p<0.05)。(5)術前有衰弱者在術前的平均握力顯著偏低於前衰弱及非衰弱者(p<0.05),但於術後六個月內的恢復並無顯著差異。(6)術前有衰弱者在術前、術後三個月內的六分鐘走路距離皆顯著低於前衰弱及非衰弱者 (p<0.05)。 | zh_TW |
dc.description.abstract | Frailty is an overarching geriatric syndrome characterized by decreased reserves against stressors and may lead to vulnerability. Clinically, frailty and cardiovascular disease (CVD) often exist concurrently. The prevalence of frailty is relatively high in patients with CVD (25-50%), and undergoing cardiac surgery patients (up to 42%). Furthermore, frailty may compromise functional recovery after cardiac surgery.
In this prospective study, 100 participants undergoing cardiac surgery were enrolled and assessed at 4 time points (before surgery, 1 month, 3-month, and 6-months after surgery). Fried’s frailty phenotype, grip strength, 6-minute walking distance, lean body mass, barthel index, and Lowton IADL were assessed. The mean age was 62.3 subjects in the study, the results were below:(1) The prevalence of frailty was 19%、35%、9.9%、8.8% ,from before surgery to 6 months after operation.(2) With the view to the trajectory of frailty, most patients belonged the unchanged frailty group .In improved frailty group, the improvement started since three months post operation and reached the peak at six months post operation. However, it had the peak at one month post operation and dropped rapidly at three months post operation in the retrograde frailty group.(3) Frailty group had significantly poorer basic daily activities than non-frailty and pre-frailty groups before and one month after operation (p<0.05) (4) Frailty group had significantly poorer instrumental activity than non-frailty and pre-frailty groups before, one and six months after operation (p<0.05). (5) There was significant different (p<0.05) between the phenotype of frailty before operation and grip strength. However, it didn’t reach statistically significant between frailty and the recovery within six months after operation.(6) Frailty group had significantly shorter 6-minute walking distance than non-frailty and pre-frailty groups before and three months after operation (p<0.05). | en |
dc.description.provenance | Made available in DSpace on 2021-06-16T07:10:57Z (GMT). No. of bitstreams: 1 ntu-103-R01426017-1.pdf: 2844231 bytes, checksum: f568032f5b961d5081417b5255664537 (MD5) Previous issue date: 2014 | en |
dc.description.tableofcontents | 口試委員審定書.............................................i
致謝......................................................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 名詞界定...................................4 第二章 文獻查證...........................................5 第一節 衰弱概念與量測.............................5 第二節 衰弱以及心臟血管疾病之病理機轉.............8 第三節 手術現況分析及身體活動功能改變與恢復......12 第四節 衰弱與心臟手術之不良結果..................14 第三章 研究方法..........................................16 第一節 研究設計..................................16 第二節 研究假設..................................18 第三節 研究架構..................................19 第四節 研究對象與場所............................20 第五節 研究工具..................................21 第六節 資料處理及分析............................24 第七節 研究倫理考量..............................25 第四章 研究結果..........................................26 第一節 研究對象之基本屬性與手術相關資料..................28 第二節 衰弱的盛行率及轉變趨勢............................30 第三節 衰弱的盛行率及基本屬性、疾病與手術相關分析........35 第四節 衰弱程度與六個月內的日常活動功能差異及趨勢........38 第五節 衰弱程度與六個月內的工具性活動功能差異及趨勢......40 第六節 衰弱程度與六個月內的握力差異及趨勢................42 第七節 衰弱程度與六個月內的六分鐘走路距離差異及趨勢......44 第五章 討論..............................................46 第一節 心臟手術後衰弱盛行率及其相關因素分析......46 第二節 心臟手術後衰弱轉變程度及其相關因素分析....49 第三節 衰弱程度及其身體活動功能恢復曲線相關分析..52 第六章 結論與建議........................................54 第一節 結論......................................54 第二節 研究限制..................................56 第七章 參考文獻..........................................57 | |
dc.language.iso | zh-TW | |
dc.title | 心臟術後病人衰弱盛行率及其身體活動功能之相關性研究 | zh_TW |
dc.title | A Correlation Study of Frailty and Functional Trajectory in Patient Undergoing Cardiac Surgery | en |
dc.type | Thesis | |
dc.date.schoolyear | 102-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 王水深(Shoei-Shen Wang),陳思遠(Ssu-Yuan Chen),蔡明芬(Ming-Fen Tsai) | |
dc.subject.keyword | 衰弱,心臟血管疾病,身體活動功能,握力,六分鐘行走距離,身體組成, | zh_TW |
dc.subject.keyword | frailty,cardiovascular disease,physical activity,grip strength,6-minute walking distance,body compositions, | en |
dc.relation.page | 72 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2014-07-07 | |
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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