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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 陳佳慧 | |
| dc.contributor.author | Li-Chuan Wu | en |
| dc.contributor.author | 吳麗娟 | zh_TW |
| dc.date.accessioned | 2021-06-08T07:05:00Z | - |
| dc.date.copyright | 2009-02-10 | |
| dc.date.issued | 2008 | |
| dc.date.submitted | 2008-12-11 | |
| dc.identifier.citation | 中文部份
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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/26281 | - |
| dc.description.abstract | 住院中日常生活功能下降是一個常見的現象，臥床是造成肌肉力量下降、肺擴張不全及日常生活功能下降的重要因子，對腹部手術後的住院老人影響更甚。本研究目的探討早期活動介入於腹部術後的住院老人在日常生活功能及肌肉力量的改善成效。本研究為前、後測之臨床控制試驗(Controlled Clinical Trial, CCT)。於北部某醫學中心，選取符合年齡大於65歲、接受腹部手術且預期術後住院天數大於5天之個案數共108位，九十六年八月至九十七年四月，收為控制組共71人；九十七年五月至九十七年八月為實驗組共37人。控制組接受病房常規照護(usual care)，實驗組術後第一天開始接受早期活動介入措施直到出院。測量項目包括日常生活功能(巴氏量表)、肌肉力量(hand grip strength)。統計方法以配對t檢定(Paired t test)、獨立t 檢定(Independence t test)、共變數分析(ANCOVA)及多元迴歸分析(Multiple linear regression)檢定資料，研究結果以p＜0.05為顯著意義。研究顯示: (1) 日常生活功能方面，實驗組的巴氏量表下降平均差，顯著低於控制組(12.5 ± 10.5 vs 28.0 ± 10.5 ) (p < 0.001)，實驗組在術後三週已持續恢復，與出院時相比達顯著上升(91.9 ± 10.2 vs 86.6 ± 10.4) (p < 0.01)。(2) 肌肉力量，實驗組出院時握力顯著高於控制組(24.6 ± 7.8公斤vs 20.6 ± 8.2公斤) (p = 0.03)。(3) 實驗組術後住院天數平均短於控制組(13.2 ± 6.4 vs 17.6 ± 16.2天) (p < 0.05)。整體而言，早期漸進性活動對腹部術後住院老人可有效預防日常生活功能及肌肉力量的下降，建議未來可運用於臨床護理。 | zh_TW |
| dc.description.abstract | Functional decline is a common threat to elderly hospitalized patients. Immobility is one of the major contributors lead to decreased muscle strength, atelectasis, and functional decline. For elderly patients undergoing abdominal surgery, risks for these threats are even greater. The purpose of this study was to test the effect of an early mobilization protocol in postoperative elderly patients undergoing an elective abdominal surgery. A pre-and post controlled clinical trial design was employed with the subjects enrolled during 8/2007 to 4/2008 served as the control group (n=71) and subjects enrolled since 5/2008 served as the experimental group (n=37). In total, 108 subjects aged 65 years and older who scheduled for an elective abdominal surgery with expected postoperative length of stay over 5 days were enrolled from a 2000-bed medical center in Taipei, Taiwan. For the experimental group, a daily standardized 20-minute early mobilization protocol was conducted by a research nurse trained for the project until patient discharge. Subjects in the control group received usual care. The major outcome measures included hand grip strength, and activities of daily function measured by Barthel Index, A P value of less than 0.05 was considered significant.
The results showed that patients at experimental group had significant less decline in Barthel index during hospitalization (12.5 ± 10.5 vs. 28.0 ± 10.5 points, p < 0.001) and better hand grip strength at discharge (24.6 ± 7.8 kg vs. 20.6 ± 8.2 kg, p = 0.03), compared to the control group. In addition, the postoperative length of stay in the experimental group was significantly shorter than the control group (13.2 ± 6.4 vs. 17.6 ± 16.2 days, p < 0.05). This early mobilization intervention is shown to be feasible and effective in reducing functional decline for elderly patients who undergoing an elective abdominal surgery. | en |
| dc.description.provenance | Made available in DSpace on 2021-06-08T07:05:00Z (GMT). No. of bitstreams: 1 ntu-97-R94426016-1.pdf: 2044159 bytes, checksum: bb06563131206d1e8841a3dd01f5f397 (MD5) Previous issue date: 2008 | en |
| dc.description.tableofcontents | 口試審定書 I
誌謝 II 中文摘要 III ABSTRACT IV 第一章 緒論 1 第一節 研究動機及背景 1 第二節 研究目的 3 第三節 研究假設 3 第四節 名詞解釋 4 第二章 文獻查證 5 第一節 臥床對住院老人的影響 5 第二節 住院老人功能下降情形 7 第三節 腹部手術對老人生理功能之影響 10 第四節 早期活動對預防術後合併症及功能下降之成效探討 13 第五節 設計早期下床活動注意事項 19 第六節 概念架構 22 第三章 研究方法 23 第一節 研究設計 23 第二節 研究對象與場所 24 第三節 研究工具 25 第四節 資料收集流程 32 第五節 資料處理與分析 35 第六節 研究倫理考量 35 第四章 研究結果 36 第一節 研究對象基本資料分析 36 第二節 兩組病患腹部手術前日常生活功能及肌肉力量 40 第三節 兩組病患腹部手術後日常生活功能及肌肉力量 41 第四節 早期活動對日常生活功能、肌肉力量及持續性最大吸氣量之影響 44 第五節 兩組病患背景資料變項對日常生活功能及肌肉力量之影響 51 第五章 討論 53 第一節 日常生活功能的成效 53 第二節 肌肉力量的改善效果 55 第三節 持續性最大吸氣量的變化 56 第六章 結論與建議 57 第一節 研究限制建議 57 第二節 結論 58 參考文獻 59 附錄一 基本資料表 73 附錄二 巴氏量表 75 附錄三 疼痛視覺量尺 76 附錄四 肌肉力量 77 附錄五 持續性最大吸氣量 78 表一 研究設計 23 表二 早期漸進性活動計畫 28 表三 資料收集時間 34 表四 實驗組測量項目與時間點 34 表五 基本資料 38 表六 控制組與實驗組在手術方式及手術時間的比較 39 表七 控制組與實驗組之入院巴氏量表與握力的差異 40 表八 兩組出院時巴氏量表與握力 42 表九 調整兩組入院之巴氏量表，比較出院時差異 42 表十 兩組入院至出院巴氏量表及握力平均差的比較 43 表十一 實驗組巴氏量表與握力變化 45 表十二 控制組與實驗組在住院天數及術後住院天數的比較 50 表十三 基本資料對日常生活功能平均下降程度之影響 51 表十四 女性基本資料對握力平均下降程度之影響 52 表十五 男性基本資料對握力平均下降程度之影響 52 圖一 概念架構 22 圖二 資料收集流程 33 圖三 收案流程圖 36 圖四 實驗組術後下床活動之時間 46 圖五 實驗組巴氏量表變化 47 圖六 兩組出院之巴氏量表 47 圖七 實驗組術後握力變化 48 圖八 兩組握力變化 49 圖九 實驗組術後最大吸氣量變化 50 | |
| dc.language.iso | zh-TW | |
| dc.subject | 巴氏量表 | zh_TW |
| dc.subject | 腹部手術 | zh_TW |
| dc.subject | 肌肉力量 | zh_TW |
| dc.subject | 早期活動 | zh_TW |
| dc.subject | 日常生活功能 | zh_TW |
| dc.subject | hand grip strength | en |
| dc.subject | Barthel Index | en |
| dc.subject | elective abdominal surgery | en |
| dc.subject | activities of daily function | en |
| dc.subject | early mobilization | en |
| dc.title | 住院老人病患於腹部手術後接受早期漸進性活動
之成效探討 | zh_TW |
| dc.title | Effects of Early Mobilization in Postoperative Elderly Patients Undergoing an Elective Abdominal Surgery | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 97-1 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 林明燦,嚴崇仁 | |
| dc.subject.keyword | 早期活動,日常生活功能,腹部手術,肌肉力量,巴氏量表, | zh_TW |
| dc.subject.keyword | early mobilization,activities of daily function,elective abdominal surgery,hand grip strength,Barthel Index, | en |
| dc.relation.page | 78 | |
| dc.rights.note | 未授權 | |
| dc.date.accepted | 2008-12-11 | |
| 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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| 檔案 | 大小 | 格式 | |
|---|---|---|---|
| ntu-97-1.pdf 未授權公開取用 | 2 MB | Adobe PDF |
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