慢性精神病患減重達成率之改善方案

The Program for Weight Management among Chronic Psychiatric In-patients

精神病患肥胖盛行率高於一般人，而肥胖又是導致多種慢性疾病的危險因素。本精神科病房於2010年調查發現，住院慢性病患肥胖率已高達66.7%，體重正常者僅為11.7%。因此推行減重計畫及各項活動，讓住院病患平均體重每月減少一公斤，且肥胖人數減少一半以上，標準體重人數增加一倍以上，故於2010年5月至10月，鼓勵所有病患（60名）參與飲食衛教、熱舞及健康操、佐以日誌及競賽活動，並協助病患執行與成效評估。本專案成果為60名病患由原先的平均體重74.9 Kg降至70.3 Kg，其中肥胖者由40名（66.7%）減為18名（30%），標準體重者由7名（11.7%）增至17名（28.4%）。本方案實施應用多元介入方式將體重控制觀念與行為融入病患生活且有效控制肥胖問題，期望此經驗分享能提供醫護人員於實務上的參考。

The prevalence of overweight and obesity is high among psychiatric patients. Obesity could result in increased mortality and various health problems. A survey conducted in 2010 found that the rate of obesity among 60 patients in a psychiatric hospital setting was 66.7 %, while the rate of those with normal body weight was only 11.7%. By following regular exercise and proper diet, the mean weight loss of psychiatric in-patients was 1 kg per month, the number of obese subjects decreased, and the number of normal-weight subjects increased. This project execution period was from May to October, 2010, with several practices intended to render in-patients a better understanding of how to prevent unhealthy weight gain, by self-monitoring of physical activity and dietary intake. The results of this project showed that mean body weight of the subjects declined from 74.9 Kg to 70.3 Kg. The proportion of obese subjects dropped from 66.7% (n = 40) to 30% (n = 18). The number of subjects with normal body weight increased from 7 (11.7%) to 17 (28.4%). Accordingly, this project allowed the demonstration of appropriate ways of dealing with overweight (and obesity) and nursing interventions, which will be of significant benefit to such patients. It is expected that this report can serve as a reference for nursing staff working in hospitals.