居家護理新收案管灌病人營養狀況之初探

The Preliminary Study ofNutritional Status in New Home Care Patients with Tube Feeding

本研究目的在了解居家新收案管灌病人之營養狀況，以作為後續照護及研究之參考基礎。採橫斷面描述研究設計，經方便取樣，以某醫學中心附設居家護理所新收案管灌病人為對象，十個月共取得有效樣本33位。研究工具包括：體位測量、實驗室數據及迷你營養評估量表（MNA）等，以卡方檢定及費雪正確機率考驗（Fisher's exact probability test）進行校正分析。結果：個案年齡、罹病數比其他研究偏高，熱量及蛋白質攝取量、身體質量指數（BMI）、迷你營養評估量表得分等比其他研究偏低，其中78.8%已達營養不良。以迷你營養評估表得分區別高危險性營養不良和營養不良兩組，兩組個案在身體質量指數及血清白蛋白有顯著差異，但許多預期指標均未呈現其差異性，可能是因為樣本特殊性造成的地板或天花板效應，日後需要進一步更廣泛及嚴謹之研究。The purpose of this preliminary study was to examine the nutritional status of newly recruited home-care patients receiving enteral tube feeding. This study utilized a cross-sectional descriptive research design. Included in the study were 33 consecutive, new home-care patients on enteral tube feeding from the Home Care Center of a medical center. Measurements of the nutritional status included anthropometric indicators, laboratory data, and the Mini Nutritional Assessment. The χ2 and Fisher's exact probability test were used to analyze the data. The results showed that the age and number of disease for the study subjects were higher than those of the previous studies. The total energy expenditure, protein, BMI, and MNA score for the study subjects were lower than those of the previous studies. Among 33 patients, 78.8% were classified as having malnutrition based on the MNA score, BMI, Serum albumin differentiated the at-risk malnutrition patients from malnutrition patients, whereas other nutrition indicators showed no group differences. Future research should include a larger sample size and adopt logistic regression analysis to identify the determinants of nutritional status of new home-care patients on enteral tube feeding.