降低慢性住院精神病人之BMI異常率

Reducing Abnormal Rates of BMI among Inpatients with Chronic Psychosis

在2012年時調查發現某醫院慢性精神病住院病人BMI異常率為49.5%，且有逐月增加的趨勢。於是在同年5月成立體重控制專案小組期望能來降低這群病人的BMI異常率。針對病人體重異常之原因，提出如：減少或增加三餐主食的份量、減少油脂的攝取量、減少或增加點心攝取的份量及次數、增加病人的動態活動時間及次數及宣導相關健康知識等改善策略。經本活動介入後共71位慢性精神病住院病人參與，BMI異常率由2012年5月的52.1%降為該年11月的36.6%；總計體位有明顯進步者有21%（15/71）、體位維持正常或明顯改善者共計69%（49/71），活動介入後對體位改變無效者只有31%（22/71）。體態活動參與率、計步器達成率、飲食控制配合度及團體衛教答對率等監測指標都有顯著上升。總結本專案發現飲食控制、健康認知行為的衛生教育和運動習慣的執行等方法可在半年內降低慢性精神病住院病人肥胖的比例，建議可將相關措施融入病房常規活動及品管指標中。

In a 2012 survey, we found that the body mass index (BMI) rate of hospitalized psychiatric patients at our hospital was abnormal49.5% in those with chronic diseases. The trend increased monthly. Therefore, in May of the same year we set up a weight control group with the goal of reducing the abnormal BMI rate in these patients. Based on the patient's stated reasons for their abnormal BMI rate, we proposed some strategies for improvement, including changing the amount eaten three meals a day, cutting down the consumption of fat, changing the frequency of the dessert intake, increasing the patient's time and frequency of daily dynamic activity, and promoting the health-related information. The percentage of abnormal BMI among 71 enrolled psychiatric inpatients declined from 52.1% to 36.6% between May and November, 2012. There were 21% of the studied subjects with significant improvement of their BMI and, including the normal BMIs, 69% of those with good intervention effects on their BMI. That meant only 31% of poor response to the treatments. All the indicators including activity participation rate, walking count rate, diet control rate and accurate knowledge rate were found significantly enhanced. In conclusions diet control, health education and exercise can improve obesity status among the chronic psychotic inpatients. We recommend that the above methods could be set as routine activities and indicators of medical care quality in a chronic psychiatric ward.