老年住院手術病人急性混亂發生率及其相關因素研究

Incidence and Related Factors of Acute Confusion on Post-operative Hospitalized Elderly Patients

雖然急性混亂是手術後常見的合併症，但是若沒有及時發現並予矯治，便會使得預後變差、增加病人的死亡率、延長住院天數以及增加護理工作的需要量。由於護理人員和病人接觸時間最多，所以經常是第一位發覺病人急性混亂現象的工作人員。本研究的目的為使用「急性混亂行為量表」來偵測老年住院手術病人的急性混亂發生率及相關因素，並比較發生急性混亂與未發生急性混亂老年住院手術病人急性混亂行為量表的結果，研究工具包含參加同意書，基本資料，知能篩檢測驗，急性混亂行為量表，及DSM-IV譫妄的診斷標準。結果在79位合於收案條件的外科住院老年病人中有11人在住院期間發生急性混亂，發生率為13.9%。多數急性混亂者的Na,Ca,albumin,RBC,Hct檢驗值低於正常值，而且急性混亂者經常會出現急性混亂行為量表上的行為。建議護理人員可隨時依需要使用急性混亂行為量表並瞭解此症狀發生時的情形及危險因子。本研究的結果可以建立此臨床現象的本土化資料，並做為進一步研擬護理及醫療措施的參考。

Acute confusion is a surgical complication often found on post-surgery elders. If it is not correct in time, it will increase patient's mortality rate, worse progression, prolonged hospitalization, and increased nursing hours. The purposes of this study are to understand surgically hospitalized elders' incidence of acute confusion, and to understand the related factors that cause acute confusion. In this study, acute confusion incidence was 13.9%. The result showed acute confusion had nothing to do with gender, age, education level, marital status, previous confusion experience, being restrained, and room in. The lab testing results showed that Na, Ca, albumin, RBC, Hct influenced on acute confusion, acutely confused elders had lower value than normal. Acute confused patients have really different actions as compared to non-confused patients. We can conclude that careful assessment and understanding the nature and risk factors are the best way to keep off acute confusion. The results of this study can be used as a reference for nursing and medical interventions.