推廣自立支援照護以醫院延緩失能活動訓練成效為例

Promoting self-supporting and supporting care, taking the effectiveness of training in hospitals to delay disability activities as an example

本老化隨之身體功能退化，其照顧需求亦隨之增加。如能協助個案維持其日常生活活動，及生活品質，便是自立支援照護。依文獻顯示：計畫性運動及肌力訓練，可達延緩失能以增進自我照顧能力。故本研究採回溯式分析南投某醫院110年延緩失能方案，該原始計畫收案共150人，符合本研究65歲以上的住院病患26人，實施每週1次彈力帶運動訓練，每次30分鐘，共4次，自主訓練2次，每次30分鐘共8次。依此分析個案介入訓練前后數據，包括ADL、老人憂鬱量表、上肢握力、30秒屈臂檢測、30秒坐到站檢測、抓背測試、坐椅體前彎測試等。結果顯示介入前後之成對樣本t檢定為：ADL（P=0.004）、老人憂鬱量表分數（P=0.000）、30秒坐到站測試（P=0.000）、30秒屈臂測試（P=0.000），已達顯著差具（P<0.05）。上肢握力、抓臂試、坐椅體前彎測試等雖P>0.05無顯著差異，但訓練前後皆有進步。證實運動訓練可提升身體功能及日常生活功能，建議個案在住院期間可提早執行運動訓練，可有助提升預防及延緩的成效。

Aging brings with it the loss of body function and disability, and the need for care increases accordingly. If the activities of daily living and the quality of life of the person being cared for can be maintained, it is independent support care. According to the literature, planned exercise and muscle strength training can delay disability and improve self-care ability. Therefore, this study adopts retrospective collection and analysis of the 110-year disability delay plan of a hospital in Nantou. The original plan admitted a total of 150 patients, and 26 inpatients over 65 years old were eligible for this study. Explore the effectiveness of elastic band exercise training once a week, 30 minutes each time, 4 times in total, and independent training twice, 30 minutes each time, 8 times in total. Analyze the data before and after the case intervention training, including ADL, Elderly Depression Scale, upper limb grip strength, 30-second arm flexion test, 30-second sit-to-stand test, back grab test, chair forward bend test, etc. The results showed that the paired sample t test before and after the intervention was: ADL (P=0.004), Elderly Depression Scale score (P=0.000), 30-second sit-to-stand test (P=0.000), 30-second arm flexion test (P= 0.000), reaching a significant difference (P<0.05). Although there was no significant difference at P>0.05 in the upper limb grip strength, arm grasping test, and chair forward bending test, there was improvement before and after training. It has been proven that exercise training can improve physical function and daily life functions. It is recommended that patients can perform exercise training early during hospitalization, which can help improve the effectiveness of preventing and delaying disability.