長者參與社區巷弄長照站活動與身心功能評估之相關探討

Association Between Community-based Long-term care Station Participation and Physical and Mental Function Among Older Adults

目的：本研究探討長者參與社區巷弄長照站活動與身心功能評估之相關性。方法：採類實驗研究設計，以便利取樣於北高雄某地區醫院中醫科醫師轉介個案至社區健康促進組，收案共74位65歲或以上長者，定義有參與社區巷弄長照站健康促進活動者為實驗組（n=29），無參與者為對照組（n=45）。使用長者功能評估量表測量社區長者身心功能是否異常，而統計方法包括獨立樣本T、卡方、Fisher’s精確檢定，以及廣義線性模式。結果：實驗組為女性比例顯著較高於對照者（93.1％vs. 66.7％，p=0.01）。實驗組有時間定向力異常比例顯著較高於對照組（17.2％vs. 2.2％，p=0.031）。然而，實驗組雙手抱胸連續起立坐下5次所需平均時間顯著較短於對照組（10.2秒vs. 12.7秒，p=0.042）。經校正性別、年齡、身體質量指數、慢性疾病等變項後，結果顯示實驗組發生時間定向力異常機率顯著較高於對照組（OR=12.46, 95％CI：3.12-49.73, p<0.001）。結論：有參與社區巷弄長照站活動長者會有明顯時間定向力異常，後續需對其進行腦適能測驗做認知功能篩檢。建議醫院社區醫護團隊持續推廣社區巷弄長照站健康促進相關活動，並與社區鄰里攜手合作，吸引更多長者外出參與及互動，以維持或提升長者身心功能。

Purposes: In this study, we investigated the association between participation in community-based long-term care station activities and physical and mental functional status in older adults. Methods: A quasi-experimental design was adopted, involving 74 older adults aged 65 years and over referred by traditional Chinese medicine physicians from a regional hospital in northern Kaohsiung to a community health promotion team. Participants who took part in community-based long-term care station health promotion activities were assigned to the experimental group (n=29), while those who did not participate were assigned to the control group (n=45). The Integrated Care for Older People (ICOPE) questionnaire was employed to evaluate abnormalities in physical and mental function among community-dwelling older adults. Statistical analyses included the independent samples t-test, Chi-square test, Fisher’s exact test, and generalized linear model (GLM). Results: The proportion of females was significantly higher in the experimental group than in the control group (93.1% vs. 66.7%, p=0.01). The experimental group also showed a significantly higher proportion of temporal disorientation than the control group (17.2%vs. 2.2%, p=0.031). However, participants in the experimental group completed five consecutive sit-to-stand movements with arms crossed in significantly less time than that in the control group (10.2 seconds vs. 12.7 seconds, p=0.042). After adjusting for variables, such as sex, age, body mass index, and chronic disease status, temporal disorientation was still significantly more likely in the experimental group than in the control group (OR=12.46, 95% CI: 3.12-49.73, p<0.001). Conclusions: Older adults who participated in community-based long-term care station activities exhibited a significantly higher incidence of temporal disorientation. Follow-up cognitive screening through brain fitness assessments is therefore recommended. Hospital-affiliated community healthcare teams are encouraged to continue promoting health promotion activities at community-based long-term care stations and to collaborate with local neighborhood organizations to encourage greater social participation among older adults, thereby supporting the maintenance and improvement of their physical and mental functions.