Meiho University Institutional Repository:Item 987654321/2516
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    题名: Comprehensive Care Improves Physical Recovery of Hip-Fractured Elderly Taiwanese Patients With Poor Nutritional Status
    作者: Liu, Hsin-Yun
    Tseng, Ming-Yueh
    Li, Hsiao-Juan
    Wu, Chi-Chuan
    Cheng, Huey-Shinn
    Yang, Ching-Tzu
    Chou, Shih-Wei
    Chen, Ching-Yen
    Yea-Ing, L.Shyu
    关键词: Hip-fractured elders;nutrition intervention;poor nutrition;physical function
    日期: 2014
    上传时间: 2014-09-15T06:26:17Z (UTC)
    摘要: Objectives: The effects of nutritional management among other intervention components have not been examined for hip-fractured elderly persons with poor nutritional status. Accordingly, this study explored the intervention effects of an in-home program using a comprehensive care model that included a nutrition-management component on recovery of hip-fractured older persons with poor nutritional status at hospital discharge. Design: A secondary analysis of data from a randomized controlled trial with 24-month follow-up. Setting: A 3000-bed medical center in northern Taiwan. Participants: Subjects were included only if they had “poor nutritional status” at hospital discharge, including those at risk for malnutrition or malnourished. The subsample included 80 subjects with poor nutritional status in the comprehensive care group, 87 in the interdisciplinary care group, and 85 in the usual care group. Interventions: The 3 care models were usual care, interdisciplinary care, and comprehensive care. Usual care provided no in-home care, interdisciplinary care provided 4 months of in-home rehabilitation, and comprehensive care included management of depressive symptoms, falls, and nutrition as well as 1 year of in-home rehabilitation. Measurements: Data were collected on nutritional status and physical functions, including range of motion, muscle power, proprioception, balance and functional independence, and analyzed using a generalized estimating equation approach. We also compared patients’ baseline characteristics: demographic characteristics, type of surgery, comorbidities, length of hospital stay, cognitive function, and depression. Results: Patients with poor nutritional status who received comprehensive care were 1.67 times (95% confidence interval 1.06e2.61) more likely to recover their nutritional status than those who received interdisciplinary and usual care. Furthermore, the comprehensive care model improved the functional independence and balance of patients who recovered their nutritional status over the first year following discharge, but not of those who had not yet recovered. Conclusions: An in-home program using the comprehensive care model with a nutritional component effectively improved the nutritional status of hip-fractured patients with poor nutrition. This comprehensive care intervention more effectively improved recovery of functional independence and balance for patients with recovered nutritional status.
    關聯: JAMDA 15 (2014) 416e422
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