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Rehabilitation Practice and Science

Translated Title

護理之家住民住院之相關因素分析：初步報告

Abstract

There are increasing numbers of elderly people spending the last years of their lives in a nursing home (NH) or other long-term care institution, mostly because of physical and/or mental disabilities. NH residents may have a variety of acute illnesses; hospitalization is an important treatment option for the frail NH resident owing to the insufficient resources of NHs. The purpose of this study is to investigate the cause of hospitalization, and to analyze the correlation between the NH residents’ characteristics and hospitalization.Residents staying in the participating NH for more than one year were recruited into this study, and from September 2003 to September 2006 there were 48 subjects enrolled. After thorough chart reviewarticle by the same investigator, the number of chronic diseases, hospitalization episodes and length of stay, initial symptoms and final diagnoses at discharge of recruited residents were defined and recorded. There were 84 episodes of hospitalization in total in the study period. The most frequent symptoms were fever and/or chills (50%, 42 cases out of all those hospitalized), dyspnea or shortness of breath (16 cases, 19% out of all those hospitalized), and coffee ground vomit or tarry stools (10 cases, 12% out of all those hospitalized). The most frequent diagnoses were genitourinary tract infections (54%, 45 cases out of all those hospitalized), lung infections and/or chronic lung disease (19 cases, 23% out of all those hospitalized), and upper gastrointestinal tract bleeding and/or gastro-esophageal reflux disease (10 cases, 12% out of all those hospitalized). The residents' Mini Mental State Examination (MMSE) and Barthel index score were found to be significantly and negatively correlated with hospitalization. Although limiting factors, including the small size of the case sample, limited geographic area and focusing on only a single NH, existed in this study, it was concluded that the mentality and activities of daily living functions of the NH residents were strong indicators of hospitalization. Early prevention of predisposing acute illness in the NH may reduce the need for hospitalization for many patients. Moreover, a rehabilitation program for reconditioning residents should be used continuously, even if the residents' functional status has declined greatly.

Language

English

First Page

83

Last Page

90

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