| 摘要: | 背景:台灣已邁入高齡社會，65歲以上人口占18.35%，高齡化帶來沉重醫療負擔。高齡住院患者常見虛弱、失智、譫妄等共病問題，其中譫妄為一種可逆性的急性認知障礙，在一般病房發生率約15%–30%。臨床上多數譫妄未被即時辨識與介入，易導致病情惡化與死亡風險，早期識別與處置至關重要。
目的:探討高齡住院患者譫妄及譫妄嚴重程度之相關因素。
方法:採橫斷式設計，運用方便取樣方式，以宜蘭某醫院一般病房之高齡住院病患為研究對象，共計收案26人。研究問卷包含：人口學特性、臨床病歷資料、簡易心智量表（MMSE）以評估受試者之認知功能、混亂評估量表(CAM)作為譫妄篩檢工具，以及譫妄評分量表－修訂版98(DRS-R98)評估譫妄之嚴重程度。
結果:譫妄發生率為30.8%，其顯著相關因素包括年齡、疾病末期、曾有譫妄病史、認知功能障礙、侵入性導管置入、醫療監測儀器使用及缺乏訪客探視。譫妄嚴重程度平均得分為15.13(SD=9.70)，其顯著相關因素包括疾病末期、曾有譫妄病史與認知功能障礙者。
結論:高齡住院患者譫妄發生率約為三成，結果突顯多重因素對譫妄發生與嚴重程度的影響。建議未來擴大樣本與收案範圍，採多中心及多時點設計，並加強高齡友善收案與臨床預防措施，以提升照護品質與實證基礎。
Background: Taiwan has become an aged society,with people aged 65 years and above accounting for 18.35% of the population.Population aging results in an immense healthcare burden.Elderly inpatients often have comorbidities such as frailty,dementia,and delirium,of which delirium is a reversible acute cognitive impairment with an incidence of 15-30% in general wards.In clinical practice,many cases of delirium are not promptly identified,and intervention was not carried out.This tends to cause worsening and risk of death.Thence,early identification and management are vital.
Objective:To examine the correlation factors of delirium and its severity in elderly inpatients.
Methods:A cross-sectional study design was employed and convenience sampling was used to recruit elderly inpatients in a general ward in a hospital in Yilan County.A total of 26 subjects were recruited.The study questionnaire includes: demographic characteristics,clinical medical record data,Mini-Mental State Examination(MMSE) to evaluate cognitive function,Confusion Assessment Method (CAM) for delirium screening,and Delirium Rating Scale-Revised-98(DRS-R-98) to evaluate delirium severity.
Results:The incidence of delirium was 30.8% and significant correlation factors include age,terminal disease,history of delirium,cognitive impairment,invasive catheterization,medical monitoring equipment usage,and lack of visitors.The mean delirium severity score was 15.13(SD = 9.70) and significant correlation factors include terminal disease,history of delirium,and cognitive impairment.
Conclusion:The incidence of delirium in elderly inpatients is around 30% and the results highlight that multiple factors affect the onset of delirium and its severity.We recommend that the sample size and scope of enrollment be enlarged in the future,a multi-center and multiple time point design be used,and elderly-friendly enrollment and clinical prevention measures be enhanced to increase care quality and empirical foundation. |
