一般病院に入院中の高齢患者における生活機能の変化に影響する要因

Factors Affecting Changes in Vital Functions of the Elderly Hospitalized in an General Hospital

抄録

　高齢者が一般病院の入院によって生じる生活機能（認知機能，意欲，ADL）の変化，およびその影響要因を明らかにした．対象は一般病院入院中の65歳以上の患者176人である．方法は入院時と退院時に生活機能（認知機能，意欲，ADL）を評価し，その変化と影響要因について検討した．影響要因は，基本属性，治療・ケア，生活背景からなる12項目とし，多重ロジスティック回帰分析を用いた．結果は，①入院時と退院時の生活機能の変化は，認知機能（p＜.01），意欲（p＜.01）が入院時より退院時に有意に低下を認めたが，ADLに変化は認められなかった．②認知機能，意欲，ADLの変化の影響要因は，年齢，診療科，在院日数であり，年齢は1歳，在院日数は1日増すごとに生活機能低下のリスクが高くなることを示した．したがって生活機能低下の予防は，3つの要因からリスクの高い患者を予測し，入院時より意図的な介入をすることが必要であることが示唆された．

　This study was performed to determine the changes in vital functions and the factors affecting them in hospitalized elderly patients. The study population consisted of 176 hospitalized patients, 65 years old and without dementia. Patients' vital functions, i.e., cognitive functions, motivation, and activities of daily living (ADL), were evaluated at the time of hospitalization and discharge. The changes before and after hospitalization, and 12 variables affecting these functions, were examined. The results indicated that cognitive function and motivation decreased after hospitalization, but there were no changes in ADL. The factors affecting the decreased vital functions included age, diagnosis and treatment department, and the number of days spent in the hospital. The results of this study suggested that early evaluation of vital functions, and preventative nursing intervention for high-risk patients may be necessary to prevent decreases in vital functions in the elderly during hospital stays.