[[alternative]]Correlated Factors for the Improvement of Basic Activities of Daily Living Function of Home-based Rehabilitation: A preliminary study

[[abstract]]本研究目的在了解台北縣實施居家復健服務之成效，並初步探討可能影響其復健成效之相關因子，以作為日後長期照護管理中心轉介個案的參考。本研究採回溯性的研究設計，研究樣本為2006年1月至12月台北縣長期照護管理中心實際接受居家復健治療服務的個案，須年滿18歲以上，接受居家復健服務至少滿二次以上，且有完整的轉介、初評治療及結案紀錄者。本研究中居家復健成效的定義為基本日常生活活動功能(BADL)有無進步，居家復健成效相關因子包含人口學特徵、身心功能狀況及使用長期照護資源情況等，並進行單變項與多變項分析，以確認影響其成效之相關因子。研究結果顯示：符合條件之樣本有95名，平均年齡為68.9歲(±17.9)。復健成效進步組有57名，佔總樣本的60%。單變項分析結果顯示：有進步與無進步兩組可能影響的相關因子為治療前BI之失能嚴重程度、認知功能及接受治療次數等三項因子達顯著差異。多變項邏輯斯回歸分析則顯示治療前的失能嚴重程度(BI)15~45分較BI 0~10分者顯現成效的傾向較大，其勝算比為7.19。認知功能完好較重度損傷不全者有成效的傾向較大，勝算比為5.70。接受治療的次數12~24次較接受次數2~4次有成效的傾向較大，勝算比為4.12。結論：建議轉介認知功能較佳、治療前的失能程度中等(介於BI 15~45分)者作為居家復健的個案，以期可以針對具有復健潛能的個案加以治療訓練並發揮居家復健之成效。[[abstract]]The purpose of this study is to investigate the effect of the Home-based Rehabilitation Program held by the Taipei County and to try to explore the correlated factors that might affect the effect. This study is a retrospective design. Data was collected through the database of the Long-term Care Management Division of the Public Health Bureau of Taipei County. The samples were those who received the service of the Home-based Rehabilitation Program from Jan. to Dec. 2006. The effect of Home-based rehabilitation was defined as the improvement of the basic activity of daily living (BADL) function. Univariate and multivariate analysis were conducted to ensure the correlation among various factors or effects.The data of ninety-five subjects with a mean age of 68.9 years old (± 17.9) was collected and analyzed. The improved group was composed of 57 subjects (60%). The results of univariate analysis revealed that there were significant differences between improved and non-improved group. The results of logistic regression, indicated that the better initial Barthel Index (15-45 vs BI 0-10), the better of the cognitive function and the frequency of receiving therapy (12-24 vs 2-4), were found to be significantly correlated with the trend of improving effect (OR. 7.19, 5.70, and 4.12, respectively).In conclusion, in terms of the improvement in the BADL function, suggested referral criteria of home-based rehabilitation should include clients with better cognitive function, more independency of before therapy to ensure better effect. We are supposed to treat those with good rehabilitation potential and pose the good outcomes on the Home-based Rehabilitation Program