健康生態學視域下構建高齡衰弱老年人營養干預方案

Construct the nutrition intervention program for the aged and weak from the perspective of health ecology

YIN Xia，YUAN Xiaoyi，WANG QinghuaBinzhou Hospital of Traditional Chinese Medicine，Shandong 256603 ChinaCorresponding Author WANG Qinghua，E-mail：pingxing05@126.com

Abstract Objective：To construct nutrition intervention program for the aged and frail elderly under the guidance of health ecology theory，and to provide basis for nutrition management of this population.Methods：The domestic and foreign literatures on nutrition intervention for the aged with frailty were systematically searched，and the nutrition intervention program for the aged and frail elderly was constructed through literature study，discussion of the research group and two rounds of Dephi method correspondence from 16 experts.Results：The effective recovery rate of the two rounds of expert letter consultation was 100%，the expert authority coefficient of the second round of expert letter consultation was 0.827，and the Kendall′s coefficient of the first，second and third indexes were 0.591，0.495 and 0.482，respectively.Finally，a nutrition intervention scheme for the frail elderly was formed including 4 first-level indexes，8 second-level indexes and 40 third-level indexes.Conclusion：The nutrition intervention program for the aged with frailty from the perspective of health ecology established in this study is necessary and scientific and can provide standardized and reasonable reference for nutritional intervention management for elderly people with frailty.

Keywords frailty elderly;Delphi method;nutrition intervention;health ecology;nursing

摘要 目的：以健康生態學理論為指導，構建高齡衰弱老年人營養干預方案，為高齡衰弱老年人營養管理提供依據。方法：系統檢索國內外高齡衰弱老年人營養干預文獻，經文獻研究、研究小組討論，通過16名專家兩輪德爾菲法專家函詢，構建高齡衰弱老年人營養干預方案。結果：兩輪專家函詢的有效回收率均為100%，第2輪專家函詢專家權威系數為0.827，一級指標、二級指標、三級指標的肯德爾和諧系數分別為0.591，0.495，0.482，最終形成包含4個一級指標、8個二級指標、40個三級指標的衰弱老年人營養干預方案。結論：本研究構建的健康生態學視域下高齡衰弱老年人營養干預方案具有必要性和科學性，可為高齡衰弱老年人營養干預管理提供規范、合理的參考。

關鍵詞 衰弱老年人；德爾菲法；營養干預；健康生態學；護理

doi：10.12102/j.issn.2095-8668.2024.19.010

在我國，80歲及以上老年人稱為高齡老年人［1］。我國老年人口快速增長，特別是高齡老年人數量不斷上升［2］。2020年11月第7次全國人口普查結果顯示，60歲及以上老年人占總人口的18.7％，未來，老年人口將超過4億人，其中80歲以上的老年人將占老年人口的20%［3］。衰弱是老年人普遍存在的一種狀態，其表現為生理功能儲備下降，導致身體易受傷害，抗應激能力降低［4］。一般表現為體重減輕、步速下降、肌力減弱、日常活動能力降低、自訴疲憊感等，具有3項及以上表現者可被認定為衰弱［5］。年長者的行動能力隨著年齡增長而下降［6］，因此，其通過緩步來彌補運動能力減弱，但這樣的步態容易導致跌倒和相關損傷，進而影響其生活質量［7］。……