| Summary: | 博士 === 國立陽明大學 === 護理學系 === 102 === Background: Activity of daily living (ADL) is an important indicator of health status for institutionalized older residents. ADL is the dynamic process and has differences in developmental trajectories patterns. Objectives: To examine developmental trajectory patterns of ADL among older residents and to determine the relative risks of personal characteristics and health related factors in explaining the trajectories patterns of ADL. Methods: Data was obtained from the National Science Council’s three-year research project (2009-2011). Three hundred and sixty-four older residents completed the whole research process. Group-based trajectory modeling and multinomial logit models have been used in the statistical analysis. Results: 1. Result of this study showed that three ADL developmental trajectory patterns among older residents were the high dependency with function declined group (22.53%), low dependency with function declined group (43.13%), and function persistently independent group (34.34%). 2. In comparison with the “function persistently independent group”, “high dependency with function declined group” was related to the following potential risk factors: older age, female, non-Mainland China province, and married status. After added health status of residents’ into the analysis, three significant factors of “high dependency with function declined group” were the number of illness, depressive symptoms, and cognition status. 3. In comparison with the “function persistently independent group”, “low dependency with function declined group” was related to older age. After added health status of residents’ into the analysis, two significant factors of “low dependency with function declined group” were the number of illness and depressive symptoms. Conclusions: The findings of this study indicated that the health factors including the number of illness, cognitive status, and depressive symptoms were more likely to develop a decline pattern of ADL. Personal characteristics, such as age, sex, marital status, and province were significant risk factors of ADL decline. Suggestions: According to the results of this study, nurses who work in long-term care facilities have to be competent in their assessment skills, especially for assessing ADL, depressive symptoms, and cognitive status. The competence for nurses to provide services to ameliorate residents' depressive symptoms and cognitive status is important. Other than that, nurses should provide health promoting services to residents according to their ADL developmental trajectory patterns in order to slow the speed of ADL disability.
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