Lowery K, Buri H, Ballard C
Clinical Research Nurse, Medical Research Council, Newcastle upon Tyne, UK.
Int J Geriatr Psychiatry. 2000 Oct;15(10):883-6. doi: 10.1002/1099-1166(200010)15:10<883::aid-gps981>3.0.co;2-9.
To examine the frequency of environmental hazards in the homes and care environments of patients with dementia and their associations with falls.
Falls were prospectively assessed in 65 dementia patients using carer diaries, and the safety of the environment assessed by an occupational therapist using a home hazard checklist.
Hazards were found in 20 (95%) of patients' own homes and 31 (74%) of residential or nursing home environments (care environments). Patients' homes had a mean of 5.4 hazards compared to a mean of 1.8 hazards in care environments, with two or more hazards in 90% of patients' homes and 52% of care environments. Common hazards included low chairs, an absence of grab rails (toilet area), toilets too low and a missing second banister on the stairs. There was no significant association between the number of hazards and the number of falls, although 13 (10%) falls could be attributed to a specific hazard.
Rigorous assessment of the patient's environment revealed multiple rectifiable risks that were contributory to a significant minority of falls.
研究痴呆患者家庭及照护环境中环境危险因素的出现频率及其与跌倒的关联。
通过照护者日志对65名痴呆患者的跌倒情况进行前瞻性评估，由职业治疗师使用家庭危险因素清单对环境安全性进行评估。
在20名（95%）患者的自家住宅以及31名（74%）居住或疗养机构环境（照护环境）中发现了危险因素。患者家中平均有5.4个危险因素，而照护环境中平均为1.8个，90%的患者家中及52%的照护环境中有两个或更多危险因素。常见危险因素包括矮椅子、（卫生间区域）缺少扶手、马桶过低以及楼梯缺少第二层扶手。危险因素数量与跌倒次数之间无显著关联，不过13次（10%）跌倒可归因于某一特定危险因素。
对患者环境进行严格评估发现了多个可纠正的风险因素，这些因素在少数跌倒事件中起到了作用。
