Huang Hui-Chi, Lee Chian-Her, Wu Shang-Liang
Graduate Institute of Long Term Care, National Taipei College of Nursing, Taipei, Taiwan, ROC.
J Clin Nurs. 2006 Apr;15(4):436-43. doi: 10.1111/j.1365-2702.2006.01346.x.
This research explores the compliance by older people in Taiwan with wearing hip protectors and whether protectors can prevent fractures or decrease injuries after falls.
The ageing process causes degeneration of nerves, joints, muscles and then the incidence of falls in the older people is higher than in the young. Therefore, fractures caused by falls, particularly hip fractures of older people, need to be studied. Hip protectors are designed to reduce hip fractures and hip injuries when falls occur, by distributing the impact load and absorbing the impact force generated during a fall.
This research was designed as a longitudinal study using purposive sampling and intervention for six months.
The target population were older people at high risk for falls and the study was carried out during a six-month period. Self-reported data were collected by interview and questionnaires. The expert validity of the questionnaires, including demographics, high-risk group, compliance and correct wearing of hip protectors and fall injuries, as assessed by three experts, was 0.94 and the test-retest correlation coefficient was 0.95. Individuals were excluded from the research sample if they were 24-hour bedridden, non-mobile or had an existing hip injury.
Ten female subjects participated in this study. Their mean age was 76.1 years. During a six-month follow-up, there were 12 falls while wearing hip protectors, however, no fractures occurred because of the falls.
This is the first research into hip protectors in Taiwan. The reasons for low compliance by older people were (1) unaccustomed to use, (2) discomfort, (3) wearing only during the daytime, (4) lack of assistance from family caregivers.
Fall prevention, exercise and the use of hip protectors can significantly decrease the incidence of hip fractures. Although hip protectors are effective in reducing fall fracture risk, the compliance rate remains low. In the future, the researchers will develop a hip protector program related to teaching the correct method for wearing protectors. Helping older people learn how to overcome the discomfort of wearing hip protectors and encouraging a willingness to wear them is imperative.
本研究探讨台湾老年人佩戴髋部保护器的依从性,以及保护器能否预防跌倒后的骨折或减少伤害。
衰老过程会导致神经、关节、肌肉退化,老年人跌倒的发生率高于年轻人。因此,需要研究跌倒导致的骨折,尤其是老年人的髋部骨折。髋部保护器旨在通过分散撞击负荷和吸收跌倒时产生的冲击力,减少跌倒时的髋部骨折和髋部损伤。
本研究设计为一项纵向研究,采用目的抽样法并进行为期六个月的干预。
目标人群为跌倒高风险的老年人,研究为期六个月。通过访谈和问卷收集自我报告数据。由三位专家评估的问卷的专家效度,包括人口统计学、高风险组、髋部保护器的依从性和正确佩戴情况以及跌倒伤害,为0.94,重测相关系数为0.95。如果个体卧床24小时、无法活动或已有髋部损伤,则将其排除在研究样本之外。
十名女性受试者参与了本研究。她们的平均年龄为76.1岁。在为期六个月的随访期间,佩戴髋部保护器时发生了12次跌倒,但没有因跌倒而发生骨折。
这是台湾首次对髋部保护器进行的研究。老年人依从性低的原因有:(1)不习惯使用;(2)不舒服;(3)仅在白天佩戴;(4)缺乏家庭照顾者的协助。
预防跌倒、锻炼和使用髋部保护器可显著降低髋部骨折的发生率。尽管髋部保护器在降低跌倒骨折风险方面有效,但依从率仍然很低。未来,研究人员将制定一个与教授正确佩戴保护器方法相关的髋部保护器项目。帮助老年人学会如何克服佩戴髋部保护器的不适感并鼓励他们愿意佩戴是当务之急。