Mertens Elke I, Halfens Ruud J G, Dassen Theo
Department of Nursing Science, Centre for the Humanities and Health Science, Charité-Universitätsmedizin Berlin, Berlin, Germany.
J Adv Nurs. 2007 Jun;58(6):594-601. doi: 10.1111/j.1365-2648.2007.04265.x. Epub 2007 May 1.
This paper is a report of a study conducted to estimate the sensitivity and specificity of the Care Dependency Scale as a measure of risk of falling for individuals in hospital and nursing home settings.
Falls and their consequences are common problems in hospitals and nursing homes and nurses should assess the potential risks of their patients. Items in fall risk scales resemble a general nursing assessment, which leads to redundant assessment procedures. It would be beneficial to have a single generic instrument for general assessment and fall risk screening.
Standardized questionnaires were used in a cross-sectional study in 2004 and data were gathered from 9943 German nursing home residents and hospital patients (response rate 77.1%). Sensitivity and specificity of all Care Dependency Scale scores were calculated for fall risk. Relationships between the 15 scale items and falls were described using odds ratios and logistic regression analysis.
Patients with falls in hospitals were more care dependent than those without falls. Sensitivity and specificity values showed that with the Care Dependency Scale a differentiation is possible between the falls group and the no-falls group. High odds ratios and logistic regression analysis suggest that the Care Dependency Scale item 'Avoidance of danger' indicated fall risk. Nursing home residents with and without falls had similar care dependency scores.
Nursing assessment in hospitals could be simplified by using the Care Dependency Scale for fall risk screening. Its value in fall risk screening in nursing homes requires further testing.
本文报告一项研究，旨在评估护理依赖量表作为衡量医院和养老院中个体跌倒风险指标的敏感性和特异性。
跌倒及其后果是医院和养老院中的常见问题，护士应评估患者的潜在风险。跌倒风险量表中的项目类似于一般护理评估，这导致评估程序冗余。拥有一种用于一般评估和跌倒风险筛查的单一通用工具将是有益的。
2004年在一项横断面研究中使用标准化问卷，从9943名德国养老院居民和医院患者中收集数据（回复率77.1%）。计算护理依赖量表所有得分对跌倒风险的敏感性和特异性。使用比值比和逻辑回归分析描述15个量表项目与跌倒之间的关系。
医院中跌倒的患者比未跌倒的患者更依赖护理。敏感性和特异性值表明，使用护理依赖量表可以区分跌倒组和未跌倒组。高比值比和逻辑回归分析表明，护理依赖量表项目“避免危险”表明存在跌倒风险。有跌倒和无跌倒的养老院居民的护理依赖得分相似。
在医院中使用护理依赖量表进行跌倒风险筛查可简化护理评估。其在养老院跌倒风险筛查中的价值需要进一步测试。
