Fonad Edit, Wahlin Tarja-Brita Robins, Winblad Bengt, Emami Azita, Sandmark Helene
Stockholm's Sjukhem, Foundation Stockholm and Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
J Clin Nurs. 2008 Jan;17(1):126-34. doi: 10.1111/j.1365-2702.2007.02005.x.
The aim of this study was to identify risk factors for falls in older people living in nursing homes.
Impaired cognitive function and a poor sense of orientation could lead to an increase in falls among those with impaired freedom of movement. Many accidents occur while an older person is walking or being moved.
The study was carried out over four years (2000-2003) and 21 nursing home units in five municipal homes for older people in Stockholm, Sweden, participated. A questionnaire was sent to staff nurses, including questions on fall risk assessments, falls, fractures, medication and freedom-restricting measures, such as wheelchairs with belts and bed rails. The data were aggregated and not patient-bound. The study covered 2,343 reported incidents.
There was a significant correlation between falls and fractures (r = 0.365, p = 0.004), fall risk and use of wheelchairs (r = 0.406, p = 0.001, safety belts (r = 0.403, p = 0.001 and bed rails (r = 0.446, p = 0.000) and between the occurrence of fractures and the use of sleeping pills with benzodiazepines (r = 0.352, p = 0.005). Associations were also found between fall risk and the use of anti-depressants (r = 0.412, p = 0.001).
In clinical practice, patient safety is very important. Preventative measures should focus on risk factors associated with individuals, including their environment. Wheelchairs with safety belts and bed rails did not eliminate falls but our results support the hypothesis that they might be protective when used selectively with less anti-depressants and sleeping pills, especially benzodiazepines.
本研究旨在确定养老院中老年人跌倒的风险因素。
认知功能受损和定向感差可能导致行动自由受限者跌倒几率增加。许多事故发生在老年人行走或被移动时。
该研究历时四年（2000 - 2003年），瑞典斯德哥尔摩市五家养老院的21个护理单元参与其中。向护士发送了一份问卷，包括有关跌倒风险评估、跌倒、骨折、用药以及诸如带安全带的轮椅和床栏等限制自由措施的问题。数据进行了汇总，并非针对特定患者。该研究涵盖了2343起报告事件。
跌倒与骨折之间存在显著相关性（r = 0.365，p = 0.004），跌倒风险与轮椅使用（r = 0.406，p = 0.001）、安全带（r = 0.403，p = 0.001）和床栏（r = 0.446，p = 0.000）之间存在显著相关性，骨折发生与使用含苯二氮䓬类的安眠药之间也存在相关性（r = 0.352，p = 0.005）。还发现跌倒风险与使用抗抑郁药之间存在关联（r = 0.412，p = 0.001）。
在临床实践中，患者安全非常重要。预防措施应侧重于与个体相关的风险因素，包括其环境。带安全带的轮椅和床栏并不能消除跌倒，但我们的结果支持这样的假设，即当与较少的抗抑郁药和安眠药（尤其是苯二氮䓬类）选择性使用时，它们可能具有保护作用。
