Huang Hui-Chi, Lin Wen-Chuan, Lin Jin-Ding
Department of Nursing, National Taipei College of Nursing, Taipei, Taiwan.
J Clin Nurs. 2008 Sep;17(17):2275-83. doi: 10.1111/j.1365-2702.2008.02337.x.
This study developed a checklist of both intrinsic and extrinsic risk factors for falls among older people based on consensus among a panel of experts and obtained expert content validity. The developed checklist is intended to help nurses better understand risk factors and take effective measures to prevent falls.
Ageing involves changes in musculoskeletal and neuromuscular systems that make older people more prone to balance problems and falling. While it is believed that both environmental factors and personal habits play important roles in predisposing older people to falls, few broad-based approach checklists to identify both intrinsic and extrinsic risk factors have been published. Even fewer checklists addressing psychosocial problems currently exist. The authors developed a preliminary checklist through literature review.
This study was designed using the Delphi technique, which is widely accepted as an effective method to secure consensus from experts of different backgrounds and perspectives.
The Delphi technique was used to consolidate and compare the opinions of qualified experts from six different fields over three review rounds. Experts' content validity index was used to confirm validity.
Authors developed a preliminary checklist covering nine domains, which, after using the Delphi technique, was expanded to the 10 domains of demographics, illness, medicine, balance measurement, footwear, nutrition, cognitive function, social support, environment and fear of falling. Changes based on panel member suggestions made in the first review round included clarification of definitions for 'dim light', 'slippery', 'doormat' and 'clutter' and revisions to definitions of cigarette and alcohol consumption and types of exercise. Changes made following the second round review included clarification of the meaning and function of social support and the replacement of SPMSQ with MMSE. In the final round, the term 'physical mental disturbance' was changed to 'fear of falling'. The scores of CVI were very high.
The Delphi technique was used successfully to refine the author-developed checklist based on experts' input. To ensure expert input reliability, concepts were defined by the authors and supported with photographs and videos, as needed.
The checklist helps assess risk factors and identify older people at higher risk of falls and may help reduce fall risk.
本研究基于专家小组的共识，制定了一份老年人跌倒的内在和外在风险因素清单，并获得了专家内容效度。所制定的清单旨在帮助护士更好地理解风险因素，并采取有效措施预防跌倒。
衰老涉及肌肉骨骼和神经肌肉系统的变化，使老年人更容易出现平衡问题和跌倒。虽然人们认为环境因素和个人习惯在使老年人易跌倒方面都起着重要作用，但很少有广泛适用的方法清单来识别内在和外在风险因素。目前解决心理社会问题的清单更少。作者通过文献综述制定了一份初步清单。
本研究采用德尔菲技术进行设计，该技术被广泛认为是一种从不同背景和观点的专家那里获得共识的有效方法。
使用德尔菲技术在三轮评审中整合和比较来自六个不同领域的合格专家的意见。专家内容效度指数用于确认效度。
作者制定了一份涵盖九个领域的初步清单，在使用德尔菲技术后，扩展到人口统计学、疾病、药物、平衡测量、鞋类、营养、认知功能、社会支持、环境和跌倒恐惧这十个领域。根据第一轮评审中专家小组成员的建议所做的更改包括对“昏暗灯光”“滑”“门垫”和“杂乱”的定义进行澄清，以及对吸烟和饮酒的定义以及运动类型进行修订。第二轮评审后所做的更改包括对社会支持的含义和功能进行澄清，并用MMSE取代SPMSQ。在最后一轮中，“身心障碍”一词改为“跌倒恐惧”。CVI得分非常高。
成功使用德尔菲技术根据专家的意见完善了作者制定的清单。为确保专家意见的可靠性，作者对概念进行了定义，并在需要时辅以照片和视频。
该清单有助于评估风险因素，识别跌倒风险较高的老年人，并可能有助于降低跌倒风险。
