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老年人与跌倒:近期跌倒后的健康状况、生活质量、生活方式、护理网络、预防措施以及对服务使用的看法

Older people and falls: health status, quality of life, lifestyle, care networks, prevention and views on service use following a recent fall.

作者信息

Roe Brenda, Howell Fiona, Riniotis Konstantinos, Beech Roger, Crome Peter, Ong Bie Nio

机构信息

Evidence-based Practice Research Centre, Faculty of Health, Edge Hill University, Ormskirk, UK.

出版信息

J Clin Nurs. 2009 Aug;18(16):2261-72. doi: 10.1111/j.1365-2702.2008.02747.x.

Abstract

AIM AND OBJECTIVE

This study has investigated older people's experiences of a recent fall, its impact on their health, lifestyle, quality of life, care networks, prevention and their views on service use.

BACKGROUND

Falls are common in older people and prevalence increases with age. Falls prevention is a major policy and service initiative.

DESIGN

An exploratory, qualitative design involving two time points.

METHOD

A convenience sample of 27 older people from two primary care trusts who had a recent fall. Taped semi structured qualitative interviews were conducted and repeated at follow up to detect change over time and repeat falls. Data were collected on their experience of falls, health, activities of living, lifestyle, quality of life, use of services, prevention of falls, informal care and social networks. Content analysis of transcribed interviews identified key themes.

RESULTS

The majority of people fell indoors (n = 23), were repeat fallers (n = 22) with more than half alone when they fell (n = 15). For five people it was their first ever fall. Participants in primary care trust 1 had a higher mean age than those in primary care trust 2 and had more injurious falls (n = 12, mean age 87 years vs. n = 15, mean age 81 years). The majority of non-injurious falls went unreported to formal services. Falls can result in a decline in health status, ability to undertake activities of living, lifestyle and quality of life.

CONCLUSIONS

Local informal care and support networks are as important as formal care for older people at risk of falls or who have fallen. Access to falls prevention programmes and services is limited for people living in more rural communities.

RELEVANCE TO PRACTICE

Falls prevention initiatives and services should work with local communities, agencies and informal carers to ensure equitable access and provision of information, resources and care to meet the needs of older people at risk or who have fallen.

摘要

目的

本研究调查了老年人近期跌倒的经历、跌倒对其健康、生活方式、生活质量、护理网络、预防措施的影响以及他们对服务使用的看法。

背景

跌倒在老年人中很常见,且患病率随年龄增长而增加。预防跌倒是一项主要的政策和服务举措。

设计

采用涉及两个时间点的探索性定性设计。

方法

从两个初级保健信托机构中选取27名近期跌倒的老年人作为便利样本。进行了录音的半结构化定性访谈,并在随访时重复进行,以检测随时间变化以及再次跌倒的情况。收集了他们关于跌倒经历、健康状况、日常生活活动、生活方式、生活质量、服务使用、跌倒预防、非正式护理和社交网络的数据。对转录访谈进行内容分析以确定关键主题。

结果

大多数人在室内跌倒(n = 23),是多次跌倒者(n = 22),超过一半的人跌倒时独自一人(n = 15)。有五人是首次跌倒。初级保健信托机构1的参与者平均年龄高于初级保健信托机构2的参与者,且受伤跌倒的情况更多(n = 12,平均年龄87岁,对比n = 15,平均年龄81岁)。大多数未造成伤害的跌倒未向正规服务机构报告。跌倒会导致健康状况、进行日常生活活动的能力、生活方式和生活质量下降。

结论

对于有跌倒风险或已经跌倒的老年人来说,当地的非正式护理和支持网络与正规护理同样重要。生活在农村社区的人们获得跌倒预防计划和服务的机会有限。

与实践的相关性

跌倒预防举措和服务应与当地社区、机构和非正式护理人员合作,以确保公平获取并提供信息、资源和护理,以满足有跌倒风险或已经跌倒的老年人的需求。

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