Department of Geriatric Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Aging Ment Health. 2010 Sep;14(7):834-42. doi: 10.1080/13607861003781825.
The primary aim of this study was to explore the impact of falling for frail community-dwelling older persons with and without cognitive impairments who have experienced a recent fall and their primary family caregivers. The secondary aim was to define components for a future fall prevention programme.
Grounded theory interview study, with 10 patients (three cognitively unimpaired, four with mild cognitive impairment and three with dementia) and 10 caregivers.
All patients described a fear of falling and social withdrawal. Caregivers reported a fear of their care recipient (CR) falling. Most patients were unable to name a cause for the falls. Patients rejected the ideas that falling is preventable and that the fear of falling can be reduced. Some caregivers rated the consequences of their CRs' cognitive problems as more burdensome than their falls and believed that a prevention programme would not be useful because of the CRs' cognitive impairment, physical problems, age and personalities.
Falling has major physical and emotional consequences for patients and caregivers. A fall prevention programme should focus on reducing the consequences of falling and on promoting self-efficacy and activity. The causes of falls should be discussed. The programme should include dyads of patients and caregivers because caregivers are highly involved and also suffer from anxiety. Before beginning such a programme, providers should transform negative expectations about the programme into positive ones. Finally, caregivers must learn how to deal with the consequences of their CRs' falling as well as their cognitive impairment.
本研究的主要目的是探讨最近跌倒的伴有和不伴有认知障碍的脆弱社区居住的老年跌倒患者及其主要照顾者的跌倒感受。次要目的是确定未来跌倒预防计划的组成部分。
采用扎根理论访谈研究，纳入 10 名患者（3 名认知无障碍、4 名轻度认知障碍和 3 名痴呆）和 10 名照顾者。
所有患者均描述了对跌倒的恐惧和社会退缩。照顾者报告了对其照顾对象（CR）跌倒的恐惧。大多数患者无法说出跌倒的原因。患者拒绝了跌倒可预防和跌倒恐惧可减轻的观点。一些照顾者认为 CR 的认知问题的后果比跌倒更麻烦，并认为由于 CR 的认知障碍、身体问题、年龄和个性，预防计划不会有用。
跌倒对患者和照顾者都有重大的身体和情感后果。跌倒预防计划应侧重于减轻跌倒的后果，并增强自我效能感和活动能力。应讨论跌倒的原因。该计划应包括患者和照顾者的二人组，因为照顾者高度参与，也会感到焦虑。在开始此类计划之前，提供者应将对计划的负面期望转变为正面期望。最后，照顾者必须学会应对 CR 跌倒及其认知障碍的后果。
