Department of Nursing Home Medicine Amsterdam, VU University Medical Centre/EMGO Institute for Research in Extramural Medicine, Amsterdam, The Netherlands.
J Am Geriatr Soc. 2010 Sep;58(9):1739-48. doi: 10.1111/j.1532-5415.2010.03036.x.
The objective of this review was to systematically describe and analyze fear of falling (FoF) in patients after a hip fracture, focusing on measurement instruments for FoF, the prevalence of FoF, factors associated with FoF, and interventions that may reduce FoF. Fifteen relevant studies were found through a systematic literature review, in which the PubMed, Embase, PsychINFO, and CINAHL databases were searched. Some of these studies indicated that 50% or more of patients with a hip fracture suffer from FoF, although adequate instruments still have to be validated for this specific group. FoF was associated with several negative rehabilitation outcomes, such as loss of mobility, institutionalization, and mortality. FoF was also related to less time spent on exercise and an increase in falls, although knowledge about risk factors, the prevalence over a longer time period, and the exact causal relations with important health outcomes is limited. Most studies suffer from selection bias by excluding patients with physical and cognitive disorders. Hence, more research is required, including in patients who are frail and have comorbidities. Only when knowledge such as this becomes available can interventions be implemented to address FoF and improve rehabilitation outcomes after a hip fracture.
本次综述的目的在于系统性描述和分析髋关节骨折患者的跌倒恐惧（Fear of Falling，FoF）情况，重点在于 FoF 的测量工具、FoF 的发生率、与 FoF 相关的因素，以及可能降低 FoF 的干预措施。通过系统性文献检索，在 PubMed、Embase、PsychINFO 和 CINAHL 数据库中找到了 15 项相关研究。其中一些研究表明，50%或更多的髋关节骨折患者患有 FoF，但针对这一特定人群，仍需要对充分的工具进行验证。FoF 与多种负面康复结果相关，如活动能力丧失、住院治疗和死亡。FoF 也与锻炼时间减少和跌倒增加有关，尽管对危险因素、更长时间内的患病率以及与重要健康结果的确切因果关系的了解有限。大多数研究因排除了身体和认知障碍患者而存在选择偏倚。因此，需要开展更多的研究，包括针对虚弱和合并症患者的研究。只有当获得此类知识后，才能实施干预措施以解决 FoF 问题，并改善髋关节骨折后的康复结果。
