Vikman Irene, Nordlund Anders, Näslund Annika, Nyberg Lars
Division of Health & Rehabilitation, Department of Health Science, Luleå University of Technology, SE 971 87 Luleå, Sweden.
Int J Circumpolar Health. 2011 Apr;70(2):195-204. doi: 10.3402/ijch.v70i2.17813. Epub 2011 Apr 11.
Falls among old people is a well-documented phenomenon; however, falls among people living in the community and receiving home help services have been under-researched. The aim of this study was to investigate the incidence, including possible seasonal variation, circumstances and injuries related to falls among community living home help receivers, and to investigate whether fall incidence is associated with the type and amount of home help services received.
Prospective cohort study.
All 614 persons aged 65 and over who were living in a particular northern Swedish community and receiving municipality home help were included. Data on age, sex and home help service use were collected from home help service records, and falls were reported by staff on report forms specifically designed for the study. Results. A total number of 264 falls were recorded among 122 participants. The overall fall incidence was 626 per 1,000 PY, and incidence rate ratios were significantly correlated to the total amount of services used (p<0.001), as well as to the degree of help for I-ADL needs (p<0.001), P-ADL needs (p<0.001) and escort service (p=0.007). The proportion of falls reported as resulting in injury was 33%. The monthly fall incidence was significantly associated to daylight photoperiod, however it was not associated to temperature.
Fall incidence among home help receivers aged 65 and over seems correlated to the amount of services they receive. This is probably explained by the fact that impairments connected to ADL limitations and home help needs also are connected to an increased risk of falls. This implies that fall prevention should be considered when planning home help care for old people with ADL limitations. Further research on the connection between daylight photoperiod and fall incidence in populations at different latitudes is needed.
老年人跌倒现象已有充分记录；然而，对于社区中接受居家帮助服务的人群的跌倒情况研究不足。本研究的目的是调查社区居家帮助服务接受者跌倒的发生率，包括可能的季节变化、跌倒相关情况及损伤，并调查跌倒发生率是否与所接受的居家帮助服务类型和数量有关。
前瞻性队列研究。
纳入瑞典北部某特定社区所有65岁及以上且接受市政居家帮助服务的614人。从居家帮助服务记录中收集年龄、性别和居家帮助服务使用情况的数据，跌倒情况由专门为该研究设计的报告表上的工作人员进行报告。结果。122名参与者共记录到264次跌倒。总体跌倒发生率为每1000人年626次，发生率比值与所使用服务的总量显著相关（p<0.001），也与针对工具性日常生活活动（I-ADL）需求、基础性日常生活活动（P-ADL）需求的帮助程度以及护送服务显著相关（p=0.007）。报告称因跌倒导致受伤的比例为33%。每月跌倒发生率与日照时长显著相关，但与温度无关。
65岁及以上居家帮助服务接受者的跌倒发生率似乎与其所接受的服务量相关。这可能是由于与ADL限制和居家帮助需求相关的损伤也与跌倒风险增加有关。这意味着在为有ADL限制的老年人规划居家帮助护理时应考虑预防跌倒。需要进一步研究不同纬度人群中日照时长与跌倒发生率之间的关系。
