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出院后跌倒:老年人对预防跌倒策略的了解与研究证据之间存在差距吗?

Falls after discharge from hospital: is there a gap between older peoples' knowledge about falls prevention strategies and the research evidence?

机构信息

School of Physiotherapy, The University of Notre Dame Australia, Australia.

出版信息

Gerontologist. 2011 Oct;51(5):653-62. doi: 10.1093/geront/gnr052. Epub 2011 May 17.

Abstract

PURPOSE

The aim of this study was to examine whether older people are prepared to engage in appropriate falls prevention strategies after discharge from hospital.

DESIGN AND METHODS

We used a semi-structured interview to survey older patients about to be discharged from hospital and examined their knowledge regarding falls prevention strategies to utilize in the post-discharge period. The study was part of a prospective cohort study, nested within a larger, randomized controlled trial. Participants (n = 333) were asked to suggest strategies to reduce their falls risk at home after discharge, and their responses were compared with current reported research evidence for falls prevention interventions.

RESULTS

Participants' strategies (n = 629) were classified into 7 categories: behavioral, support while mobilizing, approach to movement, physical environment, visual, medical, and activities or exercise. Although exercise has been identified as an effective falls risk reduction strategy, only 2.9% of participants suggested engaging in exercises. Falls prevention was most often conceptualized by participants as requiring 1 (35.4%) or 2 (40.8%) strategies for avoiding an accidental event, rather than engaging in sustained multiple risk reduction behaviors.

IMPLICATIONS

Results demonstrate that older patients have low levels of knowledge about appropriate falls prevention strategies that could be used after discharge in spite of their increased falls risk during this period. Findings suggest that health care workers should design and deliver falls prevention education programs specifically targeted to older people who are to be discharged from hospital.

摘要

目的

本研究旨在探讨老年人在出院后是否准备好采取适当的防跌倒策略。

设计与方法

我们使用半结构式访谈调查了即将出院的老年患者,检查了他们在出院后利用防跌倒策略的知识。该研究是一项前瞻性队列研究的一部分,嵌套在一项更大的随机对照试验中。研究要求参与者(n=333)提出在出院后降低家中跌倒风险的策略,并将他们的回答与当前关于防跌倒干预措施的研究证据进行比较。

结果

参与者的策略(n=629)分为 7 类:行为、移动时的支持、运动方法、物理环境、视觉、医疗和活动或锻炼。尽管运动已被确定为有效的跌倒风险降低策略,但只有 2.9%的参与者建议进行锻炼。参与者对防跌倒的理解通常是认为需要采取 1(35.4%)或 2(40.8%)种策略来避免意外事件,而不是采取持续的多种风险降低行为。

意义

研究结果表明,尽管在这一时期老年人的跌倒风险增加,但他们对出院后可使用的适当防跌倒策略知之甚少。研究结果表明,医护人员应该为即将出院的老年人设计和提供专门的防跌倒教育计划。

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