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智力障碍者的跌倒预防:量身定制的多因素跌倒风险评估和干预策略的制定、实施和过程评估。

Falls prevention in persons with intellectual disabilities: development, implementation, and process evaluation of a tailored multifactorial fall risk assessment and intervention strategy.

机构信息

Radboud University Medical Centre, Nijmegen Centre for Evidence Based Practice, Department of Rehabilitation, Nijmegen, The Netherlands.

出版信息

Res Dev Disabil. 2013 Sep;34(9):2788-98. doi: 10.1016/j.ridd.2013.05.041. Epub 2013 Jun 20.

Abstract

In the general elderly population, multifactorial screening of fall risks has been shown to be effective. Although persons with intellectual disabilities (ID) fall more often, there appears to be no targeted screening for them. The aim of this study was to develop, implement, and evaluate a falls clinic for persons with ID. Based on guidelines, literature, and expert meetings, a falls clinic for persons with ID was developed. In total, 26 persons with ID and a fall history participated in the study. Process evaluation was conducted with evaluation forms and focus groups. Fifty interventions (0-8 per person) were prescribed. The (para)medical experts, clients, and caregivers described the falls clinic as useful. Advice for improvement included minor changes to clinic content. Logistics were the largest challenge for the falls clinic, for example organizing meetings, completing questionnaires prior to meetings, and ensuring that a personal caregiver accompanied the person with ID. Furthermore, the need for a screening tool to determine whether a person would benefit from the falls clinic was reported. In conclusion, the falls clinic for persons with ID was considered feasible and useful. Some minor content changes are necessary and there is a need for a screening tool. However, logistics concerning the falls clinic need improvement. More attention and time for multifactorial and multidisciplinary treatment of persons with ID is necessary. Implementation on a larger scale would also make it possible to investigate the effectiveness of the falls clinic with regard to the prevention of falls in this population.

摘要

在一般的老年人群中,已经证明多因素跌倒风险筛查是有效的。尽管智障人士(ID)跌倒的频率更高,但似乎没有针对他们的有针对性的筛查。本研究的目的是为智障人士开发、实施和评估跌倒诊所。基于指南、文献和专家会议,为智障人士开发了跌倒诊所。共有 26 名有跌倒史的 ID 人士参与了这项研究。采用评估表和焦点小组进行了过程评估。共开出了 50 项(0-8 项/人)干预措施。(准)医疗专家、客户和护理人员都认为跌倒诊所很有用。改进建议包括对诊所内容进行微小调整。诊所的后勤工作是最大的挑战,例如组织会议、在会议前完成问卷、并确保有一名个人护理人员陪同 ID 人士。此外,还需要一种筛查工具来确定一个人是否需要从跌倒诊所中受益。总之,为 ID 人士设立的跌倒诊所被认为是可行且有用的。一些小的内容调整是必要的,并且需要一种筛查工具。然而,诊所的后勤工作需要改进。需要更多的关注和时间来对 ID 人士进行多因素和多学科的治疗。在更大的范围内实施,也将有可能调查该跌倒诊所对预防该人群跌倒的效果。

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