Hughes C C, Kneebone I I, Jones F, Brady B
Canterbury Christ Church University,Salomans Centre for Applied Psychology,UK.
University of Western Sydney,Clinical and Health Psychology Research Initiative,Australia.
Int Psychogeriatr. 2015 Jul;27(7):1071-87. doi: 10.1017/S1041610214002701. Epub 2015 Jan 30.
Four constructs are encompassed by the term "falls-related psychological concerns" (FrPC); "fear of falling" (FOF), "falls-related self-efficacy" (FSe), "balance confidence" (BC) and "outcome expectancy" (OE). FrPC are associated with negative consequences including physical, psychological, and social. Identifying factors associated with FrPC could inform interventions to reduce these concerns.
Sixty-two empirical papers relating to psychological factors associated with FrPC in community-dwelling older people (CDOP) were reviewed. Four levels of evidence were used when evaluating the literature: good, moderate, tentative, and none.
Evidence that anxiety predicted FOF, BC, and OE was tentative. Moderate evidence was found for anxiety predicting FSe. Good evidence was found for depression predicting FSe. Moderate evidence was found for depression predicting both FOF and BC. No evidence was found for depression predicting OE. Tentative evidence was found for FSe predicting depression. Good and moderate evidence was found for quality of life (QoL) being predicted by FOF and BC respectively. Tentative evidence was found for FSe predicting QoL. Moderate evidence was found for QoL predicting both FSe and BC. No evidence was found for QoL predicting FOF. Good and moderate evidence was found for activity avoidance/restriction (AA/AR) being predicted by FOF and FSe respectively. Tentative evidence was found for BC and OE predicting AA/AR, as well as for AA/AR predicting FOF. Moderate evidence for activity level (AL) predicting FOF was identified, however the evidence of this predicting FSe and BC was tentative. Evidence for FOF, FSe, and BC predicting AL was tentative as was evidence to suggest FOF predicted coping.
Mixed evidence has been found for the association of psychological factors in association with FrPCs. Future research should employ theoretically grounded concepts, use multivariate analysis and longitudinal designs.
“跌倒相关心理问题”（FrPC）这一术语涵盖四种概念；“害怕跌倒”（FOF）、“跌倒相关自我效能感”（FSe）、“平衡信心”（BC）和“结果期望”（OE）。FrPC与包括身体、心理和社会方面的负面后果相关。识别与FrPC相关的因素可为减少这些问题的干预措施提供依据。
对62篇关于社区居住老年人（CDOP）中与FrPC相关心理因素的实证论文进行了综述。在评估文献时使用了四个证据级别：充分、中等、初步和无。
焦虑预测FOF、BC和OE的证据是初步的。发现焦虑预测FSe有中等证据。发现抑郁预测FSe有充分证据。发现抑郁预测FOF和BC有中等证据。未发现抑郁预测OE的证据。发现FSe预测抑郁有初步证据。发现FOF和BC分别预测生活质量（QoL）有充分和中等证据。发现FSe预测QoL有初步证据。发现QoL预测FSe和BC有中等证据。未发现QoL预测FOF的证据。发现FOF和FSe分别预测活动回避/限制（AA/AR）有充分和中等证据。发现BC和OE预测AA/AR以及AA/AR预测FOF有初步证据。确定了活动水平（AL）预测FOF的中等证据，然而其预测FSe和BC的证据是初步的。FOF、FSe和BC预测AL的证据是初步的，表明FOF预测应对的证据也是初步的。
已发现心理因素与FrPCs之间的关联证据不一。未来的研究应采用基于理论的概念，使用多变量分析和纵向设计。
