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机构养老老年人队列研究:基于护理诊断的跌倒危险因素

Cohort study of institutionalized elderly people: fall risk factors from the nursing diagnosis.

作者信息

dos Reis Karine Marques Costa, de Jesus Cristine Alves Costa

机构信息

Universidade de Brasília, Brasília, DF, Brazil.

Departamento de Enfermagem, Faculdade de Ciências da Saúde, Universidade de Brasília, Brasília, DF, Brazil.

出版信息

Rev Lat Am Enfermagem. 2015 Nov-Dec;23(6):1130-8. doi: 10.1590/0104-1169.0285.2658.

Abstract

OBJECTIVE

To determine the incidence of falls in elderly residents of long-stay institutions of the Federal District, to identify the aspects involved in the falls, in terms of risk factors, from the application of scales and the Taxonomy II of NANDA-I, and to define the level of accuracy with its sensitivity and specificity for application in the clinical nursing practice.

METHOD

This was a cohort study with the evaluation of 271 elderly people. Cognition, functionality, mobility and other intrinsic factors were evaluated. After six months, the elderly people who fell were identified, with significance analysis then performed to define the risk factors.

RESULTS

The results showed an incidence of 41%. Of the 271 patients included, 69 suffered 111 episodes of falls during the monitoring period. Risk factors were the presence of stroke with its sequelae (OR: 1.82, 95% CI 1.01 - 3.28, p=.045), presenting more than five chronic diseases (OR: 2.82, 95% CI 1.43 - 5.56, p=.0028), foot problem (OR: 2.45, 95% CI 1.35 - 4.44, p=.0033) and motion (OR: 2.04, 95% CI 1.15 - 3.61, p=.0145).

CONCLUSION

The taxonomy has high validity regarding the detection of elderly people at risk of falling and should be applied consistently in the clinical nursing practice.

摘要

目的

确定联邦区长期护理机构中老年居民跌倒的发生率,通过应用量表和北美护理诊断协会国际版(NANDA-I)的护理诊断分类法II,从危险因素方面识别跌倒所涉及的因素,并确定其在临床护理实践中应用的准确性水平及其敏感性和特异性。

方法

这是一项队列研究,对271名老年人进行评估。评估了认知、功能、活动能力和其他内在因素。六个月后,确定跌倒的老年人,然后进行显著性分析以确定危险因素。

结果

结果显示跌倒发生率为41%。在纳入的271名患者中,69人在监测期间发生了111次跌倒事件。危险因素包括有中风后遗症(比值比:1.82,95%置信区间1.01 - 3.28,p = 0.045)、患有五种以上慢性病(比值比:2.82,95%置信区间1.43 - 5.56,p = 0.0028)、足部问题(比值比:2.45,95%置信区间1.35 - 4.44,p = 0.0033)和行动不便(比值比:2.04,95%置信区间1.15 - 3.61,p = 0.0145)。

结论

该分类法在检测有跌倒风险的老年人方面具有很高的有效性,应在临床护理实践中持续应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77af/4664014/20d7ff11782a/0104-1169-rlae-23-06-01130-gf01.jpg

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