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夏威夷州老年人预防跌倒的见解。

Insights about Fall Prevention of Older Adults in the State of Hawai'i.

作者信息

Yamazaki Yuka, Hayashida Cullen T, Yontz Valerie

机构信息

Department of Public Health Sciences, University of Hawai'i, Honolulu, HI.

出版信息

Hawaii J Med Public Health. 2017 Jan;76(1):3-8.

Abstract

The senior population in Hawai'i is growing at a dramatic pace. In the older population, falls and fall-related injuries are leading causes of morbidity and mortality. Moreover, the health care costs for falls are very high. The State of Hawai'i has taken measures to prevent falls through the promotion of medication reviews, vision checks, home assessments, and exercise. However, current published examinations of fall preventive measures have been insufficient, and more research is needed to confirm risk factors, effectiveness of preventive measures, and to explore future objectives. This paper examined the validity of fall risk factors and fall preventive measures for Hawai'i's seniors by conducting mail questionnaire surveys to a sample of seniors using medical alert services from one company in Hawai'i. The results of chi-square analysis suggest that having reduced ability to perform Activities of Daily Living (ADL) and reduced Instrumental Activities of Daily Living (IADL) were associated with a greater risk of falls ( < .01). In addition, those who fell were more likely to talk about fall preventions with their family members or friends and health providers compared with those who did not ( = .048 and .003, respectively). Evidence-based exercise programs for strengthening muscles and controlling physical balance may be needed to improve ADL and IADL. Furthermore, the results suggest that seniors do not accept that they are at risk of falling before they actually fall. Public health providers should consider how they approach seniors, and how they inform them of the importance of fall prevention across the life span.

摘要

夏威夷的老年人口正以惊人的速度增长。在老年人群体中,跌倒及与跌倒相关的伤害是发病和死亡的主要原因。此外,跌倒的医疗费用非常高昂。夏威夷州已采取措施,通过推广药物审查、视力检查、家庭评估和锻炼来预防跌倒。然而,目前已发表的关于跌倒预防措施的研究并不充分,还需要更多研究来确认风险因素、预防措施的有效性,并探索未来目标。本文通过对夏威夷一家公司使用医疗警报服务的老年人群体样本进行邮寄问卷调查,研究了夏威夷老年人跌倒风险因素和跌倒预防措施的有效性。卡方分析结果表明,日常生活活动能力(ADL)下降和工具性日常生活活动能力(IADL)下降与跌倒风险增加相关(<0.01)。此外,与未跌倒者相比,跌倒者更有可能与家人、朋友及医疗服务提供者谈论跌倒预防问题(分别为P = 0.048和0.003)。可能需要基于证据的锻炼计划来增强肌肉力量和控制身体平衡,以改善ADL和IADL。此外,研究结果表明,老年人在实际跌倒之前并不认为自己有跌倒风险。公共卫生服务提供者应考虑如何与老年人沟通,以及如何告知他们在整个生命周期中预防跌倒的重要性。

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