Tsai Li-Yun, Campbell Malcolm, Chen Ching-Ju, Hsieh Ruey-Kuen, Chien Hui-Hsien, Tsai Jung-Mei
1PhD, RN, Director, Department of Nursing, China Medical University Hospital, and Associate Professor, College of Nursing and Health Sciences Da-Yeh University, Taiwan, ROC 2PhD, Lecturer in Statistics, School of Nursing, Midwifery and Social Work, University of Manchester, England 3PhD, RN, Assistant Professor, College of Nursing and Health Sciences Da-Yeh University, Taiwan, ROC 4MD, Physician, Department of Hematology & Oncology, Mackay Memorial Hospital, Taiwan, ROC 5MSN, RN, Leader, Department of Nursing, Mackay Memorial Hospital, and Instructor, Department of Nursing, Mackay Medical College, Taiwan, ROC 6PhD, RN, Supervisor, Department of Nursing, Mackay Memorial Hospital, and Assistant Professor, Department of Nursing, Mackay Medical College, Taiwan, ROC.
J Nurs Res. 2017 Aug;25(4):310-318. doi: 10.1097/JNR.0000000000000174.
Falls and fall-related injuries are important indicators for quality of nursing care in institutions. Few studies have been conducted specifically on this topic for hospitalized patients with cancer in Taiwan.
The aims of this study were to understand falls and levels of injury; to identify associations among fall-related injuries, demographics, and causes of falling; and to predict fall-related injuries in hospitalized patients with cancer.
A retrospective survey design was used. Data were retrieved from the Taiwan Patient-Safety Reporting system query fall incidences for persons hospitalized with cancer at a medical center in northern Taiwan from 2010 to 2012. Data were encoded and analyzed with descriptive statistics, the chi-square test, and multiple stepwise logistic regression analysis using IBM SPSS Statistics version 18.0.
One hundred fifty-six (85%) of the 184 hospitalized patients with cancer had fall-related injuries. Falling tended to be more frequent in men without a history of falls and more prevalentat night. The results of regression analysis showed that the variables being with companions at the time of a fall (OR = 5.411, 95% CI [1.619, 18.081]), lower limb weakness (OR = 0.284, 95% CI [0.097, 0.832]), postural hypotension (OR = 0.101, 95% CI [0.014, 0.733]), total score of fall risk factors (OR = 1.688, 95% CI [1.071, 2.660]), and a fall occurring at the bedside (OR = 3.493, 95% CI [1.119, 10.903]) were all positively associated with fall-related injuries, with a Nagelkerke R of 42.8%.
CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The risk factors for falls that affect hospitalized patients with cancer are complex. Nursing staff must evaluate the risk factors and treatment methods for each patient and facilitate fall prevention measures to achieve safety-centered quality of care. This study provides an example for nursing staff when assessing factors associated with falls and working to reduce fall-related injuries among patients with cancer.
跌倒及与跌倒相关的损伤是机构护理质量的重要指标。台湾针对住院癌症患者这一主题开展的专门研究较少。
本研究的目的是了解跌倒情况及损伤程度；确定与跌倒相关的损伤、人口统计学特征和跌倒原因之间的关联；并预测住院癌症患者的跌倒相关损伤。
采用回顾性调查设计。从台湾患者安全报告系统中检索2010年至2012年台湾北部某医疗中心住院癌症患者的跌倒发生率数据。使用IBM SPSS Statistics 18.0版本对数据进行编码，并进行描述性统计、卡方检验和多元逐步逻辑回归分析。
184例住院癌症患者中有156例（85%）发生了与跌倒相关的损伤。无跌倒史的男性跌倒倾向更频繁，且夜间更为普遍。回归分析结果显示，跌倒时有人陪伴（比值比[OR]=5.411，95%置信区间[CI][1.619,18.081]）、下肢无力（OR=0.284，95%CI[0.097,0.832]）、体位性低血压（OR=0.101，95%CI[0.
