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老年人患有复杂慢性病时的跌倒、跌倒恐惧和相关因素。

Falls, a fear of falling and related factors in older adults with complex chronic disease.

机构信息

College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea.

Department of Nursing, Bucheon University, Bucheon-si, Gyeonggi-do, Korea.

出版信息

J Clin Nurs. 2017 Dec;26(23-24):4964-4972. doi: 10.1111/jocn.13995. Epub 2017 Oct 2.

Abstract

AIMS AND OBJECTIVES

To identify factors influencing falls and the fear of falling among older adults with chronic diseases in Korea.

BACKGROUND

The fear of falling and falls in older adults are significant health problems towards which healthcare providers should direct their attention. Further investigation is needed to improve nursing practice specifically decreasing risk of falls and the fear of falling in Korea.

DESIGN

Descriptive, cross-sectional survey.

METHODS

A convenience sample of 108 patients was recruited at the geriatric outpatient department of a tertiary hospital in Seoul, Korea. Demographic characteristics, comorbidities, medication use, fall history, level of physical activity, activities of daily living, mobility, muscle strength, and a fear of falling were investigated. Student's t tests, chi-square tests and multiple linear regressions were used in statistical analysis.

RESULTS

Thirty-six participants (33.3%) among 108 subjects reported experiencing ≥1 falls in the past year. Marital status and the use of antipsychotics were associated with falls, while other factors were not significantly related to falls. Only benign prostatic hypertrophy and polypharmacy were significantly related to the fear of falling in the analysis of the relationships between chronic disease, medication use and fear of falling. In the regression model, the number of comorbidities, level of physical activity, activities of daily living and mobility were predictors of a fear of falling. Medication use was marginally significant, in the model.

CONCLUSION

Increasing physical activity, functional fitness and physical independence is important to decrease the fear of falling, and to encourage active and healthy lives in older adults.

RELEVANCE TO CLINICAL PRACTICE

The findings from this study provide evidence for the development of nursing interventions for older adults. We recommend early screening for a fear of falling and nursing interventions to decrease the fear of falling through enhancing physical activity level and function.

摘要

目的和目标

确定影响韩国慢性病老年患者跌倒和跌倒恐惧的因素。

背景

老年患者的跌倒恐惧和跌倒问题是重要的健康问题,医护人员应予以关注。需要进一步调查,以改善韩国的护理实践,特别是降低跌倒风险和跌倒恐惧。

设计

描述性、横断面调查。

方法

在首尔一家三级医院的老年门诊,便利选取 108 例患者作为研究对象。调查人口统计学特征、合并症、用药情况、跌倒史、身体活动水平、日常生活活动、活动能力、肌肉力量和跌倒恐惧。采用 Student's t 检验、卡方检验和多元线性回归进行统计分析。

结果

108 例患者中,36 例(33.3%)报告过去 1 年中至少跌倒 1 次。婚姻状况和使用抗精神病药与跌倒有关,而其他因素与跌倒无关。仅良性前列腺增生和多种药物治疗与跌倒恐惧显著相关。在慢性病、用药与跌倒恐惧的关系分析中,只有药物使用与跌倒恐惧显著相关。在回归模型中,合并症数量、身体活动水平、日常生活活动和活动能力是跌倒恐惧的预测因素。药物使用在模型中具有边际显著性。

结论

增加身体活动、功能适应性和身体独立性对降低跌倒恐惧、鼓励老年患者积极健康生活非常重要。

临床意义

本研究结果为老年患者护理干预的发展提供了依据。我们建议对跌倒恐惧进行早期筛查,并通过提高身体活动水平和功能来实施护理干预,以降低跌倒恐惧。

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