Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar comprehensive specialized hospital, University of Gondar, P.O. Box: 196, Gondar, Ethiopia.
Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
BMC Public Health. 2020 Apr 15;20(1):498. doi: 10.1186/s12889-020-08628-2.
Fall is a major public health problem and potentially disabling issue. A vast burden of visually impaired live in low-middle income countries particularly in Sub-Saharan Africa. Limited ability to detect environmental hazards puts visually impaired at a greater risk of falls and unintentional injuries. Falls among visually impaired is associated with considerable disability, health care cost, loss of independence, and socio-economic consequences. Ethiopia lacked estimates of fall among any vulnerable population, particularly among visually impaired people. Therefore, this study aimed to estimate the prevalence of falls and factors associated among adult people with medically diagnosed visual impairment in Ethiopia.
An institutional-based cross-sectional study was conducted among visually impaired adults who attended the ophthalmology clinic at the University of Gondar comprehensive specialized hospital during the study period. Data were collected by interview method using structured questionnaires, patient medical record reviews, and physical measurements. Bivariate and multivariable binary logistic regression model analysis was used to identify factors associated with falls. Adjusted odds ratio with corresponding 95% confidence intervals were computed to show the strength of association.
A total of 328 adults medically diagnosed with visual impairment participated in the study (97.3% response rate). The age of the participants ranged from 25 to 89 years with a mean age of (56.46 ± 14.2 years). The overall cumulative prevalence of self-reported falls among adults with visual impairment was 26.8% with 95%CI (22.7, 32.4%). The major associated factors of fall identified by multivariate analysis were; visual impairment in both eye (AOR 3.21, 95% CI 1.11, 9.29), fear of falling: some concerned: (AOR, 4.12; 95%CI, 1.44, 11.76), very concerned fear (AOR 10.03; 95% CI, 3.03, 33.21), medications: (AOR 4.63; 95% CI 2.14, 10.00) and self-reported depression: (AOR 3.46; 95% CI 1.11, 10.79).
The result of this study indicates a moderate self-reported prevalence of fall among adult people with medically diagnosed visual impairment. Identifying sub-groups at risk of falls among visually impaired, modifiable risk factors, implementation of precaution measures to avoid fall and fall-related injuries, and most importantly measures that would reduce the fear of falls in visually impaired people deserves immediate attention.
秋季是一个主要的公共卫生问题，也是一个潜在的致残问题。在中低收入国家，尤其是撒哈拉以南非洲，有大量视力受损的人生活。由于他们发现环境危害的能力有限，因此他们跌倒和意外受伤的风险更大。视力障碍者跌倒与相当大的残疾、医疗保健费用、丧失独立性以及社会经济后果有关。埃塞俄比亚缺乏任何弱势群体，尤其是视力障碍者中跌倒发生率的估计。因此，本研究旨在估计埃塞俄比亚经医学诊断患有视力障碍的成年人中跌倒的发生率和相关因素。
这是一项在研究期间参加戈德龙大学综合专科医院眼科诊所的成年视力障碍者中进行的基于机构的横断面研究。使用结构化问卷、患者病历回顾和身体测量，通过访谈方法收集数据。使用二变量和多变量二元逻辑回归模型分析来确定与跌倒相关的因素。计算调整后的优势比及其相应的 95%置信区间，以显示关联的强度。
共有 328 名经医学诊断患有视力障碍的成年人参加了这项研究（97.3%的回复率）。参与者的年龄在 25 岁至 89 岁之间，平均年龄为（56.46±14.2 岁）。视力障碍成年人中自我报告跌倒的总累积发生率为 26.8%，95%CI（22.7，32.4%）。多变量分析确定的主要跌倒相关因素是：双眼视力障碍（AOR 3.21，95%CI 1.11，9.29）、害怕跌倒：有些担心（AOR，4.12；95%CI，1.44，11.76）、非常担心（AOR 10.03；95%CI，3.03，33.21）、药物（AOR 4.63；95%CI 2.14，10.00）和自我报告的抑郁（AOR 3.46；95%CI 1.11，10.79）。
本研究结果表明，经医学诊断患有视力障碍的成年人中自我报告跌倒的发生率中等。确定视力障碍者中跌倒的高危亚群、可改变的危险因素、实施预防跌倒和跌倒相关伤害的措施，以及最重要的是减少视力障碍者对跌倒的恐惧，这些都值得立即关注。
