Mazuz Keren, Biswas Seema, Lindner Uri
Management of Service Organizations M.A., Hadassah Academic College, Jerusalem, Israel.
Galilee Medical Center, Nahariya, Israel.
Front Digit Health. 2020 Sep 2;2:11. doi: 10.3389/fdgth.2020.00011. eCollection 2020.
This paper presents a research and development project for studying aging and technology in fall prevention. Falls are an important global health problem in an aging global population. Up to 50% of serious falls may be fatal. Falls result from the cumulative effects of cognitive, musculoskeletal and sensory decline on postural control and substantially affect the activities of daily living, leading to a lower quality of life and physical injury. A near-fall, misstep and a prior fall are established risk factors for a more serious fall. The fear of falling may reduce physical activity and further predispose to falling. However, limitations in the reporting and documentation of fall events create "silent events"-events that are neither documented nor acted upon. An "Age-Techcare" Application (App) was designed using open innovation methods with local older adult populations and health care professionals through a mixed-methodology approach. The App comprised a digital diary for the self-reporting of fall events and an exercise video to strengthen balance as a fall-prevention intervention. The older adults recorded four fall events: a near-fall, the fear of falling, a fall, or no-fall. Prompts to watch the video and the number of times the video was watched were also recorded on the App. Reports retrieved from the App were analyzed after a 10-week pilot study among older adults accessing the App on their smartphones ( = 28) and through their smartTV ( = 23). All participants used the App to self-report fall events. Near-falls were the most frequently reported fall event among both smartphone and smartTV groups. The scale of silent falls (including a fear of falling and near falls) is greater than anticipated (according to prevailing literature) and significant, especially among the older cohort of participants who had previously experienced falls and are living alone. The exercise video was regularly accessed within a self-report-fall-prevention feedback loop. Watching a preventive exercise video clip as a preventive intervention is positively associated with self-reporting of all events. We have shown that the utility and effectiveness of an App in the self-management of fall events to raise self-awareness, document risk and prompt preventive action. As we address the health needs of an aging global population, Apps such as this will need to be further developed and interface with health and social care services. The facility for older adults to negotiate ideas and practices of risk and safety-the hallmark of the aging-in-place and healthy aging discourse-is important to them in their acceptance of dynamic and diverse technology.
本文介绍了一个关于研究衰老与预防跌倒技术的研发项目。在全球人口老龄化的背景下，跌倒是一个重要的全球性健康问题。高达50%的严重跌倒可能是致命的。跌倒是认知、肌肉骨骼和感官功能衰退对姿势控制产生累积影响的结果，严重影响日常生活活动，导致生活质量下降和身体受伤。险些跌倒、失足和既往跌倒都是更严重跌倒的既定风险因素。对跌倒的恐惧可能会减少身体活动，并进一步增加跌倒的易感性。然而，跌倒事件报告和记录方面的局限性导致了“无声事件”的出现，即既未记录也未采取行动的事件。通过混合方法，采用开放式创新方法，与当地老年人群体和医疗保健专业人员共同设计了一款“老年科技护理”应用程序（App）。该应用程序包括用于自我报告跌倒事件的数字日记和作为预防跌倒干预措施的增强平衡的运动视频片段。老年人记录了四种跌倒事件：险些跌倒、对跌倒的恐惧、跌倒或未跌倒。应用程序上还记录了观看视频的提示信息以及视频的观看次数。在一项为期10周的试点研究之后（28名老年人通过智能手机使用该应用程序，23名老年人通过智能电视使用该应用程序），对从应用程序检索到的报告进行了分析研究。所有参与者都使用该应用程序自我报告跌倒事件；在智能手机组和智能电视组中，险些跌倒都是报告最频繁的跌倒事件。无声跌倒（包括对跌倒的恐惧和险些跌倒）的规模比预期的更大（根据现有文献），且很显著，尤其是在那些既往有跌倒经历且独居的老年参与者中。运动视频在自我报告跌倒预防反馈回路中被定期访问。观看预防运动视频片段作为一种预防干预措施，与所有事件的自我报告呈正相关。我们已经证明了一款应用程序在跌倒事件自我管理中提高自我意识、记录风险和促使采取预防行动方面的实用性和有效性。在我们满足全球老龄化人口的健康需求时，这样的应用程序需要进一步开发，并与健康和社会护理服务相衔接。老年人对风险和安全观念及做法进行协商的能力——就地养老和健康老龄化话语的标志——对于他们接受动态多样的技术很重要。
