照顾者对骨折后患者跌倒的恐惧与患者活动能力下降之间的关联。
Association between Caregivers' Fear of Post-fracture Patients Falling and a Decline in Patients' Activities.
作者信息
Kakehi Tomohiro, Zenta Masashi, Ishimori Takuya, Tamura Naoki, Wada Hiromu, Bessho Masahiko, Kakuda Wataru
机构信息
Department of Rehabilitation Medicine, Graduate School of Medicine, International University of Health and Welfare, Narita, Japan.
School of Health and Sciences at Narita, International University of Health and Welfare, Narita, Japan.
出版信息
Prog Rehabil Med. 2023 Dec 29;8:20230046. doi: 10.2490/prm.20230046. eCollection 2023.
OBJECTIVES
To evaluate caregivers' fear of post-fracture patients falling, we previously developed the Caregivers' Fear of Falling Index (CFFI). In this study, we investigated the relationship between patient performance in activities of daily living (ADLs) and CFFI.
METHODS
We surveyed 55 patients receiving home-visit rehabilitation after fall-related fracture and their primary caregivers. Participants (patient and caregiver pair) were divided into two groups based on patient performance in basic ADLs (BADLs) and instrumental ADLs (IADLs). ROC analysis was conducted to assess the usefulness of CFFI and Falls Efficacy Scale-International (FES-I) in determining declines in performance in BADLs and IADLs. Multivariate logistic regression analysis was performed to examine the association between CFFI and declining performance in BADLs and IADLs.
RESULTS
ROC analysis showed that CFFI exhibited a higher accuracy than FES-I (AUC: 0.73 in BADLs, 0.77 in IADLs) as an indicator of reduced ADL performance. Multivariate logistic analysis adjusted for age, sex, and physical function showed that CFFI was associated with a decline in patients' performance in IADLs (odds ratio, 0.92; 95% confidence interval, 0.85-0.99).
CONCLUSIONS
Caregivers' fear of post-fracture patients falling was associated with a decline in patients' performance in IADLs. These findings may serve as a guide for supporting caregivers of post-fracture patients.
目的
为评估照料者对骨折后患者跌倒的恐惧,我们之前开发了照料者跌倒恐惧指数(CFFI)。在本研究中,我们调查了患者日常生活活动(ADL)表现与CFFI之间的关系。
方法
我们对55名跌倒相关骨折后接受家访康复的患者及其主要照料者进行了调查。参与者(患者和照料者配对)根据患者在基本日常生活活动(BADL)和工具性日常生活活动(IADL)中的表现分为两组。进行ROC分析以评估CFFI和国际跌倒效能量表(FES-I)在确定BADL和IADL表现下降方面的有用性。进行多变量逻辑回归分析以检验CFFI与BADL和IADL表现下降之间的关联。
结果
ROC分析表明,作为ADL表现降低的指标,CFFI比FES-I表现出更高的准确性(AUC:BADL中为0.73,IADL中为0.77)。对年龄、性别和身体功能进行校正的多变量逻辑分析表明,CFFI与患者IADL表现下降相关(优势比,0.92;95%置信区间,0.85 - 0.99)。
结论
照料者对骨折后患者跌倒的恐惧与患者IADL表现下降相关。这些发现可为支持骨折后患者的照料者提供指导。
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