Fhon Jack Roberto Silva, Diogo Regina Célia Dos Santos, Dos Santos Neto Alexandre Pereira, Djinan Alice Regina Felipe Silva, Lima Eveline Fontes Costa, Rodrigues Rosalina Aparecida Partezani
School of Nursing, University of São Paulo, São Paulo, Brazil.
The Graduate Program in Adult Health Nursing, School of Nursing, University of São Paulo, São Paulo, Brazil.
Int J Nurs Knowl. 2024 Jun 19. doi: 10.1111/2047-3095.12479.
To identify the risk factors for the nursing diagnosis of fall risk in adults (00303) in elderly people in the community-dwelling.
This is a methodological study, with a quantitative approach, carried out with elderly people living in the city of Ribeirão Preto, SP, Brazil, from February to December 2018. For data collection, the demographic profile, Mini-Mental State Examination, diseases self-reported, functional independence measure, Lawton and Brody scale, geriatric depression scale, and self-perception of gait instruments were used. Tests of accuracy and association of risk factors with p ≤ 0.05 were performed.
A total of 262 elderly people, aged over 80 years (55.7%), 71% of which were female and 42.7% were widowed, were included in the sample. A total of 82.1% had vascular diseases, 72.1% had diabetes, and 20.6% had depression. The predominant risk factors were difficulty performing instrumental activities of daily living (58.8%), cognitive dysfunction (43.5%), and depressive symptoms (26.3%). Difficulty performing instrumental activities of daily living had a sensitivity greater than 60%. The positive and negative predictive values were mostly greater than 50%. In the regression analysis, it was found that the elderly have a higher risk of suffering a fall if they present anxiety (p = 0.05), impaired physical mobility (p = 0.02), and difficulty to perform instrumental activities of daily living as risk factors (p = 0.03).
It was possible to identify the presence of risk factors for the diagnosis fall risk in adults (00303) in the clinical context of the elderly in home settings and contribute to the clinical validation of the taxonomy, increase the evidence and importance of the diagnosis, and generate new knowledge for gerontological nursing.
To help nurses identify risk factors that lead elderly people to suffer falls at home and to implement preventive actions in their community with the support of their families.
确定社区居住老年人中成人跌倒风险护理诊断（00303）的危险因素。
这是一项采用定量方法的方法学研究，于2018年2月至12月对居住在巴西圣保罗州里贝朗普雷图市的老年人进行。数据收集使用了人口统计学资料、简易精神状态检查表、自我报告的疾病、功能独立性测量、Lawton和Brody量表、老年抑郁量表以及步态自我感知工具。对准确性和危险因素的关联性进行了检验，p≤0.05。
样本共纳入262名80岁以上老年人（55.7%），其中71%为女性，42.7%为丧偶。共有82.1%患有血管疾病，72.1%患有糖尿病，20.6%患有抑郁症。主要危险因素为日常生活工具性活动困难（58.8%）、认知功能障碍（43.5%）和抑郁症状（26.3%）。日常生活工具性活动困难的敏感性大于60%。阳性和阴性预测值大多大于50%。在回归分析中发现，老年人若存在焦虑（p = 0.05）、身体活动能力受损（p = 0.02）以及日常生活工具性活动困难作为危险因素（p = 0.03），则跌倒风险更高。
在居家老年人的临床背景下，有可能确定成人跌倒风险诊断（00303）的危险因素存在情况，有助于该分类法的临床验证，增加该诊断的证据和重要性，并为老年护理产生新知识。
帮助护士识别导致老年人在家中跌倒的危险因素，并在其家人的支持下在社区实施预防措施。
