Jung Wonkyung, Lim Sungwon, Wi Dahee, Ustach Andrew, Thompson Hilaire J
Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA
Department of Nursing, Dongguk University-WISE, Gyeongju, South Korea.
Inj Prev. 2024 Oct 4. doi: 10.1136/ip-2024-045385.
Falls are a significant concern in long-term care facilities (LTCFs) as fall-related injuries can result in functional impairment, disability and death. Older adults living in LTCFs are at greater risk for falls than those in the community. Using scoping review methodology, we aimed to synthesise evidence examining intervention effects of person-focused interventions for risk assessment and prevention in LTCFs in order to identify evidence-based practices in LTCFs.
We included three databases (Ovid-Medline, CINAHL and EMBASE) to identify original research from 2007 to 2022 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guideline. From the initial search, we identified 988 articles. Following the removal of duplicates, title and abstract screening, and full-text review against inclusion/exclusion criteria, 20 studies remained for analysis. Then, we conducted a narrative synthesis to summarise the included studies.
Identified evidence-based interventions for fall prevention include (1) exercise programmes (eg, high-intensity functional exercise, aerobic exercise, short stick exercises, etc); (2) multifactorial programmes; and (3) other interventions (eg, lavender olfactory stimulation). Outcomes of included studies included the number of falls, fall rate, risk of falls and fear of falls before and after interventions.
Overall, most studies reported significant effects of person-focused interventions in LTCFs. Available evidence supports that well-designed person-focused interventions can reduce falls and fear of falls for individuals in LTCFs.
在长期护理机构(LTCFs)中,跌倒问题备受关注,因为与跌倒相关的伤害可能导致功能障碍、残疾甚至死亡。居住在LTCFs中的老年人比社区中的老年人面临更高的跌倒风险。我们采用范围综述方法,旨在综合研究以个体为中心的干预措施对LTCFs中跌倒风险评估和预防的干预效果的证据,以确定LTCFs中的循证实践。
我们纳入了三个数据库(Ovid-Medline、CINAHL和EMBASE),根据系统评价和Meta分析扩展的范围综述指南,检索2007年至2022年的原始研究。通过初步检索,我们识别出988篇文章。在去除重复项、进行标题和摘要筛选以及根据纳入/排除标准进行全文审查后,剩余20项研究用于分析。然后,我们进行了叙述性综合分析以总结纳入的研究。
确定的基于证据的跌倒预防干预措施包括:(1)运动计划(如高强度功能锻炼、有氧运动、短棍运动等);(2)多因素计划;(3)其他干预措施(如薰衣草嗅觉刺激)。纳入研究的结果包括干预前后的跌倒次数、跌倒率、跌倒风险和跌倒恐惧程度。
总体而言,大多数研究报告了以个体为中心的干预措施在LTCFs中具有显著效果。现有证据支持,精心设计的以个体为中心的干预措施可以减少LTCFs中个体的跌倒次数和跌倒恐惧。