• Journal of Trauma and Injury
• /
• 제22권1호
• /
• pp.12-17
• /
• 2009

Purpose: In this study, the prognostic significance of the Injury Severity Score (ISS) and the height of fall in free-fall patients were investigated. Methods: The medical records of 179 victims of falls from a height who were brought alive to the Emergency Department of Gyeongsang National University Hospital between January 2003 and December 2007 were analyzed. The age, the sex of the patients, the rate of admission, the hospital stay, the site of injury, the severity of injury, the rate of surgery, the site of the fall and the presence of alcohol intoxication were evaluated by using a retrospective review of the medical records. Injury severity was measured by using the ISS. Patients were categorized into four subgroups according to the height from where they had fallen. The data were statistically analyzed with using SPSS ver. 10.0. Results: The admission rates for the subgroups with falls of less than 3 stories were significantly lower than those for the subgroups with higher heights of falls (70.7% vs. 100%, p<0.05). These two subgroups showed statistically significant differences in mean hospital stay ($17.11{\pm}24.88$ vs. $56.73{\pm}49.21$, p<0.05), rate of operation (30.6% vs. 53.8%, p<0.05), and mean ISS ($6.86{\pm}4.97$ vs. $13.96{\pm}9.14$, p<0.05). In the correlation analysis, the ISS and the mean hospital stay showed the highest correlation with correlation coefficient of 0.666. Conclusion: In this retrospective analysis of 179 free-fall patients, we evaluated the prognostic factors affecting the outcomes for the free-fall patients. The patients who had fallen from heights of 3 stories or higher showed statistically significant higher rates of admission, longer durations of hospital stay, higher ISSs, and higher operation rates. The most accurate factor in predicting the length of hospital stay was the ISS.

• Journal of Preventive Medicine and Public Health
• /
• 제45권5호
• /
• pp.283-290
• /
• 2012

Objectives: People who have chronic diseases, as well as gait imbalance or psychiatric drug use, may be susceptible to injuries from falls and slips. The purpose of this study was to evaluate the effect of musculoskeletal diseases on incidental fall-related injuries among adults in Korea. Methods: We analyzed data from the 4th Korea National Health and Nutrition Examination Survey (2007-2009), which are national data obtained by a rolling survey sampling method. The 1-year incidence of fall-related injuries was defined by health service utilization within the last year due to injury occurring after a slip and fall, and musculoskeletal diseases included osteoarthritis, rheumatoid arthritis, osteoporosis, and back pain. To evaluate the effects of preexisting musculoskeletal diseases, adults diagnosed before the last year were considered the exposed group, and adults who had never been diagnosed were the unexposed group. Results: The weighted lifetime prevalence of musculoskeletal disease was 32 540 per 100 000 persons. Musculoskeletal diseases were associated with a higher risk of fall-related injury after adjustment for sex, age, residence, household income, education, occupation, visual disturbance, paralysis due to stroke, and medication for depression (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.03 to 1.93). As the number of comorbid musculoskeletal diseases increased, the risk of fall-induced injuries increased (p-value for trend <0.001). In particular, patients who had any musculoskeletal condition were at much higher risk of recurrent fall-related injuries (OR, 6.20; 95% CI, 1.06 to 36.08). Conclusions: One must take into account the risk of fall-related injuries and provide prevention strategies among adults who have musculoskeletal diseases.

• 한국콘텐츠학회논문지
• /
• 제13권5호
• /
• pp.354-365
• /
• 2013

본 연구는 재가노인의 낙상환경위험평가 도구를 개발하고, 신뢰도와 타당도를 검정하는 방법론적 연구이다. 예비문항은 20인의 관련 전문가에 의한 CVI(내용타당도 지수)를 사용한 내용타당도 검정을 실시하여 최종 52문항을 선정하였다. 최종도구의 타당도 및 신뢰도 검정을 위해 65세 이상 재가노인 299명에게 자료수집을 실시하여 분석하였다. 그 결과 조사자간 신뢰도는 1개 문항을 제외한 51개 문항에서 모두 kappa 값이 0.80 이상으로 나타나 신뢰도가 인정되었고, 재조사방법을 통하여 나타난 일치율은 45개 문항에서 모두 80.0% 이상으로 나타났다. 구성타당도도 낙상군과 비낙상군간에 낙상환경위험평가 점수가 통계적으로 유의한 차이를 나타내 입증되었다(t=3.50, p=.001). 본 도구는 타당도와 신뢰도가 검증되었고, 낙상예방을 위한 더 안전한 환경의 개발과 관련된 추후연구에 기여할 것이다.

• Journal of Preventive Medicine and Public Health
• /
• 제35권1호
• /
• pp.72-75
• /
• 2002

Objectives : To evaluate the health hazards in the underground storage facilities of ginger roots. Methods : The authors reviewed the emergency rescue records from the Seosan fire department over the period Jan 1, 1996 to Aug 31, 1999. The atmospheres in 3 different underground storage locations were analyzed for $O_2,\;CO_2,\;CO,\;H_2S\;and\;NH_4$. Results : From the emergency records, we were able to identify 20 individuals that had been exposed to occupational hazards in the underground storage facilities. Among these 20 cases, 13 were due to asphyxiation (resulting in f deaths) and 7 were due to falls. In the first atmospheric tests, peformed on Feb 25, 1998, the O2 level inside the underground storage facility, located about $5{\sim}6$ meters below the surface, was 20.6% and the $CO_2$ level was about 1,000 ppm. CO, $H_2S\;and\;NH_4$ were not detected. In the second tests on Jul 6, 1999, measurements of the $O_2$ level at 3 meters below the surface in two different storage locations were 15.3 and 15.1%. And the $O_2$ levels inside the storage facilities were 12.2 and 12.1%. The $CO_2$ level was above 5,000 ppm (beyond upper limits of measurement). CO, $H_2S\;and\;NH_4$ were not detected. Conclusions : We conclude that asphyxiation in the underground storage facilities for ginger roots was not due to the presence of toxic gases such as CO, $H_2S\;and\;NH_4$, but rather the exclusion of oxygen by carbon dioxide was responsible for causing casualties. For the development of a hazard free working environment, safety education as well as improvements in storage methods are needed.

• Physical Therapy Rehabilitation Science
• /
• 제7권4호
• /
• pp.197-203
• /
• 2018

Objective: Independent walking is the most essential prerequisite to maintain quality of life in older persons. The purpose of this review was to investigate the effect of fall prevention strategies on fall risk for type 2 diabetes mellitus (T2DM) within community-dwelling older adults aged 65 and over. Design: A systematic review and meta-analysis. Methods: PubMed and three other databases were searched up to October 31st, 2018 and randomized controlled trials (RCTs) evaluating fall prevention strategies for fall risk in persons who were 65 years of age or above with T2DM were included. The review extracted the following information from each study selected: first author's surname, published year, country, study population, type of intervention, intensity of intervention, comparison, measurement variables, additional therapy, summary of results, and mean and standard deviation from selected studies. Results: This review selected fourteen RCTs with 460 older adults with diabetes mellitus. Of the 14 studies, the types of intervention used to improve the risk of falls were strengthening (5), aerobic exercises (2), multimodal exercises (4), one virtual reality exercise (1), whole body vibration with balance exercise (1), and Tai Chi exercise (1). Seven RCTs were eligible for the meta-analysis. Therapeutic interventions were more effective than the control group for the Timed Up-and-Go test (-1.11; 95% CI, -1.82 to -0.41) and the 6-minute Walk Test (-1.89; 95% CI, -8.33 to 4.54). Conclusions: The results of the review suggest that interventions to prevent fall risk in older adults with T2DM should focus on strengthening, balance, aerobic, and multimodal exercises.

• 대한간호학회지
• /
• 제49권2호
• /
• pp.203-214
• /
• 2019

Purpose: The purpose of this study to develop a fringed fall prevention program based on King's goal attainment theory and education. This study is applied to the personal, interpersonal, and social systems of fall high-risk patients to test its effects. Methods: This study was a nonequivalent control group pre- and post-test design. There were 52 fall high-risk patients in the experimental group and 45 in the control group. The experimental group received six sessions, with the group sessions lasting 60 minutes and the individual sessions lasting 20~30 minutes. Data were analyzed using descriptive statistics, an ${\chi}^2-test$, a paired sample t-test, and a Wilcoxon signed-ranks test utilizing IBM SPSS software. Results: For the 3-month intervention period, the fall prevention program was found to be particularly effective for patients in the experimental group (from 3.38 to 1.69 per 1000 patient days; p=.044), as opposed to the control group (from 1.94 to 1.49 per 1000 patient days; p=.300). For the 6-month follow up period, the fall prevention program was again found to be effective for patients in the experimental group (from 3.26 to 0.76 per 1000 patient days; p=.049) compared to the control group (from 1.98 to 1.01 per 1000 patient days; p=.368). Conclusion: These results indicate that the fringed fall prevention program is very effective in reducing falls, not only during the intervention period, but also after the intervention period has ended. We can therefore recommend this program for use concerning fall high-risk patients in long-term care hospitals.

• 농촌의학ㆍ지역보건
• /
• 제47권1호
• /
• pp.27-39
• /
• 2022

Objectives: The purpose of this research was to explore Fall Risk Home Environment(FRHE) and to investigate the association between FRHE and fall experience among community-dwelling older adults. Methods: The data were collected from 299 older adults using FRHE through observation and interview at home of the participants and were analyzed with SPSS 22.0 applying descriptive statistics, χ²-test, t-test, and logistic regression analysis. Results: The prevalence of fall experience during the past year was 51.5%. 'No handles beside the toilet or bathtub'(73.2%) was most common FRHE factor, 'thresholds in your room or kitchen'(68.9%), 'wearing socks, outer socks, or slipper when you move in the house'(59.5%), and threshold on the gate (apartment entrance)(55.5%) were followed. The findings of logistic regression of FRHE on fall experiences showed darkness of house had the highest Odds Ratio (OR 9.83 95% CI 3.75-25.71), followed by furniture obstructs your walking in the house(OR 7.07, CI 2.88-17.36), dark kitchen (OR 5.13, CI 2.38-11.03). The group having fall experiences presented significantly higher score of FRHE than the group of non experiences of fall. Conclusion: The community dwelling older adults exposures to various FRHE factors and FRHE might increase the risk of falls. Assessing and modifying the home environment could be a good strategy to prevent fall among older adults.

• 가정∙방문간호학회지
• /
• 제31권1호
• /
• pp.16-29
• /
• 2024

Purpose: This scoping review aimed to synthesize the characteristics and effects of interventions designed to prevent unintentional home injuries in older adults in Korea. Methods: The review was conducted following the Joanna Briggs Institute protocol. A literature search was performed for studies published between 2001 and 2022 in the DBPia, RISS, KMBase, and NDSL databases. A total of 1,620 studies were identified, and 27 studies were included in the final analysis. Data were analyzed for characteristics of the literature, intervention-related unintentional injury mechanisms, and safety areas. Results: Most selected studies utilized a quasi-experimental design and targeted elderly women. In terms of injury mechanisms, 21 of 27 studies focused on falls, 2 on fire/disaster, 3 on drugs, and 1 on food. The most common preventive intervention for falls was exercise, and its effectiveness was verified using physical safety variables. Interventions in the fire/disaster, drug, and food domains were all educational, and changes in knowledge, behavior, and attitude were verified. Conclusion: This study confirmed the effectiveness of interventions for preventing unintentional injuries in the homes of community-dwelling older adults. These findings can serve as a foundation for developing and implementing unintentional injury prevention interventions at home for community-dwelling older adults. Multidisciplinary research is needed to address multifaceted safety issues by considering the home environment and injury risk factors.

• 간호행정학회지
• /
• 제20권2호
• /
• pp.176-186
• /
• 2014

Purpose: The purpose of this study was to analyze factors affecting fall prevention activities of emergency room (ER) nurses based on their health belief factors (perceived susceptibility, perceived benefits, perceived severity, perceived barriers, and cues to action). Methods: The study design was a descriptive survey using questionnaires which were given to 127 emergency room nurses from two regional emergency medical centers, four local emergency medical centers, and two local emergency medical facilities. Data were analyzed using descriptive analysis, t-test, one-way ANOVA with LSD test, Pearson correlation, and multiple regressions. Results: ER nurses' fall prevention activities had a mean of $3.78{\pm}0.50$. Eight individual characteristics and health belief factors accounted for 30.8% of the fall prevention activities. Fall prevention activities were found to be positively affected by emergency medical facilities, perceived benefits, and cues to action and negatively affected by factors, such as ER career and perceived severity. Conclusion: The results indicate that it is necessary to formulate a plan for enhancing perceived benefits and cues to action to improve fall prevention activities. In addition, fall prevention activities should be encouraged for ER nurses who have worked in local medical institutions for less than 1 year or more than 5 years.

• 대한간호학회지
• /
• 제44권6호
• /
• pp.697-707
• /
• 2014

Purpose: The purposes of this study was to develop a comprehensive community-based fall prevention program and to test the effects of the program on the muscle strength, postural balance and fall efficacy for elderly people. Methods: The design of this study was a nonequivalent control group pretest-posttest design. There were 28 participants in the experimental group and 29 in the control group. The program consisted of balance exercises, elastic resistance exercises and prevention education. The program was provided five times a week for 8 weeks and each session lasted 90 minutes. Data were analyzed using ${\chi}^2$-test, independent t-test and paired t-test using the SPSS program. Results: Muscle strength of the lower extremities, postural balance and fall efficacy scores significantly improved in the experimental group compared to the control group. Conclusion: These results suggest that this program can improve lower extremity muscle strength, postural balance and fall efficacy in elders. Therefore, this program is recommended for use in fall prevention programs for elders living in the community.