• Title/Summary/Keyword: Fall risk

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A Structural Equation Model of Fall Prevention Behavior among Community-dwelling Older Adults with Osteoarthritis (재가 관절염 노인의 낙상 예방행위 예측모형 구축)

  • Jang, Keong Sook;Song, Rhayun
    • Korean Journal of Adult Nursing
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    • v.27 no.6
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    • pp.684-694
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    • 2015
  • Purpose: The purpose of this study was to explain fall prevention behaviors of community-dwelling elderly with osteoarthritis based on the Health Belief Model. Methods: A total of 200 older adults with osteoarthritis residing in community was recruited from July 10 to August 30, 2013. The direct and indirect effects of perceived fall risk, perceived benefits and barriers, and self efficacy of fall prevention were examined on fall prevention behaviors. Data were collected with structured questionnaires and analyzed using SPSS/WIN 20.0 and AMOS 20.0 program. Results: The hypothetical model was a good fit for the data based on the model fit indices. Among socio-demographic variables, age and fall knowledge showed significant direct effects on fall prevention behaviors. The constructed model explained 34.2% of the variance of fall prevention behaviors, including perceived fall risk and efficacy of fall prevention behaviors as significant predictors. Conclusion: The findings revealed the need to develop an effective nursing intervention to promote fall prevention behaviors of community-dwelling elderly with osteoarthritis by focusing on perceived fall risk and efficacy of fall prevention behaviors. Knowledge about fall can also be increased by an age-based education program.

Characteristics and Risk Factors for Falls in Tertiary Hospital Inpatients (일개 종합병원 입원환자의 낙상관련 특성 및 낙상발생 예측요인)

  • Choi, Eun-Ju;Lee, Young-Shin;Yang, Eun-Jung;Kim, Ji-Hui;Kim, Yeon-Hee;Park, Hyeoun-Ae
    • Journal of Korean Academy of Nursing
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    • v.47 no.3
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    • pp.420-430
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    • 2017
  • Purpose: The aim of this study was to explore characteristics of and risk factors for accidental inpatient falls. Methods: Participants were classified as fallers or non-fallers based on the fall history of inpatients in a tertiary hospital in Seoul between June 2014 and May 2015. Data on falls were obtained from the fall report forms and data on risk factors were obtained from the electronic nursing records. Characteristics of fallers and non-fallers were analyzed using descriptive statistics. Risk factors for falls were identified using univariate analyses and logistic regression analysis. Results: Average length of stay prior to the fall was 21.52 days and average age of fallers was 61.37 years. Most falls occurred during the night shifts and in the bedroom and were due to sudden leg weakness during ambulation. It was found that gender, BMI, physical problems such elimination, gait, vision and hearing and medications such as sleeping pills, antiarrhythmics, vasodilators, and muscle relaxant were statistically significant factors affecting falls. Conclusion: The findings show that there are significant risk factors such as BMI and history of surgery which are not part of fall assessment tools. There are also items on fall assessment tools which are not found to be significant such as mental status, emotional unstability, dizziness, and impairment of urination. Therefore, these various risk factors should be examined in the fall risk assessments and these risk factors should be considered in the development of fall assessment tools.

A Meta-analysis of the Timed Up and Go test for Predicting Falls (낙상 위험 선별검사 Timed Up and Go test의 예측 타당도 메타분석)

  • Park, Seong-Hi;Lee, On-Seok
    • Quality Improvement in Health Care
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    • v.22 no.2
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    • pp.27-40
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    • 2016
  • Purpose: Globally, falls are a major public health problem. The study aimed to evaluate the predictive validity of the Timed Up and Go test (TUGT) as a screening tool for fall risk. Methods: An electronic search was performed Medline, EMBASE, CINAHL, Cochran Library, KoreaMed and the National Digital Science Library and other databases, using the following keywords: 'fall', 'fall risk assessment', 'fall screening', 'mobility scale', and 'risk assessment tool'. The QUADAS-II was applied to assess the internal validity of the diagnostic studies. Thirteen studies were analyzed using meta-analysis with MetaDisc 1.4. Results: The selected 13 studies reporting predictive validity of TUGT of fall risks were meta-analyzed with a sample size of 1004 with high methodological quality. Overall predictive validity of TGUT was as follows. The pooled sensitivity 0.72 (95% confidence interval [CI]: 0.67-0.77), pooled specificity 0.58 (95% CI: 0.54-0.63) and sROC AUC was 0.75 respectively. Heterogeneity among studies was a moderate level in sensitivity. Conclusion: The TGUT's predictive validity for fall risk is at a moderate level. Although there is a limit to interpret the results for heterogeneity between the literature, TGUT is an appropriate tool to apply to all patients at a potential risk of accidental fall in a hospital or long-term care facility.

Falls in Patients of Medical Institutions in South Korea: A Literature Review

  • Jongwon Choi;Woochol Joseph Choi
    • Physical Therapy Korea
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    • v.30 no.1
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    • pp.1-7
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    • 2023
  • Background: Like many other countries, falls and related injuries in older adults are great concerns in South Korea. In particular, falls are common in medical institutions, often causing the increase of the length of hospitalization. Objects: The purpose of this review was to help understand and address falls in hospitalized individuals in South Korea. Methods: The review was conducted on literature published in Korean from 2010 to 2022, searched in the Korea Citation Index and PubMed. Keywords used for the search were as follows: falls, fall risk, fall risk assessment, hospital, inpatient, intervention, Korea, and prevention. Results: A total of 54 articles were found and reviewed. The most common place of fall accidents was the inpatient room, where there were many cases of falls while walking. Loss of balance was the most common cause of falls, and many falls occurred in patients admitted to the internal medicine. Furthermore, a risk of falling increased with the type of medications taken. In terms of tools to assess patients' fall risk, the Morse Fall Scale (MFS) was commonly used. Patient-specific fall prevention activities were common to address falls, and they decreased the frequency of falls and the fear of falling. Factors influencing the effectiveness of the fall prevention activities included attitudes toward falls, education, environmental factors, patient safety culture, and self-efficacy in preventing falls. Conclusion: Our results should help understand and address falls and injuries in medical institutions.

Comparison of risk factors for and experiences with falls according to sex among older adults with dementia in long-term care (노인요양원 치매노인의 성별에 따른 낙상경험 요인 비교)

  • Jung, Eun Sook
    • Journal of Home Health Care Nursing
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    • v.24 no.1
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    • pp.34-43
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    • 2017
  • Purpose: The purpose of this study was to provide basic data to develop a Fall Prevention Education Program by comparing and analyzing fall experiences and the factors that influence elderly people with dementia suffering falls. Methods: The participants were 302 patients with dementia aged 60 years or older with nursing records of hospitalization in three nursing homes located in a metropolitan area. The SPSS/Win 21.0 package was used to analyze the collected data. A logistic regression analysis was performed to identify the influence factors related to fall experiences. Results: For men, fall experiences were more frequent given the following factors: overweight; high fall risk tendency; aged 90 and above; married; dementia duration period of 5 to 9 years; and taking medication for dementia. For women, the factors included age range of 80 to 89; overweight; obese; both low and high fall risk tendency; separation by death; and having spent less than 1 year in nursing homes. Conclusion: We anticipate positive results in fall prevention education programs for the elderly with dementia if the results of this study are used as basic data, and interventions are customized to consider the sex and the relevant influence factors as to fall experiences.

Risk Factors and Methods in Balance Assessment Associated with Fall in Older Adults (노인의 낙상과 연관된 위험요소와 균형 측정 방법)

  • Lee, Yun-Kyung;Bae, Sung-Soo
    • Journal of the Korean Society of Physical Medicine
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    • v.2 no.1
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    • pp.73-84
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    • 2007
  • Purpose : The purpose of this study was to determine risk factors and methods in balance assessment associated with fall in older adults. Methods : This article describes many of the tools that can be used to evaluate the physical parameters associated with fall risk in older adults. Results : Composite ratings of performance(Tinetti balance assessment, Guralnik test battery, Berg balance scale, modified-physical performance test) measures the score compounding the balance measure to determine fall risk. Static balance instruments are composed of FICSIT-4 that measures the ability of maintaining foot positions and CTSIB that measures postural stability. Dynamic balance instrument is composed of functional reach test. To measure walking velocity and mobility, 8-foot up-and-go test and walking around two cones are used. We can use 1-RM and to measure muscular strength, isokinetic dynamometery, and 30-second chair stand to measure lower extremity muscle strength. Conclusion : The described instruments are easy to use and widespread. To select and use these tool kits carefully is considered to be helpful in identifying those who are most likely to fall. The final part of the article includes a brief discussion of the potential role of exercise training interventions to improve these physical parameters and prevent falls.

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Examination of useful items for the assessment of fall risk in the Korean community-dwelling elderly (한국 노인의 낙상위험평가 설문항목의 유효성 검토)

  • Shin, Sohee
    • Journal of the Korea Convergence Society
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    • v.9 no.6
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    • pp.271-277
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    • 2018
  • The aim of this study was to select useful items for assessing fall risk in community-dwelling elderly. This study assumed five fall risk factors: Symptoms of falling, physical function, disease and physical symptoms, environment, and behavior and character based on previous studies. The questionnaire consisted of 44 items according to the contents validation, crossover analysis and factor analysis. The Korean version of the Fall Risk Assessment Scale (FRA-K) will be used as a useful tool to improve the fall problems perceived to be serious social problems and to provide important information for prevention of falls.

Circumstances, Risk Factors, and the Predictors of Falls among Patients in the Small and Medium-sized Hospitals (중소병원 입원환자의 낙상발생 시 현황, 낙상위험요인 및 낙상발생 예측요인)

  • Lee, Young Jin;Gu, Mee Ock
    • Journal of Korean Clinical Nursing Research
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    • v.21 no.2
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    • pp.252-265
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    • 2015
  • Purpose: This study examined the circumstances, risk factors, and the predictors of fall incidents among patients in the small and medium-sized hospitals. Methods: Fifty patients with any fall experiences were matched by gender, age, and medical departments with 100 patients without fall incident at the same hospital. Data were collected from 5 small and medium-sized hospitals. Data were analyzed using descriptive statistics, a Chi-square test, a Fisher's exact test, and a logistic regression with the SPSS/WIN 21.0 program. Results: In the patients with falls, the largest number of falls occurred during the day shift, in the patients' rooms, and while they were walking. Further 74.0% of the patients had physical injuries, and 34.0% had to take further medical diagnostic tests. Significant differences were found between the patients with falls and the others on 14 variables (cardiovascular disease, anemia, sedative-hypnotics, vasodilators, narcotic analgesics, dizziness, general weakness, unstable gait, walking aids, anger, anxiety, depression, orientation, and fear of fall). Narcotic analgesic use, dizziness, walking aids, and cardiovascular disease were identified as the predictors of fall incidents. Conclusion: These findings are hoped to be used in developing a fall risk assessment tool and fall prevention nursing programs for small and medium-sized hospitals.

The Effects of Sling Exercise on Fall Risk Score, Ankle Dorsiflexion and Balance in Community-Dwelling Elderly Women (슬링운동이 여성노인의 낙상위험도, 족관절배측굴곡력 및 균형에 미치는 효과)

  • Hahm, Kyoung-Lim;Lee, Wan-Hee
    • Journal of muscle and joint health
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    • v.16 no.2
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    • pp.165-173
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    • 2009
  • Purpose: The aim of this study was to examine the effects of sling exercise on fall risk score, ankle dorsiflexion and balance in community-dwelling elderly women. Method: A 6-week prospective study was conducted to examine the effects of sling exercise. Participants were required to attend their assigned exercise classes three times a week for 6 weeks. Result: After the 6 week study period, PPA fall-risk scores were reduced by 0.90 for the exercise group, which was a significant change (p<.001). Dorsiflexion strength increased significantly (p<.01) by 1.56 kg after the sling exercise. There was a 2.0 cm-increase (p<.05) in FRT and 0.38 second-improvement (p<.01) in TUGT. A 7.88 second-increase in One-leg standing with Eyes Open and a 3.12 second-increase in One-leg standing with Eyes Closed were reported during the 6-week intervention period. Conclusion: The 6-week sling exercise reduced falls risk score significantly (p<=.001) in community-dwelling elderly women by improving fall risk related factors such as reaction time, balance and strength.

Fall Risk Assessment (FRA) of Korean community-dwelling elderly (지역 재가 노인의 낙상위험평가)

  • Shin, Sohee;Sato, Susumu
    • 한국노년학
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    • v.39 no.4
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    • pp.895-902
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    • 2019
  • This study reviewed the diagnosis accuracy and evaluation criteria of the fall risk assessment questionnaire that proved validity through factor analysis in previous studies. The purpose of this study was to diagnose high-risk groups and propose personal fall risk profiles for the Korean community-dwelling elderly. The participants of this study were 439 elderly people living in S, U, B, and Y cities Korea (mean age 75.0 ± 5.7 years). Receiver operating characteristic analysis was conducted to review the accuracy of the fall risk assessment and evaluation criteria of the FRA. The results showed that the four sub-factors of the FRA: 'Potential for fall', 'Disease and physical symptoms', 'Environment' and 'Physical function', can effectively diagnose the fall risk of the community-dwelling elderly. The evaluation criteria was presented based on the sensitivity and specificity results. In addition, as a result of analyzing the patterns by the sub factors of the fall risk, the high-risk group accounted for 80% of the elderly who had problems with two or more factors. Therefore, the four sub-factors of FRA can effectively diagnose the fall risk level, and could be present individual fall risk profiles based on the evaluation criteria.