• Journal of the Korean Society of Safety
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• v.36 no.3
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• pp.50-59
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• 2021

The main purpose of accident analysis is to identify the causal factors and the mechanisms of those factors leading to the accident. However, current accident analysis techniques focus only on finding the factors related to the accident without providing more insightful results, such as structures or mechanisms. For this reason, preventive actions for safety management are concentrated on the elimination of causal factors rather than blocking the connection or chain of accident processes. This greatly reduces the effectiveness of safety management in practice. In the present study, a technique to model the correlational structure of accident risk factors is proposed by using the co-occurrence keyword network analysis technique. To investigate the effectiveness of the proposed technique, a case study involving a portable ladder fall accident is conducted. The results indicate that the proposed technique can construct the correlational structure model of the risk factors of a portable ladder fall accident. This proves the effectiveness of the proposed technique in modeling the correlational structure of accident risk factors.

• Journal of Korean Academy of Nursing
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• v.43 no.3
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• pp.341-351
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• 2013

Purpose: This study was done to analyze the effects of Tai Chi on fall-related risk factors through meta-analysis of randomized clinical trials published in English and Korean between 2000 and 2010. Methods: Using health related database and hand search of references and Google, 28 randomized studies were collected from doctoral dissertation and published peer reviewed articles. The Comprehensive Meta-analysis version 2.0 was used for the analysis. Results: The effect sizes for Tai Chi for 3 months were significant with ES=0.54 for static balance, ES=0.24 for dynamic balance, ES=0.69 for balance measured by scale, and ES=0.40 for flexibility, ES=0.48 for muscle strength, ES=0.71 for ADL, and ES=0.37 for fear of falling. Also, the effect sizes of Tai Chi for 6 months were significant for most fall-related variables. The 6 month data for flexibility was not analyzed since only one study was published. Conclusion: The analysis of studies of randomized clinical trials indicate that Tai Chi is effective in improving balance, flexibility, muscle strength, activities of daily living, and fear of falling when applied for 3 or 6 months. The findings provide the objective evidence to apply Tai Chi as a fall preventive intervention.

• Journal of the Korean Society of Safety
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• v.34 no.5
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• pp.132-138
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• 2019

Fall accident is the most frequent accident type of occupational accidents. As the age of workers increases, trip and fall accident increases more than other types of occupational accident in the middle-aged group. In this study, the gait characteristics of 25 middle-aged participants (mean ages 47.4, S.D. 5.8) were studied to analyze the trip and fall risks. The Minimum toe clearance(MTC) against the floor surface was measured in the variable conditions of gait speed by a motion capture system. In the 50s age group, the MTC decreased and the MTC tended to reduce the variation with increasing walking speed in the level walking. Therefore, the trip and fall risks for the 50s age group is higher than the 40s age group. Especially, the faster walking speed will increase the trip and fall risks even more.

• Journal of Korean Academy of Nursing
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• v.43 no.5
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• pp.595-604
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• 2013

Purpose: The purpose of this study was to identify risk factors for pediatric inpatients falls. Methods: The study was a matched case-control design. The participants were 279 patients under the age of 6 who were admitted between January 1, 2004 and December 31, 2009. Through chart reviews, 93 pediatric patients who fell and 186 ones who did not fall were paired by gender, age, diagnosis, and length of stay. Five experts evaluated the 38 fall risk factors selected by the researchers. Results: In a general hospital, pediatric patients with secondary diagnosis, tests that need the patient to be moved, intravenous lines, hyperactivity, anxiolytics, sedatives and hypnotics, and general anesthetics showed significance for falls on adjusted-odds ratios. Conditional logistic regression analysis was performed to elucidate the factors that influence pediatric inpatient falls. The probability of falls increased with hyperactivity and general weakness. Patients who didn't have tests that required them to be moved and intravenous line had a higher risk of falls. Conclusion: These findings provide information that is relevant in developing fall risk assessment tools and prevention programs for pediatric inpatient falls.

• Physical Therapy Rehabilitation Science
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• v.7 no.4
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• pp.197-203
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• 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.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.28 no.3
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• pp.61-68
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• 2022

Background: This study aimed to investigate the effects of noninvasive electrical stimulation combined with trunk stabilization exercise on balance and fall risk in patients with stroke. Methods: Twenty-two patients with stroke were enrolled in the study and randomly divided into experimental and control groups, each with 11 patients. noninvasive electrical stimulation combined with trunk stabilization training was applied to the experimental group, and sham noninvasive electrical stimulation combined with trunk stabilization training, to the control group. Both groups were treated for 6 weeks, five times a week for 30 min each time; the balance and fall risk of patients with stroke were measured before and after treatment, and the changes in the two groups were compared and analyzed. Results: The experimental group's left and right weight-bearing indices (affect and non-affect sides) and the front and rear weight-bearing indices, were significantly improved (p<.05, p<.001). when the changes in balance ability between groups were compared before and after treatment. The total fall efficacy score in the experimental group was substantially lower than that in the control group when the changes in fall efficacy score were compared between groups following treatment (p<.001). Conclusion: The improvement in balance and fall risk in patients with stroke can be attributed to using noninvasive electrical stimulation in combination with trunk stabilization training. This clinically helpful treatment method for patients with stroke warrants further promotion and implementation in the clinic.

• The Journal of the Korea Contents Association
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• v.13 no.12
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• pp.276-290
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• 2013

PURPOSE: This study compared the elderly falls and the intrinsic fall risk factors according to gender. METHODS: This descriptive cross-sectional study was a secondary analysis of the data collected for medical checkups for the Transitional Periods of Life supported from the National Health Insurance. The subjects examined were 255,505 people aged 66 years in Korea between January and December, 2008. RESULTS: The elderly people aged 66 when in the transitional periods of life experienced 10.6% of their first falls. The first falls of women (12.4%) was greater than that of men (8.5%) in the elderly. The risk factors for falls included dysuria with an odds ratio of 6.2 to 6.6, depression with an odds ratio of 1.5 to 1.8, gait disturbance with an odds ratio of 1.3 to 1.5, and blindness with an odds ratio of 1.3 to 1.4 in both elderly women and men. CONCLUSIONS: Effective fall prevention should focus on dysuria because it is a more important predictor of falls, even though many intrinsic fall risk factors can affect falls in elderly people.

• Korean Journal of Adult Nursing
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• v.25 no.1
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• pp.24-32
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• 2013

Purpose: The aim of the study was to identify the most appropriate fall-risk assessment tool for neurological patients in an acute care setting. Methods: This descriptive study compared the reliability and validity of three fall-risk assessment tools (Morse Fall Scale, MFS; St Thomas's Risk Assessment Tool in Falling Elderly Inpatients, STRATIFY; Hendrich II Fall Risk Model, HFRM II). We assessed patients who were admitted to the Department of Neurology, Neurosurgery, and Rehabilitation at Asan Medical Center between July 1 and October 31, 2011, using a constructive questionnaire including general and clinical characteristics, and each item from the three tools. We analyzed inter-rater reliability with the kappa value, and the sensitivity, specificity, predictive value, and the area under the curve (AUC) of the three tools. Results: The analysis included 1,026 patients, and 32 falls occurred during this study. Inter-rater reliability was above 80% in all three tools. and the sensitivity was 50.0% (MFS), 84.4%(STRATIFY), and 59.4%(HFRM II). The AUC of the STRATIFY was 82.8. However, when the cutoff point was regulated as not 50 but 40 points, the AUC of the MFS was higher at 83.7. Conclusion: These results suggest that the STRATIFY may be the best tool for predicting falls for acute neurological patients.

• Quality Improvement in Health Care
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• v.9 no.2
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• pp.210-228
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• 2002

Background: The purpose of this research was to examine the fall incidence rate and its related factors of fall in inpatients. Methods: The data were collected from the 138 fall incident reports in one tertiary hospital in Seoul from April 1st 1999 to September 30th 2001. The Fall Incident Report Form was originally developed based on that of Massachusetts General Hospital revised in 1995. And this was modified for this survey by the collaborating work of QI team including researcher and department of nursing service of this particular hospital. The contents of Fall Incident Form were general characteristics of patient. factors related to fall. types and places of fall. circumstances, nursing interventions. and outcome. Results: 1) The incidence rate of fall was 0.08% of total discharged patients and 0.081 per 1000 patient-day. This incidence rate is much lower than that of several hospitals in USA. This finding might result from the different incidence report system of each hospital. 2) The characteristics of fall-prone patient were found as follows. They were mostly over 60 years old, in alert mental status, ambulatory with some assistance, and dependent on ambulatory device. The types of diseases related high incidence rate were cerebrovascular disease(3.2), hypertension(1.6), cardiovascular disease(1.4), diabetes(1.3) and liver disease(0.6). 3) The majority of fall events usually occurred m bed. bedside(walking or standing) and bathroom in patient room. Usually they were up on their own when they fell. And there were more falls of elderly occurred during night time than day or evening. 4) 63.8% of fall events resulted in physical injuries such as fracture and usually the patients had diagnostic procedures and some treatment(ex. suture) which caused additional cost to the patients and their families. 5) The found risk factors of fall were drugs(antihypertensive drug, diuretics) and environmental factors like too high bed height, long distance of bedside table and lamp switch, and slippery tile of bathroom floor. Conclusion: Considering these results, every medical and nursing staff should be aware of the risk factors of patients in hospital, and should intervene more actively the preventive managements, specially for the elderly patients during night. Therefore, it is recommended that the development of Fall Prevention Programs based on these results.

• Women's Health Nursing
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• v.18 no.4
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• pp.237-247
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• 2012

Purpose: The purpose of this study was to investigate the incidence of osteoporosis and falls and their consequences, and to identify predictors of fracture risk in the postmenopausal women. Methods: A total of 687 postmenopausal women were recruited through a stratified convenience sampling. A structured questionnaire was used to obtain osteoporosis and fall history and details of their most recent fall. To predict fracture risk factors, we collected demographic and physical health variables related osteoporosis and fall. Fracture risk was measured by FRAX$^{(R)}$ to calculate 10-year probability of major osteoporotic and hip fracture. Results: The prevalence of osteoporosis was 22.1%, and 66.4% of them had treatments for osteoporosis. The incidence of falls during the past year was 19.2% and 38.6% of those who fell suffered consequent fractures. Women with history of osteoporosis and falls were significant predictors of 10-year probability of major osteoporotic and hip fracture. Other significant predictors were history of fracture, chronic disease, surgical menopause, lower BMI, poorer perceived health and no job. Conclusion: It appears that history of osteoporosis and falls are main predictors of fracture risk. Nursing assessment should be performed by detail history taking for osteoporosis, fall, chronic disease, and fracture to screen fracture risk group among postmenopausal women.