• Journal of Korean Academy of Fundamentals of Nursing
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• v.21 no.3
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• pp.264-274
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• 2014

Purpose: This study was done to determine inpatient fall rates in an acute hospital setting and to explore risk factors and characteristics across clinical departments. Methods: The medical records and standardized fall reports of 416 patients admitted between January 1 and December 31, 2012 were reviewed. Descriptive statistics and statistical tests were used, including: t-test, ${\chi}^2$-test, ANOVA. Results: The total fall rate per 1,000 inpatient days was 0.49. Fall rate, fall risk factors and characteristics such as age, type of fallers and mean MFS (Morse Fall Scale) differed significantly among clinical departments. Conclusions: The analysis results show that the fall rates, fall risk factors and characteristics of acute hospital inpatient falls varied significantly across clinical departments. The findings of this study suggest that hospitals should consider differences in fall related characteristics across clinical departments when implementation fall prevention strategies and interventions.

• Journal of muscle and joint health
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• v.21 no.1
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• pp.36-45
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• 2014

Purpose: The purpose of this study was to investigate the factors increasing fall risk in the residential environment risk and the perceived fall risk among the older adults who received home care services to provide information for developing a comprehensive falls intervention program. Methods: The subjects were 227 community-dwelling elderly aged 65 years and over who were taken care of by home-visiting nurses of the national health centers. The data were collected from July to August in 2012 using the Choi's residential environmental risk scale (2010) and the Hong's fall risk scale (2011). Results: Requires an assistive devices to walk, modified residential environment, health security, approval certificate of LTC, residential safety perception, residential environment risk, and perception of fall risk were statistically significant risk factors. A multiple logistic regression analysis showed that room & kitchen, physical perception, medication & ADL perception, floor-related environmental perception, and daily living tool-related perception were statistically significant predictors of fall. Conclusion: The results showed that the residential environment and the perceived fall risk were associated with fall experiences among the elderly. It is necessary to develope multifactorial intervention programs considering both environmental and perceived risk factors as well as physical risk factors to reduce and prevent falls among the elderly.

• Korean Journal of Adult Nursing
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• v.29 no.1
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• pp.51-62
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• 2017

Purpose: The purpose of this study was to provide data about the risk factors related to falls among elderly patients with dementia using meta-analysis. Methods: Key words used for search through electronic database (CINAHL, PubMed, Ovid-MEDLINE, RISS, KISS, DBPIA, National Assembly Library) included 'dementia', 'Alzheimer', 'fall'. Twenty studies met the inclusion criteria for the meta-analysis and 'R' version 3.2.2 was used to analyze the correlated effect size. Results: Study results showed that risk factors related to falls were identified as the demographic (age, gender, education), dementia-related (disease duration, cognition), physical (body mass index, walking, balance, activity of daily living, use of walking aids, number of medications including psychotropic drugs, musculoskeletal problems, parkinsonism, comorbidity), psychological (neuropsychiatric symptom, depression), environmental (Physical environment), and fall-related (fall history, high risk group of fall) factors. The effect size of risk factors such as high risk group of fall (r=.35), use of walking aids (r=.33), depression (r=.31), psychotropic drugs (r=.27), Musculoskeletal problems (r=.25) were higher than the other risk factors. Conclusion: Based on the findings of this study, strategies to improve elderly patient's depression, intensive care for high risk group of fall, and adequate training with walking aids are needed for prevention of falls in elderly patients with dementia.

• Quality Improvement in Health Care
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• v.15 no.2
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• pp.107-120
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• 2009

Background : To estimate fall incidence rate and associated factors in inpatients from a general hospital. Method : The data were collected from 104 fall incident reports developed by the patient safety committee in a general hospital in Seoul from 01 January 2007 to 31 December 2008. Information included general characteristics of patients, factors related to fall, types, places, circumstances and outcomes of fall. Result : The incidence rate of fall, which was 4.4 per 1,000 total discharged patients and 0.5 per 1,000 patient-days, was much lower than that of several hospitals in the United States. The difference may reflect the different incidence reporting system of each hospital. Fall-prone patients were, in general, $$\geq_-$$65 years of age, had an alert mental status, were ambulatory with some assistance, and were dependent on and ambulatory device. High incidence of falls was associated with patients with circulatory disease. The majority of fall events usually occurred in bed or at the bedside in the patient's room, and occurred more often during the night than during the day or evening. Risk factors of fall were use of drugs (antihypertensive or neuropsychiatric drugs) and environmental factors (e.g., overly high bed height, surrounding objects, inadequate fitness shoes and slippery floor). Physical injury occurred in 43.3% of fall events, which typically required diagnosis of injury and treatment such as suturing. Risk factors for repeated falls were use of a neuropsychiatric drug (odds ratio=13.9) and gait disturbance (odds ratio=91.2). Risk factors for fall-related injury were alert mental status (odds ratio=3.3 times more likely to fall than those who were drowsy or in a stupor) and general weakness(odds ratio=3.3 times more likely to fall than those who were not generally weak). Conclusion : Medical and nursing staff should be aware of the fall risk factors of hospitalized patients and should intensively pursue preventative strategies. Development of fall prevention education based on these results is recommended.

• Korean Journal of Adult Nursing
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• v.26 no.5
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• pp.533-542
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• 2014

Purpose: The purpose of this study was to understand the risk of falling associated with postmenopausal women and to identify the relationships between this risk and factors such as lifestyle, metabolic syndrome, and bone mineral density. Methods: The sample was 128 postmenopausal women between 50 and 65 from one menopausal clinic in an urban city. The Risk Assessment for Falls Scale II, developed by Glydenvand and Reinboth (1982) and adapted by Park Young-Hye (2003), was modified and used for this study. Results: The average fall-risk score in postmenopausal women was 7.2 out of 33, the fall-risk score associated with lifestyle was higher in women exposed to stress frequently or who favored spicy or salty foods. The fall-risk score associated with metabolic syndrome was higher in groups with HBP or with a waist circumference of 80cm or greater. The fall-risk score in groups with three or more factors of metabolic syndrome was the highest. Conclusion: The risk of fall in post-menopausal women was higher in groups with only elementary education, unemployed, reported two or more chronic diseases or reported frequent exposure to stress and for women who preferred spicy or salty foods or exhibited three or more factors of metabolic syndrome.

• PNF and Movement
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• v.14 no.2
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• pp.93-103
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• 2016

Purpose: This study aimed to investigate the factors that increase fall risk in the residential environment and the perceived fall risk among community-dwelling elderly through comparisons between fallers and non-fallers. Methods: The subjects were 95 community-dwelling elderly aged 65 years and over residing in the metropolitan city of Ulsan. A structured questionnaire consisting of items on sociodemographics and health- and fall-related characteristics was used and data were collected from July to August 2015. The data were analyzed with the SPSS/WIN program. Results: Among recent fallers, 38.9% had diagnosed diseases when the fall occurred, 56.87% were fearful of a recurrent fall, and 86.5% stated that they were increasing their carefulness but that had led to a decrease in activity. There were significant differences between elders who had fallen at least once and elders who had no falls in age, health status, depression, the experience of falling, fear of falling, diseases, and medications. Conclusion: The results indicate a need to assess risk factors to identify older adults with a high risk for falling and the need to develop multifactorial intervention programs that consider both environmental and perceived risk factors as well as physical risk factors to reduce and prevent falls among the elderly.

• 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.

• Journal of Korean Academic Society 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.

• Korean Journal of Adult Nursing
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• v.25 no.1
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• pp.74-82
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• 2013

Purpose: The purpose of this study was to identify the fall risk factors and to evaluate the effectiveness of the Morse Fall Scale(MFS) as an assessment tool among hospitalized inpatients. Methods: The medical records of a total of 294 patients who admitted to hospital from January 1 to December 31, 2010 were reviewed. One hundred forth seven patients who had experienced fall were matched with 147 patients who have never experienced fall. The fall information was obtained from electronic medical records and fall reports. Results: There were significant differences in visual disturbances, pain, emotional disturbances, sleep disorder, urination problems and elimination disorder at admission between fallers and non-fallers. Patients who had higher MFS scores at admission were more likely to fall as compared to the patients with lower MFS scores. When falls did occur, these occurred within five days following admission, in the patient room, among patients with alert mental status, and among patients who were ambulant with some assistance. Conclusion: The findings of this study support the need of using risk assessment tool for predicting risk for falls. This finding can be used as a useful resource to develop nursing intervention strategies for fall prevention at the hospital.

• Journal of Korean Public Health Nursing
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• v.28 no.3
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• pp.495-508
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• 2014

Purpose: This study was conducted in order to evaluate the reliability, validity, sensitivity, and specificity of the Short Form of Bobath Memorial Hospital Fall Risk Assessment Scale (BMFRAS-SF). Methods: A validation study was conducted on 207 elderly patients aged over 65 who were admitted to Bobath Memorial Hospital. Fall risk scores of BMFRAS, composed of eight subscales (age, fall history, physical activity, consciousness level, communication, fall risk factors, underlying disease, and medications) were assessed from the electronic medical record. BMFRAS-SF was derived from eight subscales of the BMFRAS representing the significance between fallers and non-fallers (fall history, physical activity, fall risk factors, underlying disease, and medications). Internal consistency reliability and interrater reliability were assessed by Cronbach's alpha and kappa coefficient. Validity was assessed by Spearman correlation analysis, factor analysis. Sensitivity, specificity, positive predictive and negative predictive values, and a receiver-operating characteristic curve (ROC) were generated. Results: Fallers had significantly higher risk scores than non-fallers in fall history, physical activity, fall risk factors, underlying disease, and medication scales. The BMFRAS-SF demonstrated acceptable Cronbach's alpha (.706) and kappa coefficients of .95. The BMFRAS-SF subscales showed good convergent validity and construct validity. The BMFRAS-SF presented good sensitivity(86.7%), specificity(67.9%), positive predictive value(42.9%) and good negative predictive value(94.8%) at a cut-off score of 5. Areas under the ROC curves were .860 for the BMFRAS and .861 for the BMFRAS-SF. Conclusion: The BMFRAS-SF was proved to be reliable and valid. It could be used for time-saving assessment and evaluation of the high risks for falls in clinical practice settings.