• Title/Summary/Keyword: Risk factors for falls

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A Study on Fall Accident (1개 종합병원 환자의 낙상에 관한 조사)

  • Lee, Hyeon-Suk;Kim, Mae-Ja
    • The Korean Nurse
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    • v.36 no.5
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    • pp.45-62
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    • 1998
  • The study was conducted from November 1995 to May 1996 at the one general hospital in Seoul. The total subjects of this study were 412 patients who have the experience of fall accident, among them 31 was who have fallen during hospitalization and 381 was who visited emergency room and out patient clinic. The purposes of this study were to determine the characteristics, risk factors and results of fall accident and to suggest the nursing strategies for prevention of fall. Data were collected by reviewing the medical records and interviewing with the fallers and their family members. For data analysis, spss/pc+ program was utilized for descriptive statistics, adjusted standardized $X^2$-test. The results of this study were as follows: 1) Total subjects were 412 fallers, of which 245(59.5%) were men and 167(40.5%) were women. Age were 0-14 years 79(19.2%), 15-44 years 125(30.4%), 45-64 years 104(25.2%), over 65 years 104(25.2%). 2) There was significant association between age and the sexes ($X^2$=39.17, P=0.00). 3) There was significant association between age and history of falls ($X^2$=44.41. P= .00). And history of falls in the elderly was significantly associated with falls. 4) There was significant association with age and medical diagnosis ($X^2$=140.66, P= .00), chief medical diagnosis were hypertension(34), diabetis mellitus(22), arthritis(11), stroke(8), fracture(7), pulmonary tuberculosis(6), dementia(5) and cataract(5), 5) There was significant association between age and intrinsic factors: cognitive impairment, mobility impairment, insomnia, emotional problems, urinary difficulty, visual impairments, hearing impairments, use of drugs (sedatives , antihypertensive drugs, diuretics, antidepressants) (P < 0.05). But there was no significant association between age and dizziness ($X^2$=2.87, P=.41). 6) 15.3% of total fallers were drunken state when they were fallen. 7) Environmental factors of fall accident were unusual posture (50.9%), slips(35.2%), trips (9.5%) and collision(4.4%). 8) Most of falls occurred during the day time, peak frequencies of falls occurred from 1pm to 6pm and 7am to 12am. 9) The places of fall accident were roads(22.6%), house-stairs 06.7%), rooms, floors, kitchen (11.2%), the roof-top, veranda, windows(10.9%), hospital(7.5%), ice or snowy ways(5.8%), bathroom(4.9%), playground, park(4.9%), subway-stairs(4.4%) and public-bathrooms (2.2%). 10) Activities at the time of fall accident were walking(37.6%), turning around or reaching for something(20.9%), going up or down stairs09.2%), exereise, working07.4%), up or down from a bed(2.7%), using wheelchair or walking aids, standing up or down from a chair(2.2%) and standing still(2.2%). 11) Anatomical locations of injuries by falls were head, face, neck(31.3%), lower extremities (29.9%). upper extremities(20.6%), spine, thorax, abdomen or pelvic contents(l1.4%) and unspecified(2.9%). 12) Types of injures were fracture(47.6%), bruises03.8%), laceration (13.3%), sprains(9.0%), headache(6.6%), abrasions(2.9%), intracranial hemorrage(2.4%) and burns(0.5%). 13) 41.5% of the fallers were hospitalized and average of hospitalization was 22.3 days. 14) The six fallers(1.46%) died from fall injuries. The two fallers died from intracranial hemorrage and the four fallers died of secondary infection; pneumonia(2), sepsis(1) and cell lulitis(1). It is suggested that 1) Further study is needed with larger sample size to identify the fall risk factors. 2) After the fall accident, comprehensive nursing care and regular physical exercise should be emphasized for the elderly person. 3) Safety education and safety facilities of the public place and home is necessary for fall prevention.

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Evaluation of the Elderly Gait Stability Using the Center of Mass and Center of Pressure Inclination Angles (전, 후방 기울기각을 이용한 노인의 보행안정성 평가)

  • Yoon, Suk-Hoon;Kim, Tae-Sam;Lee, Jae-Hun;Ryu, Ji-Seon;Kwon, Young-Hoo
    • Korean Journal of Applied Biomechanics
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    • v.17 no.4
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    • pp.99-106
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    • 2007
  • The gait instability in the elderly has been associated with age-related deterioration in physical strength and reducing the potential for elderly falls requires regular exercise. In 2005, National Center for Injury Prevention and Control(NCIPC) reported that most elderly falls occur during activities in daily living(ADL). To better reveal biomechanic mechanisms underlying age-related degeneration in gait stability, and to enhance the assessment of falls risk, an accurate quantification of a person's balance maintenance during locomotion is needed. Instantaneous orientation of the line connecting COP and COM can characterize whole body position with respect to the supporting foot during gait and the angle between this line and the vertical line passing through the COP known as a good assessment to detect the elderly gait instability. Therefore the purpose of this study was to investigate a 6-month walking exercise effects in reducing elderly fall risk factors by using COP-COM inclination angles. Twenty-two community-dwelling elderly participated this study. The participants performed a walking exercise(3 times/week, 1 hour/visit) for 6 months. Laboratory kinematics during walking was assessed at months 0, 3 and 6. Significant increased in gait velocity was found among periods(p=.011, $1.25{\pm}.03$, $1.32{\pm}.03$, and $1.39{\pm}.04\;m/s$ in 0-, 3-, and 6-month, respectively). Also, significant differences in anterior and posteriror inclination angles were found among the periods(p<.05; posterior inclination angles: $12.8{\pm}2.2$, $11.0{\pm}2.9$, & $10.9{\pm}1.9$; anterior inclination angles: $13.7{\pm}1.7$, $14.6{\pm}3.2$, & $1.46{\pm}.21$ in 0month, 3month, & 6month, respectively). These findings provide evidence of significant reduced fall risk factors of community-living older adults associated with a systematic walking program.

A Literature Review for Fall-Prevention Nursing Program Development based on the Fall Information of a Rehabilitation Hospital (일 지역 재활병원의 낙상 정보에 근거한 낙상예방 간호중재 프로그램 개발을 위한 문헌분석 연구)

  • Park, Hee-Ok;Kang, Hee-Kyung
    • Journal of Convergence for Information Technology
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    • v.10 no.8
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    • pp.99-107
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    • 2020
  • This study is to design an effective fall-prevention nursing program. Researchers investigated the current condition and risk factors for falls in the small-medium sized rehabilitation hospital with descriptive research. We conducted integrative literature review to reflect the current approach of fall-prevention nursing program. We found that the risk factors for falls are related to the characteristics of clinical setting of the hospital. We suggested the nursing intervention with applying fall risk assessment scale that is sensitive to the elderly population and the intervention that shows maximum effect. In conclusion, this study proposed the way of selecting an effective fall-prevention nursing program based on a clinical setting and prospective of its application. This will contribute to the improvement in nursing practice with the critical view in hospital fall.

MULTI-ORDER FRACTIONAL OPERATOR IN A TIME-DIFFERENTIAL FORMAL WITH BALANCE FUNCTION

  • Harikrishnan, S.;Ibrahim, Rabha W.;Kanagarajan, K.
    • Korean Journal of Mathematics
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    • v.27 no.1
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    • pp.119-129
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    • 2019
  • Balance function is one of the joint factors to determine fall in risk theory. It helps to moderate the progression and riskiness of falls for detecting balance and fall risk factors. Nevertheless, the objective measures for balance function require expensive equipment with the assessment of any expertise. We establish the existence and uniqueness of a multi-order fractional differential equations based on ${\psi}$-Hilfer operator on time scales with balance function. This class describes the dynamic of time scales derivative. Our tool is based on the Schauder fixed point theorem. Here, sufficient conditions for Ulam-stability are given.

A Study of Pain and Psychological Well-Being in Total Knee Replacement Patients (무릎 전치환술 환자의 통증과 심리적 안녕에 관한 연구)

  • Chae, Jung-Byung;Jung, Ju-Hyeon
    • PNF and Movement
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    • v.18 no.2
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    • pp.233-244
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    • 2020
  • Purpose: The study investigated pain and falls as psychological factors in Total Knee Replacement patients and examined the relationship between these factors. Methods: Ninety-six total knee replacement patients aged 69.31±7.01 (male: 21, female: 75) participated in the study. Post-surgery pain was assessed on a visual analog scale, and fall risk scores were evaluated on fall fear and fall efficacy scales. Other psychological factors assessed included national anxiety and trail anxiety, fear prevention, Beck depression score, and psychological health measures. The data were analyzed using SPSS version 22.0. Results: A statistically significant correlation was found between pain before surgery and FES fall fear score before surgery (p < 0.05). A statistically significant correlation was found between pain after surgery and PWBS fall fear score after surgery (p < 0.05). A statistically significant correlation was found between state anxiety and PWBS, Trail anxiety (p < 0.05). A statistically significant correlation was also found between trail anxiety and BDI, PWBS (p < 0.05). State anxiety and fear avoidance before surgery were found to affect trail anxiety, and pain before surgery and fall fear score before surgery were found to affect FES. In addition, PWBS was found to affect BDI. Conclusion: The study confirms that increased pain in Total Knee Replacement patients can be a risk factor for falls. In addition, fall fears increase fear avoidance and cause psychological deterioration. This suggests that efforts should be made to reduce pain and to manage psychological factors.

Incidence Rate and Characteristics of Falls in Patients Using Comprehensive Nursing Care Service (간호·간병통합서비스 이용환자의 낙상발생률과 낙상의 특성)

  • Son, Jaei;Park, Byung Kyu;Lee, Chan Hee;Ahn, Keum Hui;Kim, Jung Nam;Park, Min Hyun;Choi, Eun Young;Boo, Eun Hui;Kang, Min Jin;Hong, Jung Hwa
    • Health Policy and Management
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    • v.29 no.2
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    • pp.172-183
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    • 2019
  • Background: Falls are the most frequent adverse events reported in hospitals. The aim of this study was to investigate the incidence rate and characteristics of falls in patients who used comprehensive nursing care service in National Health Insurance Service Ilsan Hospital. Methods: Incidence rate of falls was investigated in patients using comprehensive nursing care service, from July 2013 to Jun 2017 and compared with those not using this service. The characteristics and risk factors for falls, and fall-related injuries were obtained. Results: Among the 62,445 patients who used the comprehensive nursing care service for 4 years, total of 672 falls were reported. The incidence rate of falls per 1,000 patients-day was 1.15. The percentage of fall-related injuries was 26.9% and that of major injury was 2.2%. Although the incidence rate of all falls was slightly higher in patients using comprehensive nursing care service than those not using this service, falls-related injuries were not correlated with the implementation of this service. Conclusion: The falls could be more frequently detected and reported in comprehensive nursing care service, but there was no difference in fall-related injuries.

Prevalence and Risk Factors of Orthostatic Hypotension among the Community-Dwelling Aged (재가 노인의 체위성 저혈압 발생빈도와 위험요인)

  • 유수정;송미순;김현숙
    • Journal of Korean Academy of Nursing
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    • v.33 no.2
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    • pp.200-209
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    • 2003
  • Purpose: This study was to identify the prevalence of orthostatic hypotension and its association with risk factors of orthostatic hypotension aged over 60 in Seoul and Chungju, Korea. Method: The data were collected from the 22th of August, 2000 to the 7th May 2001. The participants were 74 community-dwelling aged who could stand up from sitting position without assistance. Subjects were interviewed with structured questionnaire in order to ask experience of previous falls, hours in per day, symptoms related orthostatic hypotension and demographic characteristics. Orthostatic hypotension was assessed at 1 minute after the subjects standing from sitting position and defined as 20mmHg or greater decrease in systolic blood pressure after standing. Result: The prevalence of orthostatic hypotension was 17.1%. The mean drop of systolic blood pressure was 27.46mmHg among orthostatic hypotension subjects. The significant variables which explain the occurrence of orthostatic hypotension was the basal systolic blood pressure, the hit ratio of discriminant function with basal systolic blood pressure was 69.7%. Conclusion: Finding indicate that this study will contribute to develop nursing strategies to identify risk factors and to prevent orthostatic hypotension for the aged.

Physical and Psychological Factors Affecting Fall in Elderly Patients with Parkinson's disease (파킨슨병 노인의 낙상에 영향을 미치는 신체적, 심리적 요인)

  • Kim, Ji-Yoen;Byun, Mi-Kyong
    • Journal of Convergence for Information Technology
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    • v.12 no.3
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    • pp.55-65
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    • 2022
  • Elderly people with Parkinson's disease have higher rates of physical and mental risk factors for falls than non-Parkinson's disease elderly. The purpose of this study is to investigate this by using national data that includes the entire population of the elderly in Korea. As a secondary analysis study using data survey on the elderly by the Ministry of Health and Welfare in 2017, there were a total of 103 elderly people with Parkinson's disease, and a total of 96 subjects were analyzed excluding missing values. In the elderly with Parkinson's disease, the factor most influencing the fall was IADL, and IADL is related to motor control function. Decreased motor control limits physical movements essential for daily life, and even affects self-protective behavior in emergency situations, affecting falls. Based on the research results that IADL can affect falls, various exercise therapies for fall prevention interventions in the elderly with Parkinson's disease can be suggested.

The Effects of Tai Chi Exercise on Physiologic, Psychological Functions, and Falls among Fall-Prone Elderly (태극운동이 낙상 위험 노인의 신체적, 심리적 기능 및 낙상발생에 미치는 효과)

  • Choi, Jung-Hyun;Moon, Jung-Soon;Sohng, Kyeong-Yae
    • Journal of muscle and joint health
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    • v.10 no.1
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    • pp.62-76
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    • 2003
  • This study was a quasi-experimental study of non-equivalent control group pretest and posttest design. The purpose of this study was to determine the effect of Tai Chi exercise program on physical functions, psychological functions, and fall among the fall-prone elderly. The data were collected from September 19, 2001 to January 31, 2002. The study, conducted at two facilities located in Kwang-ju, was targeted to the ambulatory aged 60 years or older who had at least one of the key fall risk factors. Experimental group participated in Tai Chi exercise for 40 minutes per one time and three times a week for 12weeks at an auditorium. Fifty nine fall-prone elderly were assigned to 12-week Tai Chi exercise program (n=29) and control group (n=30). They underwent tests of lower muscle strength, time for chair stand, balance, flexibility, depression, falls efficacy, fear of falling, and numbers of fall at the baseline and at the 12th week. Numbers of fall and fall injuries were monitored for 16 weeks(12-weeks intervention plus 4-week follow-up periods) using fall calendar. Each participant was given a calendar to record the numbers of fall per day for a month. The calendars were collected at the last week of each month. 1. Tai Chi exercisers showed significant improvement in the strength of knee flexors, and ankle dorsiflexors and plantarflexors compared to the control group. The experimental group had improvement in the strength of knee extensors while the control group did not, with no statistical significance. 2. Tai Chi exercisers reported positive change in the average time of chair stand as compared to the control group. 3. Tai Chi exercisers had significant improvement in flexibility as compared to the control group. 4. There was no significant difference in the depression between the two groups, even though the Tai Chi exercisers maintained depression score in the same level while the others were increased. 5. Tai Chi exercisers showed significant improvements in the falls efficacy as compared to the control group. The falls efficacy was significantly improved among the experimental group while the opposite was identified among the control group. 6. The experimental group reported the significant reduction of the fear of fall, whereas control group reported the opposite. 7. Of the 59 subjects for 16weeks(12weeks intervention period and 4weeks follow up), 9 (31.0%) of the 29 in exercise group and 15 (50%) of the 30 in the control group fell (relative risk=0.62. 95% CI 0.32-1.19), even with no statistical difference. The results suggest that the Tai Chi exercise program can improve the strength of knee flexors, ankle dorsiflexors and plantarflexors, chair stand. flexibility, falls efficacy, and fear of falling for the fall-prone elderly.

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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.