• Journal of Trauma and Injury
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• 제36권3호
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• pp.187-195
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• 2023

Purpose: This study aimed to determine the risk factors associated with the severity of fall-related injuries among patients who suffered a fall from similar heights and analyze differences in injury sites according to intentionality and injury severity. Methods: The Emergency Department-based Injury In-depth Surveillance (EDIIS) data collected between 2019 and 2020 were used in this retrospective study. Patients with fall-related injuries who fell from a height of ≥6 and <9 m were included. Patients were categorized into the severe and mild/moderate groups according to their excessive mortality ratio-adjusted Injury Severity Score (EMRISS) and the intention and non-intention groups. Injury-related and outcome-related factors were compared between the groups. Results: In total, 33,046 patients sustained fall-related injuries. Among them, 543 were enrolled for analysis. A total of 256 and 287 patients were included in the severe and mild/moderate groups, respectively, and 93 and 450 patients were included in the intention and non-intention groups, respectively. The median age was 50 years (range, 39-60 years) and 45 years (range, 27-56 years) in the severe and mild/moderate groups, respectively (P<0.001). In multivariable analysis, higher height (odds ratio [OR] 1.638; 95% confidence interval [Cl], 1.279-2.098) and accompanying foot injury (OR, 0.466; 95% CI, 0.263-0.828) were independently associated with injury severity (EMR-ISS ≥25) and intentionality of fall (OR, 0.722; 95% CI, 0.418-1.248) was not associated with injury severity. The incidence of forearm injuries was four (4.3%) and 58 cases (12.9%, P=0.018) and that of foot injuries was 20 (21.5%) and 54 cases (12.0%, P=0.015) in the intention versus non-intention groups, respectively. Conclusions: Among patients who fell from a similar height, age, and fall height were associated with severe fall-related injuries. Intentionality was not related to injury severity, and patients with foot injury were less likely to experience serious injuries. Injuries in the lower and upper extremities were more common in intentional and unintentional falls, respectively.

• 기본간호학회지
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• 제22권1호
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• pp.16-24
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• 2015

Purpose: This study was done to identify essential nursing diagnoses using NANDA and their related factors and defining characteristics of patients who were cared in an emergency room. Methods: The research checklist developed by the researcher consisted of 44 nursing diagnoses with defining characteristics and related factors and was applied to 235 patients who were admitted to an emergency room from November 1 to December 31, 2012. Results: Forty-one of forty-four nursing diagnoses were identified. The most frequent nursing diagnoses were acute pain, risk for falls, and activity intolerance. The most frequent defining characteristic for the nursing diagnosis of 'acute pain' was verbal report of pain. The agreement rate with NANDA (2009)'s defining characteristics was 66.7%. Conclusion: Results indicate that identification of essential nursing diagnoses and their defining characteristics and related/risk factors is important for emergency patient nursing care to facilitate use of NANDA taxonomy in the emergency nursing practice and documentation systems.

• 한국융합학회논문지
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• 제9권6호
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• pp.271-277
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• 2018

이 연구의 목적은 우리나라 지역거주 노인의 낙상 리스크를 평가하는 문항을 선정하고 유효성을 검토하는데 있다. 낙상위험 평가는 선행연구를 참고로 '낙상잠재성', '신체기능', '질병과 신체증상', '환경', '행동과 성격'의 5가지 요인으로 구분하였으며 내용타당성 검증, 교차분석 및 요인분석 결과에 따라 총 44개 문항으로 구성하였다. 한국형 낙상위험 평가척도는 심각한 사회문제로 인식되고 있는 노인의 낙상문제를 개선하고 개인의 낙상예방에 중요한 정보를 제공하는데 유용한 도구로 사용될 수 있을 것이다.

• 한국노년학
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• 제31권3호
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• pp.539-551
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• 2011

본 연구는 허약노인의 성별에 따른 낙상두려움, 건강상태, 규칙적 운동 횟수 등을 비교하고 낙상두려움에 영향 미치는 요인을 규명하고자 하였다. 본 연구는 253개 보건소의 2009년 맞춤형 방문건강관리사업 중에서 허약 노인 사례관리를 위해 수집된 65세 이상 노인들의 기초자료를 이용하였다. 연구대상자는 총 3903명(남 259명, 여 3644명)으로, 평균 연령은 남성이 75.17세, 여성이 평균 77.54세였으며, 남성의 75.3%, 여성의 85.4%가 낙상 두려움이 있다고 응답하였다. 저소득층 허약노인의 낙상두려움에 영향을 미치는 요인은 남성의 경우 정적 균형감, 과거 낙상경험이었으며, 여성 노인의 경우 정적 균형감, 복합적 이동능력, 우울과 과거 낙상경험, 교육 수준으로 나타났다. 본 연구결과를 토대로 허약노인의 낙상두려움 여부 및 영향요인을 주기적으로 평가하여 고위험군을 발견하고, 낙상 및 낙상두려움 발생을 예방하기 위해 이들을 대상으로 정서적 접근을 포함한 다요인적 통합 프로그램을 성별에 따른 맞춤형으로 개발, 제공할 것을 제안한다.

• 재활간호학회지
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• 제7권1호
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• pp.48-57
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• 2004

Introduction : The purposes of this study was to examine physical function and psychological status in the elderly caused by a fall. Method : The study was designed as a descriptive survey. Its subjects consisted of the 299 elderly over 65 years. Collected data were analyzed by the SPSS 10.0 program package. Results : The result of this study are as follows : 1) The score for ADL was significantly lower in the fall group. 2) Grip strength was significantly lower in the fall group. 3) Lapse of the motion sitting and standing was significantly longer in the fall group. 4) One-leg-standing time with the eyes open and closed was significantly shorter in the fall group. 5) Return time of 3m walk was significantly longer in the fall group. 6) The score for dizziness was significantly higher in the fall group. 7) The score for fear for a fall and depression were significantly higher in the fall group. 8) The score for falls efficacy was significantly lower in the fall group. Conclusion: ADL, muscle strength, balance, dizziness, fear for a fall, falls efficacy and depression turned out to be closely related to the fall of the elderly. Therefore, it would be required to develop and applicate the fall prevention program regarding these above risk factors.

• 농촌의학ㆍ지역보건
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• 제47권1호
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• pp.27-39
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• 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.

• Journal of Chest Surgery
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• 제46권2호
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• pp.130-134
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• 2013

Background: Rib fractures are the most common type of thoracic trauma and cause other complications. We explored the risk factors for pneumonia in patients with multiple rib fractures. Materials and Methods: Four hundred and eighteen patients who visited our hospital with multiple rib fractures between January 2002 and December 2008 were retrospectively reviewed. Chest X-rays and chest computed tomography were used to identify injury severity. Patients with only a single rib fracture or who were transferred to another hospital within 2 days were excluded. Results: There were 327 male patients (78%), and the median age was 53 years. The etiologies of the patients' trauma included traffic accidents in 164 cases (39%), falls in 78 cases (19%), slipping and falling in 90 (22%), pedestrian accidents in 30 (7%), industrial accidents in 41 (10%), and assault in 15 (4%). The median number of rib fractures was 4.8. Pulmonary complications including flail chest (2.3%), lung contusion (22%), hemothorax (62%), pneumothorax (31%), and hemopneumothorax (20%) occurred. Chest tubes were inserted into the thoracic cavity in 216 cases (52%), and the median duration of chest tube insertion was 10.26 days. The Injury Severity Score (ISS) and rib score had a median of 15.27 and 6.9, respectively. Pneumonia occurred in 18 cases (4.3%). Of the total cases, 33% of the cases were managed in the intensive care unit (ICU), and the median duration of stay in the ICU was 7.74 days. Antibiotics were administered in 399 patients (95%) for a median of 10.53 days. Antibiotics were used for more than 6 days in 284 patients (68%). The factors affecting pneumonia in patients with multiple rib fractures in multivariate analysis included age (p=0.004), ISS (p<0.001), and rib score (p=0.038). The use of antibiotics was not associated with the occurrence of pneumonia (p=0.28). In-hospital mortality was 5.3% (n=22). Conclusion: The factors affecting risk of pneumonia in patients with multiple rib fractures included age (p=0.004), ISS (p<0.001), and rib score (p=0.038). Elderly patients with multiple traumas have a high risk of pneumonia and should be treated accordingly.

• 국제물리치료학회지
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• 제6권2호
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• pp.884-890
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• 2015

This study observed the effects of ankle strengthening exercise and whole body vibration on the balance ability of older adults, thereby intending to provide basic materials for intervention methods aimed at improving older adults' balance ability. The subjects were 20 older adults who had experienced a fall. They were equally divided into two groups. Ankle strengthening training was applied to one group and ankle strengthening training and whole body vibration were applied to the other group, a timed up and go (TUG) test and Tinetti performance oriented mobility assessment (POMA) were performed, and changes in the subjects' limits of stability were observed. The TUG and POMA results significantly differed between before and after the experiment in the angle strengthening training (AST) group and the angle strengthening training with whole body vibration (ASTWV) group. In addition, the interaction between timing and each group was statistically significant. The limits of stability significantly changed after the intervention in both groups. Differences in the posterior and right limits of stability were significant between the AST group and ASTWV group. Therefore, ankle strengthening exercise and whole body vibration improve older adults' balance maintenance and reduce falls or the risk factors for falls in older adults.

• 재활복지공학회논문지
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• 제12권1호
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• pp.46-52
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• 2018

본 연구는 65세 이상 도시거주 노인 107명을 대상으로 일반적 특성, 만성질환 상태, 낙상 관련 의학적 변수, 균형 관련 자신감, 신체적 능력, 우울감을 평가하는 도구를 통해 낙상에 영향을 미치는 관련 주 요인을 찾고자 하였다. 또한 유의한 차이가 있는 변수들 간의 상관관계를 파악하며, 이 중 낙상을 유발하는 데 높은 영향력이 있는 변수를 도출하여 예측력을 알아보았다. 연구 결과, 낙상군에서 요실금, 발의 통증, 하지근력약화, 만성 질환수 및 복용 약물수 빈도수가 비낙상군에 비해 통계적으로 유의하게 높았다. 또한 ABC (Activities-specific Balance Confidence) 총점, BBS (Berg Balance Scale) 총점, SGDS (Short Geriatric Depression Scale) 총점, FRT(Functional Reach Test) 값에서 통계학적으로 유의한 차이가 있었다. 낙상에 영향을 주는 주요인은 ABC 총점으로 점수가 낮을수록 낙상 위험이 높아짐으로써 균형능력에 대한 자기 확신감이 낮을수록 낙상의 가능성이 높아지는 것으로 나타났으며, ABC, SDGS, BBS 척도가 결합하여 적용될 경우 낙상군과 비낙상군을 구분하는 예측력은 70.1%로 높게 나타났다.

• 수산해양기술연구
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• 제58권4호
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• pp.367-373
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• 2022

We analyzed work safety risk factors, which are likely to occur during fishing in gillnet fishing vessels using the written verdict of the Korea Maritime Safety Tribunal from 2016 to 2020, and considered work safety management. Of the total of 37 fatal accidents, three cases in the East Sea, six cases in the South Sea, and 28 cases in the West Sea were very frequent. The accident rate per vessel by sea area (%) was 0.08% in East Sea, 0.12% in South Sea, and 0.40% in the West Sea. Based on the East Sea, the number of fatal accidents was 1.6 times higher in the South Sea and 5.4 times higher in the West Sea. Six cases (16.2%) occurred during departure and preparation for fishing in the fishing process, and all other 31 cases (83.8%) occurred during fishing operation. In the order of accident types, 21 cases (56.8%) of being struck by object, eight cases (21.6%) of contact with machinery and six cases (16.2%) of falls from height were found to be fatal accidents in gillnet fishery. Human factors, such as fishers' carelessness and negligent safety management by captain accounted for 27 cases (73.0%) of the main cause, and 35 cases (94.6%) of the secondary cause. In addition to human factors such as fisher's carelessness and negligent safety management by captain, mechanical factors, environmental factors and management factors must be improved together to reduce human casualties. These results are expected to be utilized as basic data for reducing safety accidents during the work of fishers.