• 재활치료과학
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• 제7권2호
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• pp.41-50
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• 2018

목적: 본 연구는 노인의 인지수준이 낙상을 유발하는 위험 행동요인과 어떤 상관관계를 갖는지 알아보기 위하여 진행되었다. 연구방법: 2017년 10월부터 12월까지 3개월 간 4개의 도시에 거주하고 있는 65세 이상 인지장애가 있는 노인 및 인지장애가 없는 노인 43명을 대상으로 인지기능 평가(K-MoCA) 및 낙상행동요인척도(FaB)를 실시하여 자료를 수집하였다. 두 평가의 총점 결과간의 상관관계를 SPSS 22를 사용하여 분석하였고, 각각의 낙상행동요인과 인지수준과의 상관관계를 분석하였다. 결과: 노인의 인지수준과 낙상행동요인 간에 통계적으로 유의미한 양의 상관관계가 있는 것으로 나타났다(p<.01). 노인 낙상행동요인 척도의 총 30개의 문항 중 9개의 문항이 K-MoCA의 총점과 통계적으로 유의미한 상관관계를 보였다. 결론 : 노인의 인지수준이 높을수록 낙상위험 행동요인이 적고, 인지수준이 낮을수록 낙상위험 행동요인을 인식하지 못하고 낙상관련 위험행동을 하는 양상을 보인다. 특히 일부 낙상위험 행동요인은 인지수준과 상관관계가 있어 관련 중재를 제공할 시 고려해주는 것이 필요하다.

• 한국산학기술학회논문지
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• 제21권7호
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• pp.510-516
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• 2020

본 연구는 2008년부터 2017년까지의 질병관리본부의 퇴원손상심층조사 자료를 이용하여 입원 아동 중 낙상을 경험한 환자를 대상으로 유·아동·청소년 낙상의 특성과 낙상영향 요인을 규명하고자 하였다. 이를 위하여 입원 중 낙상(한국표준질병사인분류, W00-W19)으로 손상(한국표준질병사인분류, S00-S99)을 경험한 18세 이하 아동 환자 116건의 데이터를 수집·분석하였다. 수집된 자료는 SPSS 23을 이용하여 빈도분석, 교차분석, 다중회귀분석을 실시하였다. 연구결과, 입원 중 낙상을 경험한 아동은 남자가 여자 보다 많았고, 1세 이상 6세 이하의 연령에서 낙상이 가장 많이 발생하는 것으로 나타났다. 낙상을 경험한 아동의 질병유형으로는 호흡기 질환이 가장 많았고 낙상으로 인한 상해유형은 열린 상처나 타박상의 빈도가 가장 높았으며, 낙상 사고 원인으로는 침대와 관련된 낙상이 가장 많았다. 낙상 관련 요인분석 결과 성별을 제외한 연령(β=.318), 주진단명(β=.231), 손상(β=.169)의 순으로 낙상에 영향을 미치는 것으로 나타났다. 이와 같은 연구결과는 아동에 대한 낙상예방 교육이 연령, 질병 유형, 아동의 발달단계에 따른 특성과 연령대를 고려하여 실시되어야 함을 시사하는 결과라 할 수 있다. 또한 비교적 활동에 제약이 적은 경미한 질환의 아동이나 과다행동을 보이는 유아기 아동 등 질병의 유형과 연령별 아동 발달 단계특성을 고려한 낙상 사고 위험군에 대한 스크리닝 및 이와 관련한 섬세한 낙상예방 매뉴얼 개발에 힘써야 할 것이다. 마지막으로, 본 연구결과가 입원을 필요로 하는 아동 환자, 보호자, 그리고 관련 의료진에게 연령별 아동 발달단계의 특성에 따른 낙상예방 교육 및 매뉴얼 개발의 단초로 사용되기를 기대한다.

• 한국사회복지학
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• 제66권2호
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• pp.159-177
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• 2014

본 연구는 고령화패널 자료를 이용하여 우울증 여부에 대해 성별간 영향을 미치는 변인들을 살펴보고, 성별 격차에 영향을 미치는 변인들을 분석하였다. 분석 결과, 인구학적, 경제적, 건강 관련 변인들이 폭넓게 남녀 그룹 모두에서 우울증을 높이는 변인들로 나타났으며, 사회활동, 낙상여부 등의 변수들이 남녀간 우울증 여부에 상이하게 영향을 미치는 것으로 나타났다. 요인분해분석 결과, 결혼 상태만족도, 경제 상태 만족도, 건강 관련 변수들이 남녀간 불균등하게 분포되어 있어 남녀간 우울증 격차를 늘리는 것으로 나타났으며, 남성에 비해 여성이 결혼상태로부터 보상을 덜 받는 것으로 나타났다. 결혼 상태로부터의 보상이 여성과 남성이 같다면, 남녀간 우울증 격차의 약 40% 가량이 줄어드는 것으로 나타났다.

• The Journal of Korean Physical Therapy
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• 제21권4호
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• pp.57-63
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• 2009

Purpose: To better understand falls in elderly women, we measured differences in muscle activities of 4 lower extremity muscles (tibialis anterior, soleus, rectus femoris, biceps femoris) based on angle plantar-flexion in elderly women. Methods: Subjects were 15 healthy elderly women. No subjects had musculoskeletal or nervous disorders. EMGs were used to check muscle activity of lower extremity muscles. For statistic analysis, data were expressed as a percentage of maximal voluntary isometric contraction (%MVIC). We measured %MVIC for 5 sec under 4 conditions and did not use data for the first and last second. Muscle activities of the muscles of the lower extremities were measured based on the degree of plantar-flexion of the ankle joint. The 4 conditions corresponded to different degrees of: 0, 10, 20 and 30 degrees. This was done using a 50 cm board for measuring the degrees. Results: The tibialis anterior, soleus, and bicpes femoris showed increasing muscle activity associated with increasing degree of plantar-flexion of the ankle joint. All muscles showed a significant increase in muscle activities in association with increasing degrees. Rectus femoris showed a significant increase in muscle activity for 0 degrees and for the other degrees, but there were no further changes when plantar flexion of the ankle joint was over 10 degrees. Conclusion: Activities of the muscles of the lower extremities except rectus femoris were higher with increasing degree of plantar flexion. High muscle activity may result in muscle fatigue. Thus, increasing degree of plantar flexion may be risk factors of falls in elderly women.

• 가정간호학회지
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• 제31권1호
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• pp.16-29
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• 2024

Purpose: This scoping review aimed to synthesize the characteristics and effects of interventions designed to prevent unintentional home injuries in older adults in Korea. Methods: The review was conducted following the Joanna Briggs Institute protocol. A literature search was performed for studies published between 2001 and 2022 in the DBPia, RISS, KMBase, and NDSL databases. A total of 1,620 studies were identified, and 27 studies were included in the final analysis. Data were analyzed for characteristics of the literature, intervention-related unintentional injury mechanisms, and safety areas. Results: Most selected studies utilized a quasi-experimental design and targeted elderly women. In terms of injury mechanisms, 21 of 27 studies focused on falls, 2 on fire/disaster, 3 on drugs, and 1 on food. The most common preventive intervention for falls was exercise, and its effectiveness was verified using physical safety variables. Interventions in the fire/disaster, drug, and food domains were all educational, and changes in knowledge, behavior, and attitude were verified. Conclusion: This study confirmed the effectiveness of interventions for preventing unintentional injuries in the homes of community-dwelling older adults. These findings can serve as a foundation for developing and implementing unintentional injury prevention interventions at home for community-dwelling older adults. Multidisciplinary research is needed to address multifaceted safety issues by considering the home environment and injury risk factors.

• 한국의료질향상학회지
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• 제9권2호
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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.

• 수산해양기술연구
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• 제55권1호
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• pp.82-93
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• 2019

The International Labor Organization (ILO) selected fishing as the most dangerous group of jobs in the world, and it is well known in Korea as a 4D industry. Offshore large purse seine accounts for the largest portion of the fishing industry in the coastal region with high death rate and the accident rate. The repeated disaster rate survey by the Korea Maritime Institute (KMI) shows offshore large purse seiner is the highest at 22.3 percent and coastal gill nets and offshore stow net are following at 12.4 percent and 11.9 percent in order. Therefore, risk factors occurring in offshore large purse seiners were analyzed based on data from the National Federation of Fisheries Cooperatives (NFFC) for three years from 2015 to 2017 and 4M (Man, Machine, Media, Management) 3E (Engineering, Education, Enforcement) techniques were used to provide a safe fishing environment. The number of accidents on offshore large purse seiners each year was more than 150, and the number of accidents on every fishing boats was as high as 17 percent in 2015. If the accident rate and the risk level were divided by insurance, the accident resulting from contact with machinery was the highest, and the risk of a contact with gear was low but frequently occurring. This was caused by collisions and contact with gear in situations where death and disappearance risk are not high, and accident types in situations where death and loss risk are considered to be contact with machinery, falls or other accidents. Through these analysis techniques, the frequency and risk of each type of accident on a offshore large purse seiners can be demonstrated, and it is expected to raise awareness of a safer fishing environment and contribute to the reduction of accidents.

• The Journal of Korean Physical Therapy
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• 제24권2호
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• pp.90-97
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• 2012

Purpose: The purpose of this study was to assess the effects of virtual reality-based continuous slow exercise on muscle strength and dynamic balance capacity, in older adults over 65 years of age. Methods: Twenty-six volunteers were randomly divided into two groups; a Virtual Reality (VR) exercise-group ($67.8{\pm}4.1$ yrs) and a Control group ($65.5{\pm}5.2$ yrs). The VR group participated in eight weeks of virtual reality exercise, utilizing modified Tai-Chi provided by a motion capture system, and the Control group had no intervention. The hip muscle strength and dynamic balance of the members of both the VR group and the Control group were measured at pre- and post-intervention, using a multimodal dynamometer, and backward stepping test, respectively. Results: 1. After the 8-week VR-based exercise, the VR group showed significant improvement of hip strength, compared to the control group: hip extension (p=0.00), flexion (p=0.00), abduction (p=0.00), and adduction (p=0.00). 2. After the 8-week VR-based exercise, the VR group showed significant improvement of dynamic balance capacity as ground reaction force, compared to the control group. Eyes opened backward stepping test: Fx (+) (p=0.00), Fy (-) (p=0.02), Ver (+) (p=0.02) direction. Eyes closed backward stepping test: Fx (+) (p=0.04), Fy (-) (p=0.04), Ver (+) (p=0.03) direction. Conclusion: The VR group showed improvement of their hip muscle strength, and dynamic balance capacity. Therefore VR-based continuous slow exercise would contribute to reducing the risk of falls in the elderly.

• 기본간호학회지
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• 제17권2호
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• pp.177-186
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• 2010

Purpose: The purpose of this descriptive study was to investigate the application of physical restraints in ICUs of a university hospital. Method: Data were collected from August 1 to October 1 2009, using a recording tool from Electric Nursing Records and an observation tool for physical restraints and related factors. Frequency, percentage, and paired t-test with the SPSS/WIN 16.0 program were used to analyze the data. Results: The application rate for physical restraints in 5 ICUs was 34.3%, the highest application rate was 48.4% in the neurosurgical ICU. The mean frequency for physical restraint application per patient was 1.14, and the mean hours of restraint application per incident was 113.01 hours. The most common complications of physical restraints were bruising and edema. Conclusion: Many ICU nurses use physical restraints when caring for patients who are at high risk for falls, including patients have high levels of acuity, decreased level of consciousness or increased irritability. When physical restraints are applied, patients show resistance against the use resulting in side effects of bruising and edema. Therefore, nurses should observe changes in restrain sites, perform nursing interventions to prevent complications, and minimize the use of physical restraints.

• 한국전문물리치료학회지
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• 제17권4호
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• pp.55-60
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• 2010

Clinical measures that Quantify falling risk factors are needed for the accurate evaluation of patients and to plan an intervention strategy. The purpose of this study was to examine the test-retest and interrater reliability of the dynamic gait index (DGI) for persons with Parkinson's disease (PD). A total of 22 idiopathic PD patients were recruited from rehabilitation hospital, Korea in this study. The DGI was assessed in two sessions that were, three days apart. We also measured Berg balance test (BBT) and geriatric depression scale (GDS) for concurrent validity with DGI. Intrarater and interrater reliability (.96 and .98 respectively) for DGI were high. indicating good agreement. The DGI was showed a good positive correlation with the BBS (r=.852). but not GDS (r=-.462). Intrarater and interrater reliability of DGI were high in people with PD. The DGI could be a reliable measure to evaluate functional postural control during gait activities in the PD population, and the ability of DGI to detect real change is acceptable in research and clinical settings.