• 제목/요약/키워드: Risk factors for falls

검색결과 137건 처리시간 0.024초

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

  • 이현숙;김매자
    • 대한간호
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    • 제36권5호
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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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전, 후방 기울기각을 이용한 노인의 보행안정성 평가 (Evaluation of the Elderly Gait Stability Using the Center of Mass and Center of Pressure Inclination Angles)

  • 윤석훈;김태삼;이재훈;류지선;권영후
    • 한국운동역학회지
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    • 제17권4호
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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.

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

  • 박희옥;강희경
    • 융합정보논문지
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    • 제10권8호
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    • pp.99-107
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    • 2020
  • 본 연구목적은 일지역 중소 재활병원 입원환자의 낙상실태 및 위험요인을 규명하고, 낙상예방 간호중재 연구 트랜드를 문헌고찰하여 실제적인 낙상예방 간호중재프로그램을 구상하기 위함이다. 연구방법으로는 낙상실태 및 위험요인을 규명하기 위한 서술적 연구와 실제적 낙상예방 간호중재프로그램 구상을 위한 통합적 문헌고찰을 병행하였다. 연구결과 해당병원의 임상현장 특징이 반영된 낙상실태와 낙상위험요인을 확인하였으며, 문헌고찰을 통해 노년 인구에 민감도가 높은 낙상위험사정도구의 활용과 보다 효과적인 방식의 낙상예방 간호중재를 제안하였다. 결론적으로, 본 연구는 낙상예방 간호중재의 실무근거를 마련하기 위해 통합적 문헌고찰 결과를 기반으로 실제에 맞는 낙상사정도구와 낙상예방 중재프로그램의 선택을 제안하고 이들의 활용 전망을 비춰주었다. 이는 병원낙상 간호에서 비판적사고를 통한 근거기반 간호실무 향상에 기여할 것이다.

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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    • 제27권1호
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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.

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

  • 채정병;정주현
    • PNF and Movement
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    • 제18권2호
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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.

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

  • 손재이;박병규;이찬희;안금희;김정남;박민현;최은영;부은희;강민진;홍정화
    • 보건행정학회지
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    • 제29권2호
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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.

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

  • 유수정;송미순;김현숙
    • 대한간호학회지
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    • 제33권2호
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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.

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

  • 김지연;변미경
    • 융합정보논문지
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    • 제12권3호
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    • pp.55-65
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    • 2022
  • 파킨슨병 노인은 낙상의 신체적, 정신적 위험요인을 가진 비율이 비 파킨슨병 노인에 비해 높아, 파킨슨병 노인의 낙상 경험 유무에 따라 낙상에 영향을 주는 신체적, 정신적 위험요인을 한국 노인 전체를 모집단으로 하는 국가 데이터를 이용하여 규명하였다. 2017년 보건복지부의 노인실태 자료조사를 이용한 2차 분석연구로, 파킨슨병 노인은 총 103명이었으며 결측값을 제외하고 총 96명의 대상자를 분석하였다. 파킨슨병 노인에게서 낙상에 가장 큰 영향을 미치는 요인은 IADL로 나타났으며, IADL은 운동 조절기능과 관련이 있다. 운동 조절기능의 저하는 일상생활에 필수적으로 요구되는 신체 움직임에 제약을 가하며 위급상황에서의 자기 보호적 행동까지도 영향을 미쳐 낙상에 영향을 미친다. IADL이 낙상에 영향을 줄 수 있다는 본 연구결과를 바탕으로 파킨슨병 노인의 낙상 예방 중재를 위한 다양한 운동요법을 제안할 수 있을 것이다.

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

  • 최정현;문정순;송경애
    • 근관절건강학회지
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    • 제10권1호
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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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슬링운동이 여성노인의 낙상위험도, 족관절배측굴곡력 및 균형에 미치는 효과 (The Effects of Sling Exercise on Fall Risk Score, Ankle Dorsiflexion and Balance in Community-Dwelling Elderly Women)

  • 함경림;이완희
    • 근관절건강학회지
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    • 제16권2호
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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.