• 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.

• 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.

• 한국안전학회지
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• 제36권3호
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• pp.50-59
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• 2021

The main purpose of accident analysis is to identify the causal factors and the mechanisms of those factors leading to the accident. However, current accident analysis techniques focus only on finding the factors related to the accident without providing more insightful results, such as structures or mechanisms. For this reason, preventive actions for safety management are concentrated on the elimination of causal factors rather than blocking the connection or chain of accident processes. This greatly reduces the effectiveness of safety management in practice. In the present study, a technique to model the correlational structure of accident risk factors is proposed by using the co-occurrence keyword network analysis technique. To investigate the effectiveness of the proposed technique, a case study involving a portable ladder fall accident is conducted. The results indicate that the proposed technique can construct the correlational structure model of the risk factors of a portable ladder fall accident. This proves the effectiveness of the proposed technique in modeling the correlational structure of accident risk factors.

• 한국안전학회지
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• 제34권5호
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• pp.132-138
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• 2019

Fall accident is the most frequent accident type of occupational accidents. As the age of workers increases, trip and fall accident increases more than other types of occupational accident in the middle-aged group. In this study, the gait characteristics of 25 middle-aged participants (mean ages 47.4, S.D. 5.8) were studied to analyze the trip and fall risks. The Minimum toe clearance(MTC) against the floor surface was measured in the variable conditions of gait speed by a motion capture system. In the 50s age group, the MTC decreased and the MTC tended to reduce the variation with increasing walking speed in the level walking. Therefore, the trip and fall risks for the 50s age group is higher than the 40s age group. Especially, the faster walking speed will increase the trip and fall risks even more.

• 대한간호학회지
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• 제43권3호
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• pp.341-351
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• 2013

Purpose: This study was done to analyze the effects of Tai Chi on fall-related risk factors through meta-analysis of randomized clinical trials published in English and Korean between 2000 and 2010. Methods: Using health related database and hand search of references and Google, 28 randomized studies were collected from doctoral dissertation and published peer reviewed articles. The Comprehensive Meta-analysis version 2.0 was used for the analysis. Results: The effect sizes for Tai Chi for 3 months were significant with ES=0.54 for static balance, ES=0.24 for dynamic balance, ES=0.69 for balance measured by scale, and ES=0.40 for flexibility, ES=0.48 for muscle strength, ES=0.71 for ADL, and ES=0.37 for fear of falling. Also, the effect sizes of Tai Chi for 6 months were significant for most fall-related variables. The 6 month data for flexibility was not analyzed since only one study was published. Conclusion: The analysis of studies of randomized clinical trials indicate that Tai Chi is effective in improving balance, flexibility, muscle strength, activities of daily living, and fear of falling when applied for 3 or 6 months. The findings provide the objective evidence to apply Tai Chi as a fall preventive intervention.

• Physical Therapy Rehabilitation Science
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• 제7권4호
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• pp.197-203
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• 2018

Objective: Independent walking is the most essential prerequisite to maintain quality of life in older persons. The purpose of this review was to investigate the effect of fall prevention strategies on fall risk for type 2 diabetes mellitus (T2DM) within community-dwelling older adults aged 65 and over. Design: A systematic review and meta-analysis. Methods: PubMed and three other databases were searched up to October 31st, 2018 and randomized controlled trials (RCTs) evaluating fall prevention strategies for fall risk in persons who were 65 years of age or above with T2DM were included. The review extracted the following information from each study selected: first author's surname, published year, country, study population, type of intervention, intensity of intervention, comparison, measurement variables, additional therapy, summary of results, and mean and standard deviation from selected studies. Results: This review selected fourteen RCTs with 460 older adults with diabetes mellitus. Of the 14 studies, the types of intervention used to improve the risk of falls were strengthening (5), aerobic exercises (2), multimodal exercises (4), one virtual reality exercise (1), whole body vibration with balance exercise (1), and Tai Chi exercise (1). Seven RCTs were eligible for the meta-analysis. Therapeutic interventions were more effective than the control group for the Timed Up-and-Go test (-1.11; 95% CI, -1.82 to -0.41) and the 6-minute Walk Test (-1.89; 95% CI, -8.33 to 4.54). Conclusions: The results of the review suggest that interventions to prevent fall risk in older adults with T2DM should focus on strengthening, balance, aerobic, and multimodal exercises.

• 대한정형도수물리치료학회지
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• 제28권3호
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• pp.61-68
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• 2022

Background: This study aimed to investigate the effects of noninvasive electrical stimulation combined with trunk stabilization exercise on balance and fall risk in patients with stroke. Methods: Twenty-two patients with stroke were enrolled in the study and randomly divided into experimental and control groups, each with 11 patients. noninvasive electrical stimulation combined with trunk stabilization training was applied to the experimental group, and sham noninvasive electrical stimulation combined with trunk stabilization training, to the control group. Both groups were treated for 6 weeks, five times a week for 30 min each time; the balance and fall risk of patients with stroke were measured before and after treatment, and the changes in the two groups were compared and analyzed. Results: The experimental group's left and right weight-bearing indices (affect and non-affect sides) and the front and rear weight-bearing indices, were significantly improved (p<.05, p<.001). when the changes in balance ability between groups were compared before and after treatment. The total fall efficacy score in the experimental group was substantially lower than that in the control group when the changes in fall efficacy score were compared between groups following treatment (p<.001). Conclusion: The improvement in balance and fall risk in patients with stroke can be attributed to using noninvasive electrical stimulation in combination with trunk stabilization training. This clinically helpful treatment method for patients with stroke warrants further promotion and implementation in the clinic.

• 대한간호학회지
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• 제43권5호
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• pp.595-604
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• 2013

Purpose: The purpose of this study was to identify risk factors for pediatric inpatients falls. Methods: The study was a matched case-control design. The participants were 279 patients under the age of 6 who were admitted between January 1, 2004 and December 31, 2009. Through chart reviews, 93 pediatric patients who fell and 186 ones who did not fall were paired by gender, age, diagnosis, and length of stay. Five experts evaluated the 38 fall risk factors selected by the researchers. Results: In a general hospital, pediatric patients with secondary diagnosis, tests that need the patient to be moved, intravenous lines, hyperactivity, anxiolytics, sedatives and hypnotics, and general anesthetics showed significance for falls on adjusted-odds ratios. Conditional logistic regression analysis was performed to elucidate the factors that influence pediatric inpatient falls. The probability of falls increased with hyperactivity and general weakness. Patients who didn't have tests that required them to be moved and intravenous line had a higher risk of falls. Conclusion: These findings provide information that is relevant in developing fall risk assessment tools and prevention programs for pediatric inpatient falls.

• 한국콘텐츠학회논문지
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• 제13권12호
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• pp.276-290
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• 2013

연구목적: 본 연구는 생애전환기를 맞이한 초기노인을 대상으로 낙상경험과 낙상의 내재적 요인을 성별에 따라 비교하였다. 연구방법: 연구대상자는 2008년 1월부터 12월까지 국민건강보험공단에서 실시한 66세 생애전환기 건강진단검사를 받은 수검자 중 자료가 불충분한 것을 제외한 255,505명을 대상으로 2차분석한 서술적 단면연구이다. 연구결과: 생애전환기를 맞이한 66세 초기노인의 낙상경험은 전체 10.6%로 남자 8.5%, 여자 12.4%로 여성노인이 남성노인에 비해 낙상비율이 높았다. 남녀에서 낙상위험에 영향을 미치는 요인은 배뇨장애 6.2-6.6배, 우울 1.5-1.8배, 보행장애 1.3-1.5배, 및 실명 1.3-1.4배 순서로 나타났다. 연구결론: 비록 내적 낙상위험요인이 다양할지라도 효과적인 낙상예방을 위해서 배뇨장애가 중요한 내재적 예측요인이며, 이는 초기노인의 낙상에 영향을 줄 수 있다.

• 성인간호학회지
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• 제25권1호
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• pp.24-32
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• 2013

Purpose: The aim of the study was to identify the most appropriate fall-risk assessment tool for neurological patients in an acute care setting. Methods: This descriptive study compared the reliability and validity of three fall-risk assessment tools (Morse Fall Scale, MFS; St Thomas's Risk Assessment Tool in Falling Elderly Inpatients, STRATIFY; Hendrich II Fall Risk Model, HFRM II). We assessed patients who were admitted to the Department of Neurology, Neurosurgery, and Rehabilitation at Asan Medical Center between July 1 and October 31, 2011, using a constructive questionnaire including general and clinical characteristics, and each item from the three tools. We analyzed inter-rater reliability with the kappa value, and the sensitivity, specificity, predictive value, and the area under the curve (AUC) of the three tools. Results: The analysis included 1,026 patients, and 32 falls occurred during this study. Inter-rater reliability was above 80% in all three tools. and the sensitivity was 50.0% (MFS), 84.4%(STRATIFY), and 59.4%(HFRM II). The AUC of the STRATIFY was 82.8. However, when the cutoff point was regulated as not 50 but 40 points, the AUC of the MFS was higher at 83.7. Conclusion: These results suggest that the STRATIFY may be the best tool for predicting falls for acute neurological patients.