• Title/Summary/Keyword: falls

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Falls in Patients of Medical Institutions in South Korea: A Literature Review

  • Jongwon Choi;Woochol Joseph Choi
    • Physical Therapy Korea
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    • v.30 no.1
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    • pp.1-7
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    • 2023
  • Background: Like many other countries, falls and related injuries in older adults are great concerns in South Korea. In particular, falls are common in medical institutions, often causing the increase of the length of hospitalization. Objects: The purpose of this review was to help understand and address falls in hospitalized individuals in South Korea. Methods: The review was conducted on literature published in Korean from 2010 to 2022, searched in the Korea Citation Index and PubMed. Keywords used for the search were as follows: falls, fall risk, fall risk assessment, hospital, inpatient, intervention, Korea, and prevention. Results: A total of 54 articles were found and reviewed. The most common place of fall accidents was the inpatient room, where there were many cases of falls while walking. Loss of balance was the most common cause of falls, and many falls occurred in patients admitted to the internal medicine. Furthermore, a risk of falling increased with the type of medications taken. In terms of tools to assess patients' fall risk, the Morse Fall Scale (MFS) was commonly used. Patient-specific fall prevention activities were common to address falls, and they decreased the frequency of falls and the fear of falling. Factors influencing the effectiveness of the fall prevention activities included attitudes toward falls, education, environmental factors, patient safety culture, and self-efficacy in preventing falls. Conclusion: Our results should help understand and address falls and injuries in medical institutions.

Nurses' Experience of Inpatients' Falls (입원 환자의 낙상 사고에 대한 간호사의 경험)

  • Kim, Yu Jeong
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.24 no.2
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    • pp.106-117
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    • 2017
  • Purpose: The purpose of this study was to identify nurses' experience of falls by inpatients. Methods: From December 30, 2015 to February 22, 2016 data were collected through in-depth individual interviews and analyzed using Colaizzi's phenomenological method. Participants were 11 clinical nurses and 2 head nurses. Results: Nurses' experience related to inpatients' falls were categorized as follows: 'emotional impact after falls', 'responsibility for falls', 'changes after experience of falls', 'burden of reporting falls', 'difficulty in preventing falls', 'seeking new strategies for fall prevention' Conclusion: The findings from this study suggest that there is a need to develop programs to help nurses overcome the emotional impact of falls. Also education should be provided to patients, caregivers and health providers in order to prevent falls and improve patient safety.

The Fall Circumstance and Related Factors Associated with Fall in the Stroke Patients (뇌졸중 환자의 낙상 형태와 낙상 관련요인)

  • Kwon, Mi-Ji
    • The Journal of Korean Physical Therapy
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    • v.20 no.3
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    • pp.19-28
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    • 2008
  • Purpose: We analyzed the incidence of falls and the related factors, circumstances, and consequences associated with falls in stroke patients. Methods: We recruited 127 stroke patients and used a self-reported questionnaire to measure fall prevalence rates and the related factors, circumstances, and consequences of falls. The chi-square test was used to establish associations between related factors. Results: The prevalence of falls in stroke patients was 69.3%, and was associated with gender and time since the stroke. Falls occurred 2-5 times (55.4%) poststroke and most subjects first fall in the 2$\sim$6 month (46.5%) after the stroke. Most (55%) falls occurred at the hospital. Walking was the most frequent circumstance for falls (38.5%). Most (54.4%) falls led to consequences such as fractures, ligament strains, bruises, or abrasions. Conclusion: Fall-prevention strategies decrease the number of falls and the severity of fall-related injuries. These data support the concept of preventive strategies for falls in stroke patients who are at risk.

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Changes of spatio-temporal gait parameters according to experience falls in post-stroke patients

  • Cho, Ki Hun;Lee, Wan Hee
    • Physical Therapy Rehabilitation Science
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    • v.1 no.1
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    • pp.22-27
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    • 2012
  • Objective: Falls are defined as contact of the body with the floor after losing balance during activities of daily living. Falls commonly occur among the elderly, and stroke patients in particular are at a high risk of falling. The purpose of this study was to investigate the changes of temporal and spatial gait parameters and gait symmetry according to experience falls in post-stroke patients. Design: Cross-sectional study. Methods: Fifty three patients with stroke were recruited on a voluntary basis from the rehabilitation unit, who currently undergoing physical therapy. All participants were asked to answer questions regarding the frequency of falls in the past 1 year. Fifty-three patients with stroke were allocated 2 groups according to experienced falls: stroke with falls (n=26) during past 1 year and stroke without falls (n=27). The spatial and temporal gait parameters and gait symmetry ratio were measured using GAITRite system. Results: The spatial gait parameters and the temporal gait parameters were significantly different between the stroke with falls group and the stroke without falls group (p<0.05). Furthermore, step length was the only significantly different among symmetry ratio (p<0.05). Conclusions: Experience of falls can lead to impairment of gait ability in stroke patients. This result is expected to be used as a basic data for rehabilitation program development to prevent a fall of post-stroke patients.

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The Mediating Effect of Depression in the Relationship between Muscle Strength of Extremities and Falls among Community-Dwelling Elderly (지역사회 재가노인의 사지근력과 낙상의 관계에서 우울의 매개작용)

  • Park, Hyoung-Sook;Park, Kyung-Yeon
    • Journal of Korean Academy of Nursing
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    • v.38 no.5
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    • pp.730-738
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    • 2008
  • Purpose: The purpose of this study was to identify the mediating effect of depression in the relationship between muscle strength of extremities and falls among community-dwelling elderly. Methods: Two hundred forty-seven participants were recruited from a public health center, a hall for the aged and a school for the aged in B city. Face-to-face interviews were conducted using questionnaires from May to September of 2007. Data was analyzed with descriptive statistics, Pearson correlation, and multiple regression using the SPSS WIN 14.0 program. Results: There was a significantly negative relationship between muscle strength of lower extremities and falls, muscle strength of left upper extremity and falls, and muscle strength of right upper extremity and falls. Depression positively correlated with falls. Depression showed mediating effects between muscle strength of extremities and falls. Weakness of muscle strength of extremities increased depression and the increased depression increased the frequencies of falls. Conclusion: For the effective management and prevention of community-dwelling older adults' falls, exercise programs including depression-decreasing strategies should be established. These exercise programs can decrease depression which is the mediator role between the degrees of muscle strength of extremities and falls.

The Effect of Exercise Program for Falls Prevention on Balance, Falls Efficacy, Blood Pressure and Blood Lipids in the Elderly Women (낙상예방 운동프로그램이 노인여성의 균형, 낙상효능감과 혈압 및 혈중지질에 미치는 영향)

  • Kim, Young-min
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.21 no.2
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    • pp.7-14
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    • 2015
  • Purpose: The purpose of this study was to investigate the effects of falls prevention exercise program to balance, falls efficacy, blood pressure and blood lipids in the elderly females. Methods: A total of twenty-six elderly women participated in this study. All subjects participated in exercise program based on pelvic stabilization and balance training on two times a week for twelve weeks. They were measured about Berg balance scale (BBS), Time up and go (TUG), Functional reach test (FRT), Sit to stand (STS) for balance, falls efficacy scale-international (FES-I) for falls efficacy, systolic blood pressure (SBp), diastolic pressure (DSp) for blood pressure, and total cholesterol (TC), triglyseride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) for blood lipids. Results: There were significant improvements of BBS (p<.05), TUG (p<.001) FRT (p<.01), and STS (p<.001) in the balance after exercise program. There was significant improvements in FES-I (p<.001) in the falls efficacy, There were no statistical differences of SBp and DSp in the blood pressure. There were no statistical differences of TC, TG, HDL-C, and LDL-C in the blood lipids. Conclusions: Falls prevention exercise program was meaningful increasing balance ability and falls efficacy.

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Fall Simulation and Impact Absorption system for Development of Fracture Prevention System (골절 방지 시스템의 개발을 위한 낙상 시뮬레이션과 충격 흡수 시스템에 관한 연구)

  • Kim, S.H.;Kim, D.W.;Kim, N.G.
    • Journal of Biomedical Engineering Research
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    • v.31 no.6
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    • pp.438-448
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    • 2010
  • The social activities of the elderly have been increasing as our society progresses toward an aging society. As their activities are increased, the occurrence of falls that could lead to fractures are increased. Falls are serious health hazards to the elderly and we need more thorough understanding of falls including the progress of falls and the impact area in various fall directions. Many of the traditional methods of falls research dealt with voluntary falls by younger subject since older subject can easily get fracture from voluntary falls. So, it has been difficult to get exact data about falls of the elderly. Here, we tried to capture the characteristics of the movements of major joints using three dimensional motion capture system during falls experiments using a moving mattress that can safely induce unexpected falls. Healthy younger subjects participated in the actual falls experiment and the moving mattress was actuated by a pneumatic system. The kinematic parameters such as velocities of major segments were imported to a computer simulation environment and falls to hard surfaces were simulated in a computational environment using a realistic human model of aged persons. The simulation was able to give approximations to contact forces which can occur during actual falls. And we designed impact absorption system to reduce the impact during falls. We can adapt this system to fracture prevention system that we are going to study.

A Study on Environment, Care Process, and Patient-related Factors Associated with Patient Falls - A Retrospective Study of Inpatient Falls in the Unit of General Medicine in the United States (환자낙상에 영향을 주는 환경, 의료과정, 그리고 환자 관련 요소에 관한 연구 - 미국의 일반내과병동 환자낙상 데이터 분석을 통한 후향성 연구)

  • Choi, Young-Seon
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.24 no.1
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    • pp.33-40
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    • 2018
  • Purpose: The main objective of this paper is, to assess environment, care process, and patient-related factors associated with patient falls. The study also aims at identifying various factors that would affect inpatient falls and, therefore, helping both caregivers and designers contribute to better prevent inpatient falls in their own areas of expertise. Methods: A retrospective analysis of inpatient falls that occurred in the unit of General Medicine in the United States has been conducted and environment, care process, patient-related factors associated with those falls have been analyzed at the same time. Results: The study identified several factors associated with inpatient falls. They range from environmental factors to care process- and patient-related factors. Patient visibility and patient accessibility can matter to patient falls and where those falls occur, along with patient days per room, the percentage of patient days with high fall risk patients per room, the percentage of high fall risk patients per room. Implications: The findings of the study can provide design implications that can be incorporated into design process and design decisions to promote fall prevention in inpatient care units. Inpatient falls can be effectively reduced when caregivers and designers work together to understand the complex nature of inpatient falls and the importance of multidisplinary efforts among various experts in the areas of healthcare.

Dynamic Characterization of Fall for Development of Fracture Prevention System (골절 방지 시스템의 개발을 위한 낙상 동적 특성 분석)

  • Kim, Seong-Hyun;Kim, Yong-Yook;Kwon, Tae-Kyu;Kim, Dong-Wook;Kim, Nam-Gyun
    • Journal of Biomedical Engineering Research
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    • v.28 no.6
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    • pp.811-816
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    • 2007
  • The social activities of the elderly have been increasing as our society progresses toward an aging society. As their activities are increased, the occurrence of falls that could lead to fractures are increased. Falls are serious health hazards to the elderly and we need more thorough understanding of falls including the progress of falls and the impact area in various fall directions. Many of the traditional methods of falls research dealt with voluntary falls by younger subject since older subject can easily get fracture from voluntary falls. So, it has been difficult to get exact data about falls of the elderly. Here, we tried to capture the characteristics of the movements of major joints using three dimensional motion capture system during falls experiments using a moving mattress that can safely induce unexpected falls. Healthy younger subjects participated in the actual falls experiment and the moving mattress was actuated by a pneumatic system. The kinematic parameters such as velocities and accelerations of major segments were imported to a computer simulation environment and falls to hard surfaces were simulated in a computational environment using a realistic human model of aged persons. The simulation was able to give approximations to contact forces which can occur during actual falls.

Incidence of Falls and Risk Factors of Falls in Inpatients (입원환자의 낙상 실태 및 위험요인 조사연구)

  • Yoon, Soo-Jin;Lee, Chun-Kyon;Jin, In-Sun;Kang, Jung-Gu
    • Quality Improvement in Health Care
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    • v.24 no.2
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    • pp.2-14
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    • 2018
  • Purpose: The objective of this study was to report the incidence of falls in hospitals and analyze the risk factors for falls. Methods: This study used data on 1,216 patients who experienced falls from 2015 to 2017 during their hospitalization. The data was collected from the falls incident reports and patient' electronic medical record of hospital. Data were analyzed with descriptive statistics using Chi-square test, Fisher's exact test and multiple Poisson regression analysis with the SAS 9.4 Results: The incidence of falls was 1.38 per 1,000 patients days (2015), 1.81 per 1,000patients days (2016) and 1.99 per 1,000patients days (2017). The incidence of injury caused by falls (level III~V) was 0.05 per 1,000patients days (2015), 0.04 per 1,000patients days (2016) and 0.06 per 1,000patients days (2017). The largest number of falls occurred during night shift (42.5%), specifically in the patients' room (70.8%), and medical unit (66.0%). Average age of fallers was 69.1 years and 61.7% of them were older than 71 years. CCI and the patient's department have statistically significant differences in injury or injury levels from falls, but the integrated nursing care services had no significant difference in injury or injury levels from falls. Conclusion: The result of this study can be used as a reference for establishing a fall prevention strategy for hospitalized patients by presenting index values such as the fall rate.