• 근관절건강학회지
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• 제21권1호
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• pp.36-45
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• 2014

Purpose: The purpose of this study was to investigate the factors increasing fall risk in the residential environment risk and the perceived fall risk among the older adults who received home care services to provide information for developing a comprehensive falls intervention program. Methods: The subjects were 227 community-dwelling elderly aged 65 years and over who were taken care of by home-visiting nurses of the national health centers. The data were collected from July to August in 2012 using the Choi's residential environmental risk scale (2010) and the Hong's fall risk scale (2011). Results: Requires an assistive devices to walk, modified residential environment, health security, approval certificate of LTC, residential safety perception, residential environment risk, and perception of fall risk were statistically significant risk factors. A multiple logistic regression analysis showed that room & kitchen, physical perception, medication & ADL perception, floor-related environmental perception, and daily living tool-related perception were statistically significant predictors of fall. Conclusion: The results showed that the residential environment and the perceived fall risk were associated with fall experiences among the elderly. It is necessary to develope multifactorial intervention programs considering both environmental and perceived risk factors as well as physical risk factors to reduce and prevent falls among the elderly.

• Physical Therapy Rehabilitation Science
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• 제7권3호
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• pp.139-145
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• 2018

Objective: Older persons with diabetes mellitus (DM) are particularly more likely to have fallen in the previous year than those without DM. The purpose of this study was to investigate the relationship between the risk of falls and type 2 DM in older adults who are 65 years of age or above. Design: A systematic review. Methods: PubMed and other two databases were searched up to August 2, 2018. Observational and cohort studies evaluating fall risk in people who are 65 years of age or above with DM were included. This review extracted the following information from each study selected: first author's surname, year of publication, country, average follow-up period, sex, age at enrollment, study population, measurement variables, relative risk, 95% confidence intervals and controlled variables. Results: This review involved nine cohort studies with 3,765 older adults with DM and 12,989 older adults without DM. Six studies compared with or without DM and two studies compared fallers with non-fallers with DM. Risk factors for falls included impaired cognitive function, diabetes-related complications (peripheral nerve dysfunction, visual impairment), and physical function (balance, gait velocity, muscle strength, and severity of physical activities). Conclusions: People who are 65 years of age or above with DM have increased risk of falling caused by impaired cognitive function, peripheral nerve dysfunction, visual impairment, and physical function in community-dwellers. For adults who are 65 years of age or older with DM, research fields and clinical settings should consider therapeutic approaches to improve these risk factors for falls.

• 기본간호학회지
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• 제26권1호
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• pp.1-11
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• 2019

Purpose: The goal was to use electronic health records to identify factors and outcomes associated with falls among patients admitted to hematology units. Methods: This retrospective case-control study included data from a tertiary university hospital. Analysis was done of records from 117 patients with a history of falls and 201 patients with no history of falls who were admitted to the hematology unit from January 1, 2013 to December 31, 2014. Risk factors were analyzed using hierarchical logistic regression; patient outcomes were analyzed using multiple logistic regression, Cox proportional hazards regression, and multiple linear regression. Results: Clinical factors such as self-care nursing (OR=4.47, CI=1.64~12.11), leukopenia (OR=6.03; CI=2.51~14.50), and hypoalbuminemia (OR=2.79, CI=1.31~5.96); treatment factors such as use of narcotics (OR=2.06, CI=1.01~4.19), antipsychotics (OR=3.05, CI=1.20~7.75), and steroids (OR=4.51, CI=1.92~10.58); and patient factors such as low education (OR=3.16, CI=1.44~6.94) were significant risk factors. Falls were also associated with increased length of hospital stay to 21.58 days (p<.001), and healthcare costs of 17,052,784 Won (p<.001). Conclusion: These findings can be a resource for fall prevention education and to help develop fall risk assessment tools for adults admitted to hematology units.

• 한국전문물리치료학회지
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• 제13권4호
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• pp.16-22
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• 2006

Falling is a serious problem associated with aging. Unintentional injury, which most often results from falling, is one of the leading causes of death in elderly people. The purpose of this study is to investigate the risk factors of falls and to compare characteristics of people who fall with that of non-fallers among the rural community-dwelling elderly of Korea. A sample of 201 people, living in the community, aged 60 years and over was taken from the members of a center for seniors located in Jecheon city. The mean age of the participants was 70.5 years of age. The participants are comprised of 151 women and 50 men. Eighty four of the 201 participants (41.8%) fell during the previous year. Twenty two of the fallers (26.2%) fell down more than two times. It was found that fallers had poorer eyesight, multiple chronic diseases and a more difficult time walking than non-fallers. In the logistic regression analysis of falls, only the difficulty of walking one kilometer (OR=2.4) and chronic diseases (OR=2.5) have shown an increased risk of falls. The risk of recurrent falls is, in addition, influenced by the difficulty of walking one kilometer. The result of our study shows that the impairment of mobility was the strongest risk factor of recurrent falling.

• 한국의료질향상학회지
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• 제24권2호
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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.

• 지역사회간호학회지
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• 제12권3호
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• pp.600-608
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• 2001

Accidents are the fourth-leading causal factor of death among the elderly, and fall is a major type of accident (53.17%). Many cases of falls in the elderly result in delayed discovery and loss of quality of life. As the number of the elderly grows, falls will be a more important health problem. Most previous research on falls investigated prevalence. mortality, and the related factors. There are many studies proving the effect of rhythmic movements. But few researches considered linking risk factors of fall with rhythmic movements. Purpose: We want to show the changes after performing rhythmic movement program, in risk factors of falls and mobility such as flexibility, balance, muscle power and persistency in the elderly, in order to provide basic information needed for the development of fall injury prevention program for the elderly. Method: The design of this study is quasi-experimental, the equivalent control group, pretest-posttest. The subjects consist of 124 people who lived in Do-Bong-Qu. Seoul, agreed to participate in this study, and were able to follow this rhythmic movement program. About 93 % of them are from 65 to 84 years (Mean${\pm}$sd: $73.7{\pm}5.7$): 64% are female. The rhythmic movement program was designed. and performed by two community health nurses working in the Do-Bong-Gu Public Health Center, regularly twice a week from May, 4 to December, 17. in 10 senior citizens' community centers. Risk factors of fall were measured with RAFS- II (Risk Assessment for Falls Scale II) by asking about each item: mobility was measured by observing their specific movements asked by investigators. Results: 1. After performing the program during 7 months, risk factors score of falls were decreased significantly (paired-t = 4.77. p<0.01). 2. After performing the program during 7 months, flexibility (paired-t = 2.26. p=0.03) and mobility were improved (paired-t = 4.98. p<0.01). but muscle power and persistency did not change (paired-t = 0.33. p=0.74). Overall, mobility affecting the occurrence of falls was improved significantly (paired-t = 5.15. p<0.01). Conclusions: A regular rhythmic movement program can be helpful in preventing falls in the elderly. Further. we can develop a fall injury prevention program using rhythmic movement.

• 임상간호연구
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• 제21권2호
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• pp.252-265
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• 2015

Purpose: This study examined the circumstances, risk factors, and the predictors of fall incidents among patients in the small and medium-sized hospitals. Methods: Fifty patients with any fall experiences were matched by gender, age, and medical departments with 100 patients without fall incident at the same hospital. Data were collected from 5 small and medium-sized hospitals. Data were analyzed using descriptive statistics, a Chi-square test, a Fisher's exact test, and a logistic regression with the SPSS/WIN 21.0 program. Results: In the patients with falls, the largest number of falls occurred during the day shift, in the patients' rooms, and while they were walking. Further 74.0% of the patients had physical injuries, and 34.0% had to take further medical diagnostic tests. Significant differences were found between the patients with falls and the others on 14 variables (cardiovascular disease, anemia, sedative-hypnotics, vasodilators, narcotic analgesics, dizziness, general weakness, unstable gait, walking aids, anger, anxiety, depression, orientation, and fear of fall). Narcotic analgesic use, dizziness, walking aids, and cardiovascular disease were identified as the predictors of fall incidents. Conclusion: These findings are hoped to be used in developing a fall risk assessment tool and fall prevention nursing programs for small and medium-sized hospitals.

• The Journal of Korean Physical Therapy
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• 제20권3호
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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.

• 보건교육건강증진학회지
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• 제24권4호
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• pp.23-39
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• 2007

Objective: The objective of this study is to identify the risk factors for falls among the Korean elderly population. Methods: We analyzed the data on 167 persons of 65 years of age or older who have experienced falls drawn from the Third Korea National Health and Nutrition Examination Survey. We conducted a cross-tabulation analysis and logistic regression analysis of the impact of the socio-demographic characteristics, health-related behavior, mobility, and morbidity upon the frequencies of falls. Results: Among the socio-demographic characteristics, gender(p<0.001), marital status(p<0.1), and the type of medical insurance(<0.1) were found to be statistically significant, Among the constraints on mobility, the severity of walking problems, (p<0.001) and depression(p<0.05) proved to be significant, As for variables related to health-related behavior, the level of routine physical activities (p<0.001) was found significant, Finally, rheumatism(p<0.1), osteoporosis(p<0.05), diabetes(p<0.1), urinary incontinence(p<0.01) were also significant. A logistic regression analysis of the incidence of falls revealed that urinary incontinence was the most important risk factor with an odds ratio of 2.7. Conclusion: Although a variety of factors affect the frequencies of falls in the elderly population, urinary incontinence proved to be the single most important risk factor. This finding implies that education for fall prevention is crucial for those with urinary incontinence.

• The Journal of Korean Physical Therapy
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• 제15권2호
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• pp.157-167
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• 2003

Falls are a leading cause of injury, disability and death among people older than 65. Even without injury, falls cause a loss of confidence that results in reduced physical activity, increased dependency and social withdrawal. Fall prevention in the eldery people is a multifaced task that includes both the identification of risk factors and their modification strategies. Fall risk factors have been identified as both intrinsic and extrinsic. Intrinsic factors are those related to the physical and cognitive function of the person. Extrinsic factors are those which are included in the environmental hazards of everyday life. Combinations of interventions aimed at modifying both intrinsic and extrinsic risk factors can result in significant fall prevention in the geriatric population. This article selectively reviews the literature reporting exercise intervention to improve strength, balance and mobility.