学校退离休老人跌倒现状及其影响因素调查

目的:探讨大学退离休老年人跌倒现状及影响因素,为制定预防措施提供依据。方法:随机整群抽取中山大学60～79岁462名退离休老人为研究对象,采用自拟调查表,以询问的方式,对研究对象进行跌倒情况调查。结果:跌倒发生率16.5%,70岁以上女性老人是跌倒的高危人群;跌倒以春夏季为多,多发生在白天;主要发生在室内;跌倒后,以软组织损伤、骨折为主;女性、高龄、步态不稳、患慢性疾病、长期用药、地面太滑是跌倒的危险因子(OR=2.120,1.998,2.182,2.011,2.008,2.211;P均<0.01),使用手杖、体育锻炼则是保护因子OR=0.696,0.411;P均<0.01)。结论:多因素交互作用,影响老年跌倒的发生;积极治疗原发病,改善居住环境,使用拐杖,加强锻炼,是预防和减少老人跌倒的重点。     

脑卒中患者跌倒危险因素及护理干预研究进展

<正>脑卒中以老年患者居多,加上疾病导致的运动及平衡功能障碍,从而使脑卒中患者成为易跌倒的高危人群。有研究显示,80岁以上的老年人发生跌倒的比率达到百分之五十,其中超过一半的老年人多次发生跌倒[1]。跌倒可导致老年患者机体创伤,功能状态衰退,生活质量明显下降,甚至危及其生命[2-3]。伴随卫生部《三级综合医院评审标准实施细则(2011年版)》的下达,"防范与减少患者跌倒、坠床等意外事     

住院老年人跌倒的预防教育

目的了解医院内老年人跌倒的状况,以更有效地进行预防跌倒的教育.方法以查阅病历、访谈和实地观察跌倒环境获取资料,回顾分析1995～2004年在住院期间发生跌倒的老年人共40例.描述跌倒者的年龄、原有疾病、跌倒发生时间的分布,以及当时是否有人在场、跌倒地点、跌倒与活动的关系等.结果跌倒者以高龄老人居多,老年痴呆、老年精神病、脑梗塞者较多;均发生在室内,在患者独处时发生;跌倒与活动密切相关.无论是否有肢体活动不便,能否自行活动,老年人均存在跌倒的危险.跌倒不仅发生在活动频繁的日间,夜间跌倒例数几乎与日间相同.跌倒后绝大部分发生不同程度损伤.结论老年人群是发生跌倒的高危人群,尤其是高龄老年人;预防教育需在对老年人反复强化教育的基础上,对他们的照护者加强教育;为减少老年人跌倒的发生,应在保持老年人自主能动性的前提下,适量限制老年人、特别是高龄老人的活动范围.老年人的居住休养环境应更适合老年人活动的需要,安装安全设施.对缺乏依从性的老年人应要求其签署跌倒发生危险的知情同意书,以避免不必要的医疗护理纠纷.     

锻炼在预防老年病人跌倒中的作用[英]／Hainsworth T／／Nursing Times．

从事老年护理的护士都知道，预防老年人跌倒是促进老年人健康的一个关键问题。英国国家临床试验评价鉴定机构草拟了一份老年人跌倒的评估及预防指南，其中提及，练15w太极拳可改善肌力和平衡功能。从而减少老年人跌倒的风险。太极拳作为预防性干预措施对于从事老年护理的护士来说还比较陌生，英国国家临床试验评价鉴定机构已经评价了太极拳及其它运动形式的效果，     

锻炼在预防老年人跌倒中的作用

从事老年护理的护士都知道, 预防老年人跌倒是促进老年人健康的一个关键问题。英国国家临床试验评价鉴定机构草拟了一份老年人跌倒的评估及预防指南, 其中提及, 练 15w太极拳可改善肌力和平衡功能, 从而减少老年人跌倒的风险。太极拳作为预防性干预措施对于从事老年护理的护士来说还比较陌生, 英国国家临床试验评价鉴定机构已经评价了太极拳及其它运动形式的效果, 使护士知道了影响干预措施效果的因素, 以及哪些因素可以影响老年人的参与。跌倒预防　2001年英国卫生部列出了老年人跌倒预防及管理目标。在英国, 75岁以上老年人残障和死亡的…     

老年脑卒中后并发吞咽障碍及肺部感染的护理干预

脑卒中主要发生在老年人,是我国老年人群的常见病、多发病,近年来呈上升趋势。在脑卒中的治疗中,并发症的处理至关重要,它直接关系着病人的预后及死亡率。吞咽障碍是脑卒中的常见并发症,如误吸误咽、吸人性肺炎、窒息甚至死亡,从而影响患者的生活质量、早期康复治疗和社会回归。为此,本研究以老年患者作为研究对象,探索脑卒中后吞咽障碍及肺部感染的护理干预措施,为预防老年人群脑卒中后肺部感染等并发症的发生。     

简易步态训练联合太极拳训练在帕金森患者预防跌倒中的应用效果

目的探讨简易步态训练联合太极拳训练在预防帕金森患者跌倒中的应用效果。方法选取2017年10月—2018年12月入住本院的56例帕金森患者为研究对象,对其进行简易步态训练联合太极拳训练,训练时间为8周,比较训练前、训练后跌倒次数、帕金森综合评分量表第三部分(unified Parkinson′s disease rating scale-Ⅲ,UPDRS-Ⅲ)、Berg平衡量表(Berg Balance Scale, BBS)以及10 m行走速度和6 min行走距离。结果帕金森患者经过8个月训练后,10 m行走速度加快,6 min行走距离增长,UPDRS-Ⅲ评分降低,BBS评分升高,与训练前比较差异均有统计学意义(P0.05)。结论运用简易步态训练联合太极拳训练,可以改善帕金森患者的行走能力以及身体平衡能力,从而预防及减少帕金森患者跌倒。     

老年人跌倒的评估与干预策略研究进展

跌倒是老年人群中常见的严重公共卫生事件。跌倒的预防和干预是老年康复医学研究的重要课题之一。本文回顾近年来老年人跌倒的相关文献,对跌倒的概念、流行病学调查、危险因素分析与评估以及多学科多因素干预策略进行综述,并就该领域未来研究方向提出建议。     

人工智能应用于老年人跌倒的文献计量学分析

目的 分析人工智能(artificial intelligence, AI)应用于老年人跌倒的研究热点和趋势,以期为我国老年跌倒研究提供思路。方法 在Web of Science与中国知网中检索AI应用于老年人跌倒的相关文献,使用Excel分析发文趋势、CiteSpace对关键词进行可视化分析。结果 最终获得515篇英文文献、96篇中文文献。年发文量总体呈上升趋势。研究热点显示AI在老年人跌倒预测、检测及预防方面备受关注。结论 近年来AI应用于老年人跌倒的研究热度持续增加,我国在该领域的发展滞后于国外。未来可在把握国际热点基础上,深化护理与AI领域合作,探索适宜我国国情的老年人精准跌倒预防与管理策略。     

太极拳对早期帕金森病平衡能力和运动能力的影响

帕金森病(Parkinson’s disease,PD)是一种主要发生于中年以上人群以黑质纹状体通路退变为主要特征的中枢神经系统变性疾病。由于PD的病情呈现出进行性加重,患者逐渐出现行动迟缓、平衡能力下降,发生跌倒的几率增加,使患者的活动能力和生存质量等方面受到严重影响[1]。研究表明,太极拳在提高老年人的肌肉适能、平衡能力和防止跌倒等方面有着良好的效果[2—3]。本研究探讨太极拳对早期PD     

我国老年人跌倒影响因素研究的可视化分析

目的分析我国近年老年人跌倒影响因素的相关研究,探讨其研究现状及发展趋势,为老年人跌倒预防提供参考依据。方法检索CNKI、万方数据库、VIP和CBM数据库中发表的有关老年人跌倒影响因素的相关文献,检索时间自数据库建库至2018年9月,使用Bicomb 2.0、Ucinet 6.0、Netdraw、gCluto软件进行可视化分析。结果共纳入相关研究432篇,通过影响因素聚类分析得出老年人跌倒的影响因素有生理机能退化、药物相关不良反应以及高龄有跌倒史的女性。通过关键词聚类分析认为该领域的研究热点有以下4类:城市老年人因居家环境、骨质疏松、糖尿病所致的骨折损伤;卒中后老人害怕跌倒、锻炼与其跌倒效能及平衡功能的关系;住院患者跌倒的预防、护理对策及健康教育;对社区、养老机构老年人跌倒的流行病学研究等。结论我国有关老年人跌倒影响因素的相关研究较多,但目前仍缺乏深入的定量分析。有关老年人跌倒影响因素的研究还有待高质量、大数据文献的进一步支持。     

应用标准护理程序预防住院老年患者跌倒的效果

目的：探讨应用标准护理程序预防住院老年患者跌倒的效果。方法：将实施标准护理程序后即2011年1～12月的4377例65岁以上的老年患者作为观察组,观察跌倒发生情况,并与2010年1～12月未实施标准护理程序的65岁以上的4025例患者作为对照组进行比较。结果：观察组跌倒发生率明显低于对照组（P〈0.05）。结论：应用标准护理程序可有效减少住院老年患者的跌倒发生率。     

抗高血压药物对老年患者跌倒的影响

目的探讨抗高血压药物对老年患者发生跌倒的影响。方法选取2007年1月—2009年12月在我院入住的老年患者中,使用抗高血压药物后发生跌倒的患者27例,分析患者一般情况,跌倒前后血压情况以及用药途径、用药时间与跌倒的关系。结果跌倒患者中,男性多于女性,有跌倒史、视听力异常、行动不便及夜尿多、伴发心脑血管疾病者占比例较高。静脉注射给药和给药后1h内跌倒的发生率明显增高。跌倒患者对用药不良反应认知差。结论应用抗高血压药物对老年患者跌倒的发生有严重影响。护理人员应特别重视高血压病患者用药中的不良反应及静脉给药后1h内的观察,做好用药指导以减少跌倒事件的发生。     

护理风险管理预防住院跌倒高危患者跌倒的实践及成效

目的探讨护理风险管理预防住院跌倒高危患者跌倒的实践及效果。方法 2010年1～12月对4230例跌倒高危患者采用常规预防跌倒管理方法,2011年1～12月对4900例跌倒高危患者采用预防跌倒风险管理。比较实施预防跌倒风险管理前后患者跌倒及跌倒损伤发生率,护士跌倒评估能力、防跌倒知识及跌倒处理能力达标率情况。结果实施护理风险管理后,跌倒高危患者跌倒及跌倒损伤发生率较实施前明显下降,护士跌倒评估能力、防跌倒知识及跌倒处理能力达标率较实施前明显提高。结论 防跌倒护理风险管理能有效预防患者跌倒,提升护理人员预防跌倒知识及能力,从而提高护理质量管理。     

老年心血管疾病患者预防跌倒的方法与效果

目的预防老年住院心血管疾病患者跌倒的发生。方法探讨适用于老年心血管疾病患者预防跌倒的方法,对护士进行系统化培训及预防患者跌倒的安全教育,制订专科特点评估表格。在评估危险因素的基础上制订针对性预防措施,并进行三级质量控制。结果提高了护士预防跌倒知识的掌握,规范了防范态度及预防护理行为(P0.01或P0.05);降低了患者跌倒发生率,提高了患者满意度度(P0.05)。结论实施预防措施可以预防老年心血管疾病患者跌倒发生率、保障患者安全。     

The risk factors related to falling in elderly females

The purpose of this study was to explore the relationship between muscle strength and functional mobility and falls in women aged 65 and over. Thirty-one female subjects with a mean age of 69.57 +/- 4.89 years (65-78) were enrolled in the study. Demographic properties, body mass index, comorbid medical conditions, smoking, the number of medications taken, and fall characteristics were recorded. Knee flexor and extensor strength of the dominant extremity was measured by Biodex isokinetic system, and physical capacity was assessed with a 6-minute walk test. Cognitive status was evaluated by the Mini-Mental State Examination, and disability in daily activities was determined with the Barthel Index. Twelve subjects (38.7%) reported experiencing a fall in the previous year. Eight (25.8%) had experienced a fall outside the home and 4 (12.9%) inside the home. Nine subjects had fallen once, 2 subjects twice, and 1 subject had fallen 3 times. Six (19.4%) subjects reported a fracture after falling. Muscle strength of the knee extensors and flexors and work capacity was similar between those who had fallen and those who had not. The risk factors related to falling were evaluated, but no related factor was determined. Fear of falling was found to be high in patients who had fallen in the previous year. In conclusion, knee extensor and flexor strength are not significant factors in falls or the risk of falling for elderly women, particularly those who are able to function independently. Balance tests in current use are not effective predictors of falls in older adults who live independently and who do not have any significant health problem. These results suggest that there may be a significant interactive effect of the many causal factors that we need to address. Further study is needed to develop new assessment tools for active elderly people to help prevent falls and fall-related injuries.     

Fear of falling among stroke survivors after discharge from inpatient rehabilitation

The objectives of this study were to assess the incidence of falls and fall consequences among patients who were discharged from inpatient stroke rehabilitation and to investigate the proportion of those who experienced a fear of falling following a fall. This was a follow-up postal questionnaire study of patients who were admitted to the rehabilitation ward in a local hospital (Japan) for stroke rehabilitation. Seventy-three patients who met inclusion criteria were sent questionnaires and 49 (67%) responded to the questionnaire. Thirty-three patients had at least one fall after discharge from the hospital and of these, four patients experienced fractures resulting from their falls. Twenty-nine patients developed a fear of falling. As falls are common in stroke survivors, more attention should be paid to falls after stroke during inpatient rehabilitation to prevent physical and emotional consequences of falls.     

养老机构睡眠障碍老人跌倒风险的危险因素研究

目的 了解养老机构睡眠障碍老人跌倒风险的影响因素。方法 采用便利抽样法,应用一般资料调查表、Morse跌倒评估量表、死亡焦虑量表和Kolcaba舒适状况量表对河北省7所养老机构内60岁及以上的睡眠障碍老人进行调查。结果 445例养老机构睡眠障碍老人中,高跌倒风险者为220例（49.4%）。Logistic回归分析结果显示,高舒适状况、不使用助行器和无下肢疾病是养老机构睡眠障碍老人跌倒风险的保护因素（P<0.05）,使用助眠药和高死亡焦虑是养老机构睡眠障碍老人跌倒风险的危险因素（P<0.05）。结论 养老机构睡眠障碍老人跌倒风险较高,护理人员可采用积极沟通、心理疏导、健康知识宣教等方式降低跌倒风险,预防跌倒发生。     

Evidence of the efficacy of occupational therapy in different conditions: an overview of systematic reviews

OBJECTIVE: To summarize the research evidence available from systematic reviews of the efficacy of occupational therapy (OT) for practitioners, researchers, purchasing organizations and policy-makers. DATA SOURCE: The search for systematic reviews was conducted in PubMed and the Cochrane Library (October 2004). METHODS: The reviews included were those that utilized a systematic search for evidence with regard to OT for specific patient groups. Data were summarized for patient group, interventions, outcome domains, type of study designs included, method of data synthesis and conclusions. RESULTS: Fourteen systematic reviews were included. Three reviews related to rheumatoid arthritis, four reviewed stroke and four focused on elderly people. Reviews of Parkinson's disease, multiple sclerosis, Huntington's disease, cerebral palsy and mental illnesses were also identified. The reviews of rheumatoid arthritis, stroke and elderly people showed evidence of the efficacy of OT in increasing functional abilities. Positive results were presented for quality of life and social participation in elderly people and stroke respectively. The efficacy of OT in all other patient groups is unknown due to insufficient evidence. CONCLUSION: This summary shows that elderly people and people with stroke or rheumatoid arthritis can expect to benefit from comprehensive OT. Evidence of the efficacy of specific interventions is sparse and should be addressed in future research. The evidence that does exist should be incorporated into OT practice.     

Gender and the risk of falling: a sociological approach

AIM: This paper reports a grounded theory study of the influence of gender on older people's perceptions of their risk of falling and their actions to prevent future falls. BACKGROUND: The incidence and rates of falls among older people, including injurious falls, are of much international concern. The risk of falling remains a major concern for older people since it increases with age, with those aged 85 years and over at greatest risk. However, research using a sociological approach to the topic is limited. METHODS: An exploratory design, with grounded theory analysis, was used. Data were collected during 2001 through in-depth interviews with a convenience sample of 40 older people living in south east of England. FINDINGS: Two core categories emerged: gendered meanings of risk and gendered responsibility. The social construction of the meaning of the risk of falling and of participants' actions was gendered. Older men and women had specific ways of talking about their 'risk' and identifying the risk factors for falling. Older men perceived themselves as 'responsible' and 'rational' individuals who expected to reduce their own risk of falling. Older women's expectations of themselves and of their peers explained their tendency to blame themselves or others for their falls. These perceptions influenced the actions they took to prevent future falls. CONCLUSION: Nurses and other healthcare professionals need to take account of the gendered meanings attached to falling by older men and women when carrying out risk assessments and giving advice on fall prevention.