害怕跌倒在老年脑卒中患者中的现状及影响因素分析

目的 了解老年脑卒中患者害怕跌倒（fear of falling,FOF）的现状,并分析其影响因素.方法 采用害怕跌倒单条目问题和修正版跌倒效能量表（modified falls efficacy scale,MFES）分别测量170例老年脑卒中患者的FOF发生率和FOF程度,并应用Berg平衡量表（berg balance scale,BBS）和计时起立-行走测试（time up and gotest,TUGT）测量其平衡力和移动能力.结果 老年脑卒中患者FOF发生率为39.4％,FOF老年患者的跌倒效能得分低于非FOF老年患者（78.21±21.88） vs （116.15±10.15）,P＜0.001].多因素Logistic回归分析显示平衡力受损、移动能力低下和近6m内跌倒史是发生FOF的独立危险因素,这三个因素可以解释总变量的56.6％.结论 FOF在老年脑卒中患者中较常见,平衡力低下、移动能力受损和近6m内跌倒史是害怕跌倒的危险因素.医护人员应对FOF老年脑卒中患者给予运动锻炼和跌倒预防健康教育相结合的方式进行干预,以改善其害怕跌倒心理.

The current status and influencing factors of fear of falling among the stroke older patients

Objective To investigate the current status and influencing factors of fear of falling （FOF） among the stroke older patients. Methods Totally 170 stroke older patients were investigated using the single direct question of fear of falling and Modified Falls Efficacy Scale （MFES）, and they were tested with Berg Balance Scale （BBS） and Time Up and Go Test （TUGT）. Results 39.4% of stroke older patients reported FOF, and the scores of MFES between those with FOF and those without FOF were significantly different （78.21 ＋21.88） vs （116.15 ＋ 10.15）, P〈 0.001]. Multiple logistic regression analysis indicated that impairments of balance and mobility, a previous history of falls in past six months were the independent influencing factors associated with FOF, which could explain 56.6% of variations. Conclusion FOF in stroke older patients is a common complaint that is caused mainly by impairments of balance and mobility, and a previous history of falls in past six months. Interventions combining exercise and education of accidental falls should be taken to al- leviate FOF of stroke older patients.