医院老年住院患者跌倒事件与内在能力的相关性分析

目的：探讨医院老年住院患者跌倒事件与内在能力(IC)的关系。方法：选取2021年1月1日～12月1日收治的100例老年住院患者作为研究对象，统计老年患者在过去1年住院时间内是否发生跌倒并对老年住院患者的IC进行评估，采用Logistic回归分析老年住院患者跌倒事件与IC的相关性。结果：100例患者中，1年内发生跌倒患者27例(27.00%);93例(93.00%)患者出现IC下降；未发生跌倒患者年龄、体质量指数(BMI)、IC下降与跌倒患者比较差异有统计学意义(P<0.05);以患者1年内是否发生跌倒事件为因变量，将年龄、BMI、IC是否下降等单因素分析有统计学意义的变量纳入多因素Logistic回归模型中，结果显示：年龄、BMI与IC下降均为医院住院老年患者1年内跌倒事件发生的危险因素。结论：IC下降为老年住院患者跌倒事件的危险因素，因此，应及时对老年患者的IC进行评估，并采取措施防止老年患者跌倒事件的发生。     

老年住院患者跌倒相关因素分析及预防对策的研究

目的通过对老年住院患者跌倒的相关因素进行分析,为制定出适宜有效的护理预防对策提供科学依据。方法对2013年5月至2016年9月在吉林大学第一医院老年病科住院的老年患者发生的跌倒不良事件进行回顾性分析,探讨老年住院患者跌倒的相关因素及预防对策。结果在19例老年住院患者跌倒不良事件中,发生跌倒的年龄主要为70-80岁,发生跌倒频次最高的地方为卫生间,时间主要发生在0:00-8:00,大部分没有造成伤害,63.16%的跌倒没有被目睹,47.37%的老年患者跌倒风险评估为中度风险,42.11%的老年住院患者有低钠血症。结论防范老年住院患者的跌倒,应在关键的年龄、时间、地点,对关键的人物给予有针对性的个体化的预防措施才能有效防范老年住院患者意外跌倒的发生。     

老年心血管疾病住院患者跌倒效能现状及相关因素分析

目的探讨老年心血管疾病住院患者跌倒效能现状及相关因素。方法选取2015年2月至2017年1月医院心血管疾病住院患者2008例,观察患者性别、年龄、疾病、病程、文化程度等基本信息和跌倒效能量表(MFES)、平衡功能、步态评分,引入多元logistic逐步回归模型和Pearson相关性分析影响跌倒效能相关因素。结果 2008例老年心血管疾病住院患者跌倒5例,跌倒率0. 25%。单因素分析显示年龄、陪伴、跌倒史、文化程度、体重指数、辅助器具、心功能分级影响老年心血管疾病住院患者跌倒效能(P 0. 05)。多元logistic回归模型分析显示陪伴、跌倒史、文化程度、体重指数、心功能分级、平衡功能、步态是影响老年心血管疾病住院跌倒效能独立危险因素。且跌倒效能与陪伴、文化程度、平衡功能、步态呈正相关,与跌倒史、体重指数、心功能呈负相关,差异有统计学意义(P 0. 05)。结论跌倒效能是评价老年心血管疾病住院患者跌倒风险的有效指标,定期进行相关因素筛查与辨别、研究,及时制定和完善相应预防对策,有利于降低跌倒率。     

帕金森患者跌倒发生情况及其相关因素分析

目的探讨帕金森患者跌倒发生情况及其相关因素。方法由专人对100例帕金森患者进行回顾性分析,了解其跌倒发生情况及其相关因素。结果帕金森患者住院期间跌倒事件发生率为46．0％;单因素分析结果：男性患者、药物因素致头晕、有跌倒史及住院期间无陪护组患者发生跌倒明显高于未跌倒组,组间比较,均P〈0．05,差异具有统计学意义;Logistic回归分析显示,男性患者、药物因素致头晕、有跌倒史是帕金森患者住院期间跌倒事件发生的危险因素（均P〈0．05）。结论帕金森患者住院期间跌倒事件发生率较高,男性患者、药物因素致头晕及入院前有跌倒史为帕金森患者住院期间发生跌倒的高危因素。在患者入院前应进行跌倒风险性评估,根据患者跌倒发生的原因,采取跌倒风险管理和跌倒危险分级管理,减少患者跌倒事件的发生。     

神经及精神障碍性老年住院患者跌倒的影响因素

目的针对神经及精神障碍性老年住院患者跌倒事件发生原因,进行全面、跨学科的系统分析,探讨老年住院患者发生跌倒的危险因素,为预防跌倒的发生,降低跌倒发生率提供实践依据.方法实时收集2017年该院发生跌倒的≥65岁神经及精神障碍性老年住院患者,并按照1∶3的比例进行匹配,抽取与跌倒患者疾病诊断类似、年龄相仿(±3岁)的未发生跌倒患者,采用Logistic回归分析老年患者住院期间发生跌倒的相关因素.结果行走能力、睡眠、巴氏评分、依从性及跌倒危险因素认知是神经及精神障碍性老年住院患者是否发生跌倒的影响因素.结论神经及精神障碍性老年住院患者发生跌倒是多因素叠加效应,因此预防老年住院患者跌倒应针对危险因素进行个体化评估,制定相应的跌倒管理模型,做到有效预防.     

老年住院患者跌倒危险因素的质性研究

目的：通过对住院老年患者跌倒的危险因素进行分析,为跌倒的预防提供循证依据。方法：运用《患者跌倒风险评估表》对1338例年龄大于60岁、有跌倒危险的住院患者进行回顾性分析。并对跌倒危险因子进行单因素和多因素统计分析。结果：发生跌倒30例,总发生率为2.24%,跌倒的方式以晕倒和下肢乏力为主。有跌倒史、服用特殊药物、睡眠障碍、自我评价能力、视力障碍、平衡能力下降、步态不稳为跌倒的危险单因素。其中服用特殊药物、平衡能力、自我评价能力进入多因素分析。结论：住院老年患者的跌倒是多个因素的累积作用结果。只有对患者进行客观、全面的评估,才能有效预防跌倒的发生。     

老年住院患者跌倒危险因素的Logistic回归分析

目的探讨老年住院患者跌倒可能的危险因素,为制定跌倒策略提供依据。方法回顾性收集408例老年住院患者的临床资料及跌倒发生情况,对临床资料进行跌倒危险因素的单因素分析,同时再进行二分类非条件Logistic回归分析。结果 403例患者中,住院期间发生跌倒95例、占比23.6%,Logistic回归分析得出高龄、无陪护、骨质疏松、近1周内服用镇静类及安眠药物是老年住院患者跌倒的危险因素。结论老年人跌倒是多种因素综合作用的结果,应采取综合措施预防跌倒。     

精神科老年住院患者跌倒危险因素分析与预防对策

目的探讨精神科老年住院患者跌倒的相关危险因素及预防对策。方法对入住精神科的128例60岁以上的老年患者(男性36例、女性92例)进行跌倒危险因素评估,并对其实施住院期间和出院后1年的随访及安全护理预防,预防意外跌倒的发生。结果128例患者中,过去1年有跌倒史者49例(38.3%),其中女性39例,男性10例,性别间的差异无统计学意义(P>0.05)。实施安全护理预防随访1年后,跌倒人数为2例(1.6%),较预防前显著减少(P<0.001)。Logistic分析显示,与跌倒相关的危险因素为不合作、行动能力差、视物模糊和服用抗精神病药。结论精神科老年住院患者跌倒危险率较高;对跌倒高危人群实施安全护理可有效预防意外跌倒的发生。     

不同特征痴呆老年住院患者跌倒伤害分析

目的 :通过对痴呆老年住院患者跌倒后的受伤害程度进行分析,探索减少痴呆老年住院患者跌倒的管理体系。方法:采用目的抽样法对我院2008年1月至2014年12月期间上报的42例痴呆老年住院患者跌倒事件进行分析。结果 :痴呆老年住院患者跌倒发生率为0.94%,其中男性患者跌倒发生率为0.88%,女性患者跌倒发生率为0.99%。跌倒后受伤害程度与患者的年龄、性别、合并慢性疾病的数量、日常生活能力、跌倒史、跌倒风险、激越行为、陪护是否在身边以及跌倒发生的时间上比较差异有统计学意义(均P0.05)。结论:痴呆老年住院患者由于疾病本身因素,更容易发生跌倒,且跌倒后损伤程度也更加严重,因此,建立持续、有效、科学的管理体系防范痴呆老年住院患者跌倒,才能确保患者的安全。     

老年住院精神病患者跌倒损伤的原因分析与护理对策

目的：了解老年住院精神病患者跌倒的原因,制定相应的护理对策。方法：对对43例老年精神病患者住院期发生跌倒损伤的相关因素进行回顾性调查分析,并提出护理对策。结果：收治的老年精神病患者1009例中发生跌倒损伤43例（4.3%）,其中以阿尔茨海默病、使用抗精神病药物及夜间跌倒发生率最高。结论：针对住院老年精神病患者跌倒原因,采取对专业护理人员进行上岗前培训,对患者及家属进行安全防范教育及改善住院环境等相关的护理对策,可减少住院期间跌倒损伤的发生率。     

渐进性放松术改善慢性肝病患者睡眠障碍的研究

目的观察护士引导下渐进性放松术改善慢性肝病患者睡眠障碍的效果。方法将120例有睡眠障碍的慢性肝病患者随机分为放松组（护士引导下渐进性放松训练）29例、薰衣草组（薰衣草温水擦浴及足浴）29例、联合组（综合使用以上两种方法）31例及对照组31例,观察并评价干预前、干预1周及2周后各组患者睡眠自评总分值、入睡困难及睡眠不稳分值的变化情况。结果护士引导下渐进性放松术能有效降低慢性肝病患者的SRSS自评总分,改善入睡困难和睡眠不稳（P＜0．05或P＜0．01）。结论护士引导下渐进性放松术是一种简便易行、快速有效的提高睡眠质量、改善睡眠障碍的护理方法。     

Luminol-dependent chemiluminescence of whole blood in children often falling ill

The functional activity of blood phagocytes, producing active oxygen forms (AOF), was studied by recording the spontaneous and prodigiosan-stimulated luminol-dependent chemiluminescence (CL) of whole blood in 120 children aged 3-8 years, frequently falling ill, during remission. Three types of ratios of spontaneous and stimulated CL were distinguished, associated with different clinical patterns of acute respiratory disease: 1) increased spontaneous and stimulated CL, 2) decreased spontaneous and stimulated CL, and 3) increased spontaneous and low stimulated CL. Studies of luminol-dependent CL of whole blood helped evaluate the functional activity of blood phagocytes producing AOF and develop the treatment strategy.     

Factors associated with use of falls risk–increasing drugs among patients of a geriatric oncology outpatient clinic in Australia: a cross‐sectional study

Older people with cancer are at increased risk of falling. Falls risk–increasing drugs (FRIDs), comprising psychotropics and medications that cause orthostatic hypotension, are a potentially modifiable risk factor for falls. The objective of this study was to determine the prevalence and factors associated with use of FRIDs in older people with cancer. Patients aged ≥70 years who presented to a hospital outpatient clinic between January 2009 and July 2010 were included in the study. Information on current medication use, falls in previous 6 months, and frailty criteria was collected. Multinomial logistic regression was used to compute odds ratios (OR) and 95% confidence intervals (CIs) for factors associated with levels of FRID use. Overall, 76.1% (n = 293) of 383 patients used FRIDs. This comprised psychotropics (31.2%, n = 120) and medications causing orthostatic hypotension (69.9%, n = 269). In total, 24.0% (n = 92) patients reported falling in the previous 6 months. Risk factors for falling were associated with use of psychotropics but not orthostatic hypotension drugs. Patients with a history of falls had increased odds of using psychotropics (≥3 psychotropics; OR 13.50; 95%CI, 2.64‐68.94). Likewise, frail patients had increased odds of using psychotropics (≥3 psychotropics; OR 27.78; 95%CI, 6.06‐127.42). Risk factors for falling were associated with the use of psychotropics. This suggests that clinicians either do not recognize or underestimate the contribution of medications to falls in this high‐risk patient group. Further efforts are needed to rationalize medication regimens at the time of patients' first presentation to outpatient oncology services.     

倒“T”字型固定腰大池引流管在治疗蛛网膜下腔出血中的应用效果

目的探讨倒“T”字型固定法在腰大池引流管的治疗蛛网膜下腔出血效果观察。方法按随机数字法将2011年1月12日南京鼓楼医院神经外科收治的120例蛛网膜下腔出血行腰大池引流术的患者分为观察组和对照组各60例，分别采取倒“T”字型固定法和“一”字型固定法对腰大池引流管进行固定，对胶布卷边或移位、管路脱落例数及皮肤压疮、引流不畅和胶布过敏等情况进行比较。结果在48h内胶布卷边或移位的例数、48h后至拔管期间胶布卷边或移位的例数、48h后至拔管期间管路脱落的例数、引流管下方皮肤压疮的例数方面，以往的“一”字型固定法分别为31．7％、56．7％、13．3％、51．7％。新研究的倒“T”字型固定法分别为1．7％、8．3％、0％、18．3％，两组比较倒“T”字型固定法更佳，差异有统计学意义（x2分别为19．440，31．947，6．563，14．652；P〈0．05）。结论倒“T”字型固定法的运用减少了感染的几率、增加了管路固定的有效性、减少压疮的产生，更便利了护士给患者进行的翻身等操作。     

The burden of falling on the quality of life of adults with Medicare supplement insurance

To study the impact of falling or risk of falling on quality of life (QOL) outcomes, a survey was mailed to a random sample of 15,000 adults with an AARP? Medicare Supplement plan insured by UnitedHealthcare from 10 states in 2008. Approximately 21% had fallen in the past year; 17% did not fall but reported balance or walking problems (i.e., at high risk of falling); and 62% were in the low-risk, no-falls comparison group. Multiple regression analyses showed the strongest predictors of falling or being at high risk of falling were advancing age, female gender, heart conditions, stroke, digestive disorders, arthritis, sciatica, diabetes, and hearing problems. Average physical and mental component scores were significantly lower for both those who fell and those at risk of falling than the comparison group, indicating that falling or being at risk of falling had a stronger negative influence on QOL than most of the comorbidities measured. Clinicians, patients, and families should be aware of the potential negative impact of falling and fear of falling on the QOL of older adults.     

PDCA循环管理在预防肝病内科高危跌倒风险住院患者跌倒中的应用

目的：探讨PDCA循环管理在降低肝病内科高危跌倒风险住院患者跌倒发生率、预防跌倒护理管理中的效果。方法对肝病内科高危跌倒风险住院患者运用PDCA程序找出跌倒常见原因并进行分析,制定相应的预防措施：包括成立跌倒管理小组;制作相关的健康宣教材料;在病房的重点区域张贴警示标识;对住院患者进行跌到风险筛查;对有高危跌倒风险的患者及家属进行告知并签署知情同意书;对高危跌倒风险患者进行有针对性的健康宣教;采取相应的预防措施并及时评价效果。结果实行PDCA循环管理后,肝病内科高危跌倒风险住院患者跌倒的人数由2014年的17例,降至2015年的1例,风险发生率仅为0.064‰,患者安全得到保障。结论执行PDCA循环管理可以减少肝病内科高危跌倒风险住院患者发生跌倒的风险。     

跌倒危险因素评分表在神经内科病房中的应用

目的探讨跌倒危险因素评分表在神经内科住院患者中的应用效果。方法应用跌倒危险因素评分表对2010年1～ 8月本院收治存在跌倒危险因素的167例患者进行评估,根据评估结果采取针对性预防护理措施。出院前调查患者跌倒发生率及对护士防跌倒护理工作满意度。结果患者住院期间未发生跌倒不良事件,患者对护士防跌倒护理工作满意度为99.8% 。结论对神经内科患者采用跌倒危险因素评估表进行评估,根据评估结果,采取针对性护理措施预防跌倒,能有效预防患者跌倒不良事件的发生。     

护理干预在老年失眠患者治疗中的应用

目的:探讨护理干预在老年失眠患者治疗中的应用效果.方法:按照随机单盲分组方法将120例老年失眠患者分为干预组和对照组各60例,对照组采用普通护理,干预组采用护理干预,比较两种护理方法下两组患者的平均入睡时间、平均夜间觉醒次数、睡眠时间、睡眠效率、日间残留效应发生率及患者对护理工作的满意度等.结果:干预组患者在1 h内入睡的人数多于对照组(P<0.05),干预组平均夜间觉醒次数少于对照组(P<0.05),睡眠时间及睡眠效率均高于对照组(P<0.05),日间残留效应发生率低于对照组(P<0.05),对护理的满意度高于对照组(P<0.05).结论:临床护理干预有助于老年失眠患者缩短入睡时间、提高睡眠质量、降低患者的日间残留效应发生率,并有助于提高患者对护理工作的满意度.     

Recurrent elderly fallers.

Factors associated with recurrent falling during a one-year period were analysed among elderly Finns (65 yrs and more) seeking medical treatment due to a fall. Recurrent falling in men was independently related to a lesser amount of depressive symptoms and to less severe injury due to the first fall. In women, recurrent falling was independently related to the non-occurrence of a fear of falling. Furthermore, recurrent falling, amount of daily movement, mental capacity, and falling during the previous year were related variables. Here the risk of recurrent falling was high among persons with poor mental capacity, who moved about a large amount daily, and who had had at least one accident during the previous year. In addition, there was an association between poor health and recurrent falling women. Demented women moving about daily, frail women, and incautious men and women seemed to be the main risk groups for repeated falling. What could general practitioners do to prevent repeated falls in the elderly? First, the overall health status and functional capacities of frail elderly women should be improved. Second, all elderly persons, especially those who have fallen, should be informed about how to minimize the risks of falls. Prevention is not easy among the demented population, however.     

Incidence and risk factors for developing fear of falling in older adults

Fear of falling is a potential cause of excess disability and an emerging public health problem. This study explores fear of falling in a longitudinal study of falls to determine incidence, prevalence, and risk factors for developing fear of falling. Prospective cohort study with annual follow-up for 2 years, conducted in a large urban metropolitan area, included 890 community-dwelling older adults--approximately equal numbers in four age groups over the age of 65. Demographic data, falls, injuries, balance, fear of falling, cognition, health, and functional status were collected through annual interviews. The prevalence of fear of falling increased over 2 years from 23 to 43%; the incidence averaged 22.5% in the 2 follow-up years. Having two or more falls, feeling unsteady, and reporting fair or poor health status were independent risk factors for developing fear of falling. The incidence and prevalence of fear of falling is significant among community-dwelling older adults and has the potential to impact function and quality of life. Public health nurses should consider fear of falling in practice, in developing screening and health programs for older adults, and as an important avenue for further research.