养老机构老年人跌倒效能及其影响因素研究

背景　害怕跌倒在养老机构和住院老年人中发生率高。由于害怕跌倒，老年人会自我强加活动限制，形成久坐不动的生活方式，从而使其身体功能下降，增加跌倒、社会隔离、焦虑、抑郁以及住院的发生。目的　调查成都市养老机构老年人跌倒效能现状及其影响因素。方法　2017年8—9月，采用便利抽样法，应用一般资料问卷、修订版跌倒效能量表、Barthel指数评定量表、老年人跌倒环境安全因素评估表和健康调查 12 条简表（SF-12）对成都市3所养老机构的300名老年人进行问卷调查。采用多元线性逐步回归分析养老机构老年人跌倒效能的影响因素。结果　回收有效问卷278份，有效回收率为92.7%。老年人跌倒效能得分为（106.62±34.22）分。多元线性逐步回归分析结果显示：过去1年内有无跌伤史、日常生活中有无活动限制、有无老伴一同入住养老机构、24 h睡眠时间、Barthel指数得分、老年人跌倒环境安全因素评估表的室内卫生间维度评分及SF-12的躯体健康评分和心理健康评分是其跌倒效能的影响因素（P<0.05）。结论　成都市养老机构老年人的跌倒效能处于中等水平，可针对不同的老年人制定相应的干预措施，以提高其跌倒效能，从而预防跌倒。

Fall Efficacy and Its Influencing Factors among the Elderly in Nursing Homes

Background　The incidence of fear of falling is high among the elderly in nursing homes and inpatient department.Because of fear of falling，the elderly may impose restrictions on their activities and form a sedentary lifestyle，which will reduce their physical function and increase the probability of falling，social isolation，anxiety，depression and hospitalization.Objective　To investigate the fall efficacy and its influencing factors among the elderly in nursing homes in Chengdu.Methods　A total of 300 elderly people from 3 nursing homes in Chengdu were selected by convenience sampling method from August to September，2017.General information questionnaire，Modified Fall Efficacy Scale，Barthel Index Scale，Elderly Fall Environmental Safety Factor Scale and the 12-items Short Form Health Survey（SF-12）were used to investigate subjects.Multivariate linear stepwise regression analysis was used to analyze the influencing factors of fall efficacy of the elderly in nursing homes.Results　A total of 278 questionnaires were collected，with effective recovery rate of 92.7%.The elderly fall efficacy were（106.62±34.22）points；Multiple linear stepwise regression analysis showed that fall history in the past one year，activity restriction in daily life，living with or without spouse，24-hour sleep time，Barthel index score，toilet environment score of Elderly Fall Environmental Safety Factor Scale，PCS score and MCS score of SF-12 were influencing factors of fall efficacy among the elderly.Conclusion　The fall efficacy of the elderly in nursing homes in Chengdu is moderate.Individualized intervention should be formulated for different elderly to improve their fall efficacy，thus preventing falls.