DOI QR코드

DOI QR Code

독거여성노인의 낙상경험에 따른 낙상두려움과 관련요인

Fear of Falling and Related Factors in Elderly Living Alone Based on Fall Experience

  • Lee, Myungsuk (Department of Nursing, Mokpo Catholic University) ;
  • Lee, Yunbok (Department of Nursing, Kyungnam University)
  • 투고 : 2013.10.02
  • 심사 : 2013.12.18
  • 발행 : 2013.12.31

초록

본 연구는 상관성 조사연구 설계를 이용하여 낙상경험 유무에 따른 낙상두려움 영향 요인을 파악하기 위해서 수행하였다. 연구대상자는 전라남도 1개시에 거주하는 낙상군 148명, 비낙상군 256명 총 404명을 대상으로 구조화된 설문지를 이용 하여 편의표집 하였으며 조사 기간은 2013년 4월 22일부터 6월 9일까지이었다. 연구결과 낙상률은 36.6%였으며 낙상군과 비낙상군은 연령, 만성질환 수, 영양위험도, 보조기구 사용, 시력장애, 청력장애에서 두 집단 간 유의한 빈도 차이를 보였다. 일반적 특성에 따른 낙상두려움 정도는 낙상군은 영양불량위험도, 보조기구 사용, 시력장애, 거주형태, 주거환경문제수에서 통계적으로 유의한 차이를 나타냈으며, 비낙상군은 연령, 종교, 영양위험도, 보조기구 사용, 시력장애, 청력장애, 거주형태, 주거환경문제수에서 통계적으로 유의한 차이를 나타냈다. 낙상군은 비낙상군에 비해 낙상두려움, 일상활동장애, 우울은 유의하게 더 높았고 낙상효능감과 주거환경 문제수는 낮았으며 정적균형, 복합이동능력, 생활만족도는 두 집단간 유의한 차이가 없었다. 상관관계를 측정한 결과 낙상군은 낙상두려움과 생활만족도, 낙상효능감 간에 유의한 음의 상관성을 보였으며, 일상활동장애, 우울, 주거환경문제수와는 유의한 양의 상관성을 보였다. 비낙상군은 낙상두려움과 생활만족도, 낙상효능감은 유의한 음의 상관성을 보였고 일상활동장애, 복합이동능력, 우울, 주거환경문제수와는 유의한 양의 상관성을 보였다. 낙상군의 낙상두려움 영향요인은 일상생활장애, 우울, 낙상효능감, 정적균형, 보조기구사용으로 46.1%의 설명력을 보였으며, 비낙상군은 낙상효능감, 주거환경문제수, 일상활동장애. 영양위험도, 주거형태, 현기증, 보조기구사용 등으로 55.2%의 설명력을 보였다. 이상의 결과를 바탕으로 독거여성노인 낙상두려움은 신체적 특성과 심리적 특성 및 주거 환경적 특성과 관련이 있는 것으로 나타났지만 낙상경험에 따라 차이가 있으므로 독거노인 의 낙상두려움을 감소시키기 위해서는 낙상경험을 고려한 중재가 필요함이 확인되었다. 그러나 낙상두려움이 재낙상의 중요한 관련 변수이기는 하지만 교정가능성이 높은 점을 고려하여 낙상두려움 정도 및 위험요인에 대한 주기적 평가를 통해 고위험군을 발견하도록 하고, 이들을 대상으로 낙상경험에 따른 통합적 중재 프로그램이 맞춤형으로 개발 제공되어 져야 할 것이다.

Objectives: This study was to investigate fear of falling and related factors in elderly living alone based on fall experience. Methods: Participants were 404 elderly women(faller=148, non-faller=256) over 65 years who were homebound living alone in Jeollanam-do Province. Face-to-face interviews were conducted using questionnaires from April $23^{th}$ to June $9^{th}$ 2013. The questionnaires consisted of demographic variables, fall experience, Fear of falling questionnaire(FOFQ), Falls Efficacy Scale(FES) and Center for Epidemiologic Studies Depression(CES-D). The collected data were analyzed using the SPSS version 14.0. Results: The fear of falling and the influential factors were different according to fall experience. Regression model for fear of falling in fallers significantly accounted for 46.1%(F=6.71, p<0.001); difficulty of performing activity, depression, fall-efficacy, static balance and assistive devices. Regression model for fear of falling in non-fallers significantly accounted for 55.2%(F=15.16, p<0.001); fall-efficacy, environmental hazards, difficulty of performing activity, risk of nutrition, housing type, dizziness and assistive devices. Conclusion: Results demonstrate that fall is an important health problem for elderly women living alone, and show fall experience for factors influencing fear of falling. These results could be used in the developing fall prevention programs.

키워드

참고문헌

  1. Korean Statistical Information Service. Statistics on the elderly in 2010. [cited 2011 July 10]. Available from : URL: http://kostat.go.kr/portal/korea/kor_nw/2/1/index.board?bmode=read&aSeq=180000 (Korean)
  2. Kim HM, Choi YH. Factors affecting depression in elderly vulnerable people living alone. J Korean Acad Community Health Nurs 2011;22(4):355-364 (Korean) https://doi.org/10.12799/jkachn.2011.22.4.355
  3. Kim JM, Lee MS, Song HJ. An analysis of risk factors for falls in the elderly by gender. Korean J Health Educ Promot 2008;25(2):1-18 (Korean)
  4. Park YH. Fall risk assessment in the community-dwelling elderly. J Korean Gerontol Nurs 2004;6(2):170-178 (Korean)
  5. Yeom JH, Na HJ. Risk factors of falls among korean elderly. J Korean Gerontr Soc 2012;32(2):577-592 (Korean)
  6. Yoo YG. Falls and functional levels associated with falls in older people living in the community. J Korean Gerontol Nurs 2010;12(1):40-50]
  7. Shin JS. A phenomenological study on the fall experience of the korean elderly living alone[dissertation]. Pusan, Catholic University, 2012 (Korean)
  8. Jang IS, Kim SM. A study on risk factors of injuries from fall experienced by homestaying elders in a provincial area. J Korean Gerontol Nurs 2006;8(2):107-116 (Korean)
  9. Kim MA. study on the fear of falling, ADL and quality of life for the elderly at home[dissertation]. Seoul, Hanyang University, 2013. (Korean)
  10. Kim MJ. Associated factors caused by falls of older people in community-dwelling [dissertation]. Seoul, Ewha Women University, 2004 (Korean)
  11. Cho JP, Paek KW, Song HJ, Jung YS, Moon HW. Prevalence and associated factors of falls in the elderly community. JPMPH 2001;34(1):47-54 (Korean)
  12. Choi KW, Lee IS. Fall risk in low-income elderly people in one urban area. The J Korean Acad Nurs, 2010;40(4):589-598 (Korean) https://doi.org/10.4040/jkan.2010.40.4.589
  13. Kim JS. Influencing Factors for Fear of Falling in Degenerative Arthritis Patients. J Korean Acad Nurs 2007;37(7):1184-1192 (Korean) https://doi.org/10.4040/jkan.2007.37.7.1184
  14. Legters K, Verbus NB, Kitchen S, Tomecsko J, Urba N. Fear of falling, balance confidence and health-related quality of life in individuals with postpolio syndrome. Physiother Theory Pract 2006;22(3):127-135 https://doi.org/10.1080/09593980600724196
  15. Murphy SL,Williams CS, Gill TM. Characteristics associated with fear of falling and activity restriction in community-living older persons. J Am Geriatri Soc 2002;50:516-520 https://doi.org/10.1046/j.1532-5415.2002.50119.x
  16. Gagnon N, Flint AJ, Naglie G, Devins GM. Affective correlates of fear of falling in elderly persons. Am J Geriatr Psychiatry 2005;13(1):7-14 https://doi.org/10.1097/00019442-200501000-00003
  17. Zijlstra GA, van Haastregt JC, van Eijk JT, van Rossum E, Stalenhoef PA, Kempen, GI. Prevalence and correlates of fear of falling, and associated avoidance of activity in the general population of community-living older people. Age Ageing 2007;36(3):304-309 https://doi.org/10.1093/ageing/afm021
  18. Choi KW, Park UA, Lee IS. Factors influencing the fear of falling according to gender in frail elderly. J Korean Gerontr Soc 2011;31(3):539-551 (Korean)
  19. Paik HW. A program for the prevention of fall down in the elderly with high risk factors. Management center for health promotion fund 2003. pp.31-36 (Korean)
  20. Friedmann SM, Munoz B, West SK, Rubin GS, Fried LP. Falls and fear of falling: which comes first? A longitudinal prediction model suggests strategies for primary and secondary prevention. J Am Geriatri Soc 2002;50(8):1329-1335 https://doi.org/10.1046/j.1532-5415.2002.50352.x
  21. Lee MS. Effects of a health diary program on fall-related outcomes in low-income elderly women with osteoarthritis. J Agric Med Community Health 2011;36(3):167-178 (Korean) https://doi.org/10.5393/JAMCH.2011.36.3.167
  22. Tideiksaar R. Falling in old age: prevention and management (2nd ed.). New York, NY: Springer Publishing Co, 1997, 266-267
  23. Tinetti ME, Richman D, Powell, L. Falls efficacy as a measure of fear of falling. J Gerontol 1990;45:239-243 https://doi.org/10.1093/geronj/45.6.P239
  24. Radloff LS. The CES-D scale: A self-report depression scale for research in the general population. Appli Psychol Measure 1977;1:385-401 https://doi.org/10.1177/014662167700100306
  25. Camphell A, Converse PE, Rodgers WL. The Quality of American life. New York, Russel Sage Foundation, 1976, pp.245-259
  26. Kane R, Ouslander J, Absrass I. Essential of clinical geriatrics(3ed). New York, McGraw-Hill, 1994, pp.229-246
  27. Chang CM, Kang HS. Physical function and psychological status in the elderly those who experienced a fall or not. Korean J Rehabil Nurs 2004;7(1):48-57 (Korean)
  28. Jung YM, Lee SY, Chung KS. Prevalence and associated factors of falls according to health status in elderly living in the community. J Korean Gerontr Soc 2006;26(2):291-303 (Korean)
  29. Cumming RG, Salkeld G., Thomas M. Prospective study of the impact of fear on daily living, SF-36 scores, and nursing home admission. J Gerontol A Biol Sci Med Sci 2000;55(5):M229-M305
  30. Rochat S, Bula CJ, Martin E, Seematter-Bagnoud L, Karmaniola A, Aminian K et al. What is the relationship between fear of falling and gait in well functioning older persons aged 65 to 70 years. Arch Phys Med Rehabil 2010;91(6):879-884 https://doi.org/10.1016/j.apmr.2010.03.005
  31. Yoo IY. Fall and housing environmental problem of the couple and single elderly. J Korean Soc Living Environ Sys 2005;12(3):199-205 (Korean)