• Title/Summary/Keyword: 낙상 예방활동

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Evaluation of a Fall Risk Assessment Tool to Establish Continuous Quality Improvement Process for Inpatients' Falls (낙상예방 활동의 지속적 질 관리 프로세스 확립을 위한 위험 사정도구 평가)

  • Park, Ihn-Sook;Cho, In-Sook;Kim, Eun-Man;Kim, Min-Kyung
    • Journal of Korean Academy of Nursing Administration
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    • v.17 no.4
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    • pp.484-492
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    • 2011
  • Purpose: The aims of study were; (1) to evaluate the validity and sensitivity of a fall-risk assessment tool, and (2) to establish continuous quality improvement (CQI) methods to monitor the effective use of the risk assessment tool. Methods: A retrospective case-control cohort design was used. Analysis was conducted for 90 admissions as cases and 3,716 as controls during the 2006 and 2007 calendar years was conducted. Fallers were identified from the hospital’s Accident Reporting System, and non-fallers were selected by randomized selection. Accuracy estimates, sensitivity analysis and logistic regression were used. Results: At the lower cutoff score of one, sensitivity, specificity, and positive and negative predictive values were 82.2%, 19.3%, 0.03%, and 96.9%, respectively. The area under the ROC was 0.60 implying poor prediction. Logistic regression analysis showed that five out of nine constitutional items; age, history of falls, gait problems, and confusion were significantly associated with falls. Based on these results, we suggested a tailored falls CQI process with specific indexes. Conclusion: The fall-risk assessment tool was found to need considerable reviews for its validity and usage problems in practice. It is also necessary to develop protocols for use and identify strategies that reflect changes in patient conditions during hospital stay.

The effect of otago exercise-based fall prevention education activities on balance, fall efficacy and activities of daily living in the subacute stroke patients: A randomized controlled clinical trial (오타고운동 기반 낙상예방교육활동이 아급성 뇌졸중 환자의 균형, 낙상 효능감 및 일상생활동작능력에 미치는 영향: 무작위 대조군 임상 연구)

  • Yoon, Hyun Sik;Han, Kyu Bum;Oh, Seung In;Lee, Da Bee;Song, Ha Hee;Song, Jeong Eun;Cha, Young Joo
    • Journal of Korean Physical Therapy Science
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    • v.27 no.1
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    • pp.1-8
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    • 2020
  • Background: This study analysed the effect of the fall prevention education activities on balance, fall efficacy, activities of daily living (ADL) of sub-acute stroke patients. Design: Randomized controlled trial. Methods: The subjects of the study were 24 subacute patients, who have onset period of less than 6 months. They are randomly allocated in the conventional therapy group (n=12) and fall prevention education group (n=12) and observed with frequency for 5 times a week for four weeks. Measuring took place before and after the experiment leading to following results of the Fall efficacy scale (FES), Berg balance scale (BBS) and Functional Independence Measure (FIM). Results: FES, BBS and FIM score was significantly greater in the post-test than in the pre-test in both groups (p<0.01). Independent t-test confirmed that the fall prevention education group showed much greater improvement change in the FES, BBS and FIM score than conventional therapy group (p<0.05). Conclusion: The present study demonstrated the importance of clinical contribution of the fall prevention education in the individuals with subacute stroke patients to the balance, fall efficacy and ADL following the stroke rehabilitation.

Clinical Practice Guideline for Assessment and Prevention of Falls in Adult People (낙상위험요인 평가 및 낙상예방활동 임상진료지침)

  • Chun, Ja-Hae;Kim, Hyun-Ah;Kwak, Mi-Jeong;Kim, Hyuo-Sun;Park, Sun-Kyung;Kim, Moon-Sook;Choi, Ae-Lee;Hwang, Jee-In;Kim, Yoon-Sook
    • Quality Improvement in Health Care
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    • v.24 no.2
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    • pp.41-61
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    • 2018
  • Purpose: Falls are one of the most frequent health events in medical institutions, however, they can be predicted and prevented. The Quality Improvement Nurse Society clinical practice guideline Steering Committee developed the Clinical Practice Guideline for the assessment and prevention of falls in adult people. The purpose of this study was to assess the risk factors for falls in adults aged 19 years and older, to present an evidence for preventing falls, formulate a recommendations, and indicators for applying the recommendations. Methods: This clinical practice guideline was developed using a 23-step adaptation method according to the Handbook for clinical practice guideline developer (version 1.0) by National Evidence-based Healthcare Collaborating Agency. Evidence levels and recommendation ratings were established in accordance to SIGN 2011 (The Scottish Intercollegiate Guidelines Network). Results: The final 15 recommendations from four domains were derived from experts' advice; 1) assessment of risk factor for falls in adult 2) preventing falls and reducing the risks of falls or falls-related injury 3) management and reassessment after a person falls 4) leadership and culture. Conclusion: This clinical practice guideline can be used as a basis for evaluation and prevention of fall risk factors for adults, to formulate recommendations for fall risk assessment and fall prevention, and to present monitoring indicators for applying the recommendations.

The Convergent Influence of the Incidence of Delirium in Patients after Arthroplasty (인공관절치환 수술 후 발생하는 섬망에 따른 융복합적 영향)

  • Kim, Young-Hee;Kwon, Young-Chae
    • Journal of Digital Convergence
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    • v.14 no.11
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    • pp.369-377
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    • 2016
  • This study examined artificial joint replacement surgery for early intervention and prevention of the occurrence of delirium surgery. Data of study were analysed using the sample through the EMR (Electronic Medical Record) and after surgery to provide basic data. The subjects were elderly aged 60 years or more and the number of the sample was 821. Data were analysed by using SPSS 20.0 with t-test, $x^2$-test and multiple logistic regression analysis. The study results showed patients with artificial joint replacement surgery incidence of delirium was 13.5%, findings of these variables insisted that the main influencing factors of delirium were caused by age, fall history, physical activity, emotional status, body mass index (BMI) before surgery. The study suggested that the above findings are required for early intervention, early detection and prevention of delirium.

Health Promotion Through Healthy People 2010 ("2010년대 건강한 시민" 정책을 통한 미국의 건강증진 방향)

  • Cho, Jung H.
    • Proceedings of The Korean Society of Health Promotion Conference
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    • 2004.10a
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    • pp.17-58
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    • 2004
  • 뉴저지주 보건교육/건강 증진정책을 논하기전에 건강증진과 보건 교육사의 뜻을 먼저 기술하기로 한다. 건강증진이란 일상 사회생활과 행동과학의 응용에서 시작하며 교육의 효율적 작전 및 기술, 질병 역학 조사, 개인 및 가족단위 건강 위해 행위 절감, 사회연관 구축망 조성, 그리고 적게는 이웃, 더 나아가 조직체계 및 지역 사회의 네트웍 실시등을 실시한다. 보건교육 및 건강증진 전문가란 ' 전국 보건교육 인증 위원회(NCHEC) ' 에서 채택된 다음 7개 활동 영역에서 개인적, 그룹, 각주단위, 그리고 범 국가적 조직에서 종사하는자로 한다. 개인 및 지역사회 보건 교육 필요성 분석- 계회, 실행, 효율성 평가, 사업 진행 조정, 자문, 컴뮤니케이션 등의 활동범위를 들 수 있다. 공인 보건 교육사(CHES)란 대학 및 대학원에서 보건 교육학 소정의 필수 과목을 이수하고 학.석사 소지자로서 ' 전국 보건 교육 인증 위원회 ' 에서 그 자격을 인정 받고 공인 자격 시험에 합격한자로 한다. 합격자는 자기 성명뒤에 CHES란 칭호를 부치며 매 5년마다 75단위이상 인정된 전문 직업 보수 교육을 받아야 한다. 보건 교육사 고용 분야는 연방, 주, 지방 정부의 보건 교육사(10-15%) 및 건강 증진 전문가로 종사하며; 이들은 지역 사회 조직화, 프로그람 기획, 공공사업 마켓팅, 메디아, 컴뮤니케이션 자질을 갓추어야 하며; 상해 예방, 학교 보건, 지역 사회 영양 실태 향상, 그 외 모든 건강 증진과 질병 예방에 일익을 담당 하여; 의사, 간호사, 약사, 영양사,환경 위생사드의 전문분야종사자들괴 한팀이 되어 지역 사회 보건 사업에 기여한다. 쥬저지 보건 교육사들은 주법령 8조 '||'&'||' 보건행정 표준 시행령 ' 에 따라 포괄적 보건교육/건강증진 프로그램을 개발하여 총체적으로 조절 관장한다. 특희 ' 미국 학술원 의료 연구원 ' 에서 제정한 ' 10대 필수 공중 보건 사업 ' 에 기준을 두고; 1) 개인 및 지역사회 필수 보건 여건 분석 평가, 2) 보건 교육 이론에 따른 사업 계획 설정, 3) 교육 전략과 보건문제 발굴에 따라 일반 대중 대상 보건 교육 실행 (프로그람 기획, 연수 교육, 미디어 캠페인, 공중보건 향상책 옹호), 4) 사업 진행 과정 정리, 그 결과에 대한 영향력과 결과 평가, 5) 프로그램진행, 인사 및 예산관리 참여, 6) 근무향상을 위한 보수교육 프로그램 개발, 7) 보건 의료 업무 종사자 상호 협조성 향상 훈련, 8) 지역 사회자원 밭굴, 9) 적절한 고객 의뢰 체제 시행, 10) 위기 관리 컴뮤니케이션 체제 개발실시, 11) 일반 대중에게 공중 보건 향상 고취, 12) 각종 협력 지원금 신청서 작성 제출, 13) 문화/인종적으로 적절한 시청각 교재 발굴, 15) 질적 및 양적 보건교육/건겅증진책 연구 실시, 16) 비 보험 가담자, 저 보험자, 빈곤자, 이민자 색출 선도, 17) 관활 구역내 상재하는 각 건강증진 프로그램 밝혀 내서 불필요한 중복 회피등이다. 그 외에도 보건 교육사들은 사회 복지 단체인 미국 암 협회, 미국 심장 협회,미국 폐장 협회 등 각종 사회 복지 비영리단체 와 자선 사업 단체들과 긴밀희 협조하거나 그 단체 임직원으로서 건강 증진 사업에 종사한다. 병원 및 의료기관에선 임직원 보수 교육, 환자의 질병 예방및 건강증진 교육, 그리고 의료 사업장내 건장 증진업무에 종사한다. 건강 유지 의료 기관(HMO)에선 예방주사, 정기검진 촉진등을 통한 입원일수 절감, 응급실 사용도 절감등으로 의료비 감축, 삶의질 향상상에 종사한다. 사업장 보건 교육사는 스트레스 관리, 금연 및 흡연 중단선도, 체중 절감, 종업원 건강증진 생활화참여 유치, 컴뮤니케이션 개발, 마켓팅, 질병 예방등에 그 전문 직업적 노하우를 사업체 건강 증진 프로그램 개발에 접목한다. 뉴저지 2010년대 건강 증진책은 5대 목표 설정하여 현재 시행하고 있다. 특이한점은 2001년 9.11사태 이후 연방정부와 주정부의 상당한 예산 지원을 그랜트 지원금 형식으로 받아 연방, 주정부, 지방 정부, 의료 기관등에서 일사 불란하게 생물/화학/방사성 테러에 대비하는데 보건 교육사들은 시민 인지도 향상과 위기관리 컴뮤니케이션 영역에서 활약한다. 총체적인 보건 교육/건강 증진책은 다음 천년간 뉴저지 건강증진 백서와 미연방 정부 건강증진 2010에 준하여 설립한 뉴저지 건강 증진 2010 에 의한다. 그 모델을 보면; 1) 생활 습관 향상으로 위해 행위 절제; 적절한 영양 섭취 와 과체중화 차단 불필요한 투약 절제와 그 관리 흡연 탐익 절감, 금연, 흡연관련 신체/정신적 피해 관리/치료 습관성 약물 중독 조기발견 예방 낙상 예방 폭력, 의도적/비의도적 상해 예방 2) 심장질환, 암, 뇌졸중, 당뇨, 폐염, 인프루엔자등 주사망원인 질병 조기 발견 예방 책 마련; 독감.폐렴 예방 주사 실시 3) 보건 교육 대상과 표적 설정 특히 보건사업 참여 동반자 발굴하여 그 동참과 책임분담 책려; 주. 지방 정부기관, 의료 종사자, 의료 보험 업자, 대학 등 교육 기관, 연구 기관, 교육자, 지방 보건소, 지역 사회 비 영리단체, 종교 단체 및 교역자 등의 참여 촉구., 지역 사회 비 영리단체, 종교 단체 및 교역자 등의 참여 촉구.

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Relationship between Physical Activity Level and Fall-Proof-related Fitness in Older Female Adults (여성 노인의 신체활동 수준과 낙상예방 관련 체력의 상관관계)

  • Ok, Hyun-Tae;Joo, Kee-Chan;Kim, Wan-Soo
    • Journal of the Korean Society of Physical Medicine
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    • v.13 no.2
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    • pp.1-9
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    • 2018
  • PURPOSE: This study investigated the relationship between the daily physical activity level and fall-proof-related fitness in older female adults. METHODS: This study promoted and sampled the subjects who participated in the study for 2 weeks, and developed a basic information questionnaire to select the subjects to be excluded from the research. The amount of energy expenditure through daily physical activity was examined, and the elderly physical fitness, and balance test were analyzed. The subjects were divided into group A (${\geq}1,500kcal/week$), group B (<$1,500-{\geq}1,000kcal/week$), and group C (<1,000 kcal/week) according to their daily physical activity level. RESULTS: A significant difference in the daily physical activity level (energy expenditure), Chair Stand Test (lower body strength), 8-Foot Up-and Go Test (dynamic balance), and CTSIB-M (modified Clinical Test of Sensory Interaction in Balance) was observed among groups A, B, and C (p<.5), but there was no significant difference in the Chair Sit-and-Reach Test (lower body flexibility) (p>.5). CONCLUSION: The increase in physical activity is an essential factor for preventing falls and it provides many health benefits for the elderly. On the other hand, considering that elderly people cannot access exercise programs easily in Korea, it can be predicted that increasing elderly people's physical activity in daily life rather than specific exercises may help prevent falls.

Barriers related to Walking Activity according to the Age Group of Rural residents (농촌 지역주민들의 연령대에 따른 신체활동의 장애요인)

  • Kim, Bokyoung;Lee, Gyeong-Ye;Seo, Ae-Rim;Kim, Mi-Ji;Seo, Sung-Hyo;Park, Ki-Soo
    • Journal of agricultural medicine and community health
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    • v.45 no.2
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    • pp.89-99
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    • 2020
  • Objective: This study aimed to report the relationship between walking activity and perceived physical activity barriers after classifying the age group(≤64, 65-74, ≥75). Methods: The subjects were conducted on 1500 residents of two areas, and the walking activity was defined as five or more times a week, 10 minutes or more at a time, and 30 minutes or more per day. Perceived physical activity barriers were lack of time, lack of social support, lack of energy, lack of willpower, and fear of falling. Results: In the group under 64 year, the lack of time (exp(B)=0.819, p=0.002) and the lack of willpower (exp(B)=0.656, p<0.001) were significantly associated. In the 65-74 year old group, the lack of willpower (exp(B)=0.714, p<0.001) and fear of falling (exp(B)=0.787, p=0.003) were a significant association. In the group aged 75 years and over, lack ofwill power (exp(B)=0.734, p<0.001) and fear of falling (exp(B)=0.807, p=0.003) were significantly associated. Conclusion: In order to solve the lack of willpower and lack of time, a walking activity should be performed together at a certain time in the village, and the elderly in the late ages should reduce the fear of falling by performing a fall prevention exercise in parallel.

Analysis for the Correlations between health Problems and Computer Game Needs in the Elderly (노인들의 건강문제와 컴퓨터 게임 요구도의 상관성 분석)

  • Lim, Kyung-Choon;Lee, Yoon-Jung;Ahn, Joon-Hee
    • The Journal of the Korea Contents Association
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    • v.9 no.11
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    • pp.475-486
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    • 2009
  • Regular activity program is needed for managing chronic disease and obesity and preventing falls as a nursing intervention. It seems that serious game will be very important for older people to keep them active with fun to improve their health. This study was conducted to explore the correlations between health problems and computer game needs in the elderly. This was a cross-sectional study. A questionnaire was developed and administered to a convenience sample of adults who are older than 55 years, recruited from several places through trained research assistants and research center that has online pools in Korea. 778 subjects (mean age: $61.4\;{\pm}\;5.6$) were participated in this study. The majority of subjects was male (68.6%). We found that there was higher needs for exercise or serious game in the group of ma1e(55.4%), below undergraduate(66.2%), under two family members(32.5%), over 350,000 won of pocket money/month (40.1%), mild depressive symptom (51.7%), and online responser(68%). Especially, they wanted to overcome physical limitations through games. Higher education, more experiences and skills of using computer/internet was statistically and positively significant to the needs for exercise or serious game. In conclusion, there exists a potential market within this demographic group for the use of serious games. Thus, we need to develop senior games in Korean to improve quality of life and health promotion.

Awareness of the Job Task Importance and Performance of Occupational Therapists in the Elderly Community Care System (노인 커뮤니티케어제도 내 작업치료사의 업무중요도와 수행에 대한 인식)

  • Hong, So-Young
    • The Journal of Korean society of community based occupational therapy
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    • v.9 no.3
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    • pp.11-19
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    • 2019
  • Objective : The purpose of this study was to investigate the awareness of job task importance and performance of occupational therapists in the community care system for the elderly. Methods : We conducted an online questionnaire survey of 152 occupational therapists nationwide from May 31, to June 24, 2019. General characteristics and institutional awareness, role and performance awareness were analyzed by descriptive statistics. One way ANOVA were conducted to compare the differences of working days, working places, and the field of work. Results : The recognition of the community care system for the elderly was low at 2.93 ± 1.0 but the importance of the community care system was 3.94 ± 0.7 and the importance of the occupational therapist in the system was 4.34 ± 0.7. Fall prevention (4.63 ± 0.7) was the most important in occupational therapist's jobs, and performance was high in instrumental activity daily living training (3.94 ± 0.8) and physical function training (3.94 ± 0.8). Conclusion : This study can be presented as basic data on job task importance and performance awareness of occupational therapists in the elderly community care system. In addition, it is expected to be used as basic data for establishing the role of occupational therapist in the elderly community care system.

Systematic Review of Evidence-Based Intervention for Gait in Dementia Patient (치매환자의 보행에 관한 근거기반 중재에 대한 체계적 고찰)

  • Kwon, Ae-Lyeong;Jung, Hai-Ik
    • The Journal of the Korea Contents Association
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    • v.21 no.2
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    • pp.667-675
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    • 2021
  • This study conducted a systematic review of evidence-based interventions to confirm the importance of gait in dementia patients and to inform the necessity of various interventions necessary for gait. Based on PRISMA's guidelines and evidence-based intervention, a systematic review were conducted, and papers published in domestic journals for the past 10years were collected, and the dependent variables measured along with the intervention type and gait were analyzed. For data search, research papers from January 2011 to June 2020 were collected through RISS, KISS, the National Library of Korea, and the Library of Congress. The main search terms were 'dementia patient', 'walking', and 'walking ability'. Searched 57 papers on dementia patients and gait that meet the literature selection criteria. Among them, papers overlapping with papers before 2010, papers whose dependent variable is not related to gait ability were excluded, and finally, other than dementia diseases. As for the type of gait intervention, there were many programs related to exercise such as fall prevention and physical activity, and the dependent variables measured along with gait were physically and psychologically diverse. Although domestic studies for dementia patients are conducted in a variety of directions and methods, there are few studies on the improvement of function and gait of the lower extremity part of the body. Therefore, it is necessary to study the multifaceted and various intervention methods for walking in dementia patients.