• Korean Journal of Adult Nursing
• /
• v.29 no.1
• /
• pp.51-62
• /
• 2017

Purpose: The purpose of this study was to provide data about the risk factors related to falls among elderly patients with dementia using meta-analysis. Methods: Key words used for search through electronic database (CINAHL, PubMed, Ovid-MEDLINE, RISS, KISS, DBPIA, National Assembly Library) included 'dementia', 'Alzheimer', 'fall'. Twenty studies met the inclusion criteria for the meta-analysis and 'R' version 3.2.2 was used to analyze the correlated effect size. Results: Study results showed that risk factors related to falls were identified as the demographic (age, gender, education), dementia-related (disease duration, cognition), physical (body mass index, walking, balance, activity of daily living, use of walking aids, number of medications including psychotropic drugs, musculoskeletal problems, parkinsonism, comorbidity), psychological (neuropsychiatric symptom, depression), environmental (Physical environment), and fall-related (fall history, high risk group of fall) factors. The effect size of risk factors such as high risk group of fall (r=.35), use of walking aids (r=.33), depression (r=.31), psychotropic drugs (r=.27), Musculoskeletal problems (r=.25) were higher than the other risk factors. Conclusion: Based on the findings of this study, strategies to improve elderly patient's depression, intensive care for high risk group of fall, and adequate training with walking aids are needed for prevention of falls in elderly patients with dementia.

• Quality Improvement in Health Care
• /
• v.15 no.2
• /
• pp.107-120
• /
• 2009

Background : To estimate fall incidence rate and associated factors in inpatients from a general hospital. Method : The data were collected from 104 fall incident reports developed by the patient safety committee in a general hospital in Seoul from 01 January 2007 to 31 December 2008. Information included general characteristics of patients, factors related to fall, types, places, circumstances and outcomes of fall. Result : The incidence rate of fall, which was 4.4 per 1,000 total discharged patients and 0.5 per 1,000 patient-days, was much lower than that of several hospitals in the United States. The difference may reflect the different incidence reporting system of each hospital. Fall-prone patients were, in general, $$\geq_-$$65 years of age, had an alert mental status, were ambulatory with some assistance, and were dependent on and ambulatory device. High incidence of falls was associated with patients with circulatory disease. The majority of fall events usually occurred in bed or at the bedside in the patient's room, and occurred more often during the night than during the day or evening. Risk factors of fall were use of drugs (antihypertensive or neuropsychiatric drugs) and environmental factors (e.g., overly high bed height, surrounding objects, inadequate fitness shoes and slippery floor). Physical injury occurred in 43.3% of fall events, which typically required diagnosis of injury and treatment such as suturing. Risk factors for repeated falls were use of a neuropsychiatric drug (odds ratio=13.9) and gait disturbance (odds ratio=91.2). Risk factors for fall-related injury were alert mental status (odds ratio=3.3 times more likely to fall than those who were drowsy or in a stupor) and general weakness(odds ratio=3.3 times more likely to fall than those who were not generally weak). Conclusion : Medical and nursing staff should be aware of the fall risk factors of hospitalized patients and should intensively pursue preventative strategies. Development of fall prevention education based on these results is recommended.

• Journal of the Korean Home Economics Association
• /
• v.48 no.3
• /
• pp.43-53
• /
• 2010

This study aimed to compare fear and prevention behaviors on accidents between mothers and teachers in family childcare centers. The participants were 117 mothers whose children were 0~2 year-olds and 121 teachers. Based on Hendrickson(2008) and Reichert & Henricks(1996), the scale was developed by the researcher, and it was composed of fear and prevention behaviors on accident. The data were analyzed using descriptive statistics and $x^2$ analysis. Results showed that mothers feared fall accidents and step-on-accidents while teachers feared suffocation accidents and liability for injury medical fee. Also, mothers did more prevention behaviors on use of car seats than teachers, whereas teachers did more behaviors on walk safety, custody of drugs and dangerous articles, and food safety.

• Research in Community and Public Health Nursing
• /
• v.18 no.1
• /
• pp.14-22
• /
• 2007

Purpose: The purpose of this study was to investigate the experience of falls, the fear of falling and fall efficacy and identify the predictors of falls in the elderly at senior citizens' centers. Method: The subjects of this study were 106 elders who used senior citizens' centers in Chungcheongbuk-do, Korea. Data were collected from May to June, 2006 through a survey using a structured questionnaire. Result: Of the elderly sampled, 35.8% experienced falls during the last 1 year. Of falls experienced by the elderly, 53% occurred indoors, 47% outdoors, 15.8% in the bathroom or toilet. In addition, 57.8% of the elderly had injuries on the hip and waist related with falls. The fear of falling was higher in those with experience in falls than in those without. Factors affecting the elders' falls were age (OR=1.113, 95% CI=1.012-1.224), the number of chronic disease (OR=2.342, 95% CI=1.365-4.019) and the fear of falling (OR=4.279, 95% CI=1.901-9.634). The predictor of the frequency of falls was fall efficacy ($R^2=24.9$). Conclusion: As a result, it is essential to develop fall prevention programs based on the fear of falling, fall efficacy, chronic diseases and medication state. And in senior citizens' centers, fall prevention safety education should be activated as a health promotion program.

• The Journal of the Institute of Internet, Broadcasting and Communication
• /
• v.22 no.2
• /
• pp.51-62
• /
• 2022

This study suggests a design of predictive modeling for a hospital fall risk based on inpatients' posture. Inpatient's profile, medical history, and body measurement data along with basic information about a bed they use, were used to predict a fall risk and suggest an algorithm to determine the level of risk. Fall risk prediction is largely divided into two parts: a real-time fall risk evaluation and a qualitative fall risk exposure assessment, which is mostly based on the inpatient's profile. The former is carried out by recognizing an inpatient's posture in bed and extracting rule-based information to measure fall risk while the latter is conducted by medical staff who examines an inpatient's health status related to hospital fall risk and assesses the level of risk exposure. The inpatient fall risk is determined using a sigmoid function with recognized inpatient posture information, body measurement data and qualitative risk assessment results combined. The procedure and prediction model suggested in this study is expected to significantly contribute to tailored services for inpatients and help ensure hospital fall prevention and inpatient safety.

• Journal of the Korean Society of Physical Medicine
• /
• v.15 no.2
• /
• pp.65-73
• /
• 2020

PURPOSE: This study examined the effects of coordinative locomotor training on the physical factors for falls in the elderly with mild cognitive impairment. METHODS: This study examined thirty subjects diagnosed with mild cognitive impairment by the radiologic findings, history, and physical examination. The subjects were assigned to a control group (n = 15) or experimental group (n = 15, coordinative locomotor training). The experimental group underwent coordinative locomotor training for four weeks, with training sessions two times per week. The control group was given a fall-prevention education for 60 minutes without coordinative locomotor training. To evaluate the physical factors for falls, the lower extremity strength and the Korean version of the Fullerton advanced balance scale and biorescue were measured for balance. These tests were conducted before and after training. RESULTS: Significant differences were observed between the two groups after the four weeks of coordinative locomotor training for the elderly with mild cognitive impairment the experimental group had a greater degree of improvement in the physical factors for falls. CONCLUSION: These findings suggest that coordinative locomotor training may have a functional effect on fall-prevention and the mobility of the elderly with mild cognitive impairment. In addition, it is expected to provide systematic and effective data that can be used as a fall prevention program for the elderly with mild cognitive impairment in each institution.

• Journal of Korean Biological Nursing Science
• /
• v.4 no.1
• /
• pp.5-23
• /
• 2002

Purpose: To determine the effect of the Fall Prevention Program(EPP) on gait, balance and muscle strength in elderly women at a nursing home. Method: The subjects of this consisted of 38 elderly women between the ages of 70 to 89 years living at a nursing home located in Seoul. Each of the experimental group and control group was composed of 19 subjects. The subjects in experimental group have participated in FPP for the 8 weeks which consisted of exercise, education and foot care. They started to exercise for 40 minutes per session, 3 sessions a week during the 1st week at 40% of age adjusted maximum heart rate. From the 2nd week to the 4th week, they increased the duration of exercise to 50 minutes per session and the intensity to 60% of age-adjusted maximum heart rate. They participated in 50 minutes at 60% of age-adjusted maximum heart rate from the 5th week to the 8th week. Each exercise session consisted of 10 minutes of warming-up exercise, 30 minutes of conditioning exercise and 10 minutes of cooling-down exercise. They participated in education for 20 minutes per week from the 1st week to the 4th week. Then they participated in a 30-minute foot care program per week from the 5th week to the 8th week. Gait, balance and muscle strength for each subject were measured before and after FPP. Gait was evaluated by step length, step width, gait speed and walking distance. Balance was measured by the duration of standing on one leg with their eyes closed and open each, and a get-up and go test. Grip strength was measured by hand dynamometer. Hip extensor and flexor strength, knee extensor and flexor strength and ankle plantarflexor and dorsiflexor strength were measured by manual muscle tester. Data was analyzed using SPSS form Windows. t-test and Chi square test were utilized as a homogeneity test. Repeated measure ANOVA was used to test the effect of FPP. Result: 1) Step width significantly decreased, and step length, gait speed and walking distance significantly increased in the experimental group compared with the control group after FPP(p<0.005). 2) There was no significant change in standing time on one leg with their eyes closed after FPP. The standing time on leg with their eyes open and the time of "get-up and go" significantly decreased in the experimental group compared with the control group after FPP(p<0.005). 3) Muscle strength-grip strength, hip extensor and flexor strength-significantly increased in the experimental group compared with the control group after FPP(p<0.005). 4) There was no significant difference of frequency of fall between the experimental group and control group during the period of FPP. Conclusion: These results suggest that FPP can increase gait, balance and muscle strength of elderly women at a nursing home.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.21 no.7
• /
• pp.510-516
• /
• 2020

This study investigated the characteristics and factors affecting inpatient infants, children, and adolescents who experienced falling, using NHDIS data from 2008 through 2017, The study analyzed data of 116 patients who were under 18 and who experienced injuries (KSCD, S00-S99) by falling (KSCD, W00-W19). Frequency analysis, cross-tabulations, and multiple regression analysis were conducted, using SPSS 23. There were more boys than girls, and most of the falls occurred at the ages of over one to under six years old. Most of the children had respiratory diseases, and most had open wounds or bruises due to falling. Also, most of the falls were related to the bed. In the factor analysis, age (β=.318), the main diagnosis (β=.231), and injury (β=.169) except gender affected falling. This suggests that it is necessary to conduct fall prevention education for children, considering the developmental stage characteristics and age group. It is necessary to screen the risk group such as children with a disease with relatively less restriction of activities or with a hyperactive disorder, and to develop a related manual. Hopefully, the results will be used as the basic data for fall prevention education and creating a fall prevention manual according to the characteristics of children's developmental stage for patients who need hospitalization, their caregivers, and the relevant medical team.

• Journal of Preventive Medicine and Public Health
• /
• v.45 no.5
• /
• pp.283-290
• /
• 2012

Objectives: People who have chronic diseases, as well as gait imbalance or psychiatric drug use, may be susceptible to injuries from falls and slips. The purpose of this study was to evaluate the effect of musculoskeletal diseases on incidental fall-related injuries among adults in Korea. Methods: We analyzed data from the 4th Korea National Health and Nutrition Examination Survey (2007-2009), which are national data obtained by a rolling survey sampling method. The 1-year incidence of fall-related injuries was defined by health service utilization within the last year due to injury occurring after a slip and fall, and musculoskeletal diseases included osteoarthritis, rheumatoid arthritis, osteoporosis, and back pain. To evaluate the effects of preexisting musculoskeletal diseases, adults diagnosed before the last year were considered the exposed group, and adults who had never been diagnosed were the unexposed group. Results: The weighted lifetime prevalence of musculoskeletal disease was 32 540 per 100 000 persons. Musculoskeletal diseases were associated with a higher risk of fall-related injury after adjustment for sex, age, residence, household income, education, occupation, visual disturbance, paralysis due to stroke, and medication for depression (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.03 to 1.93). As the number of comorbid musculoskeletal diseases increased, the risk of fall-induced injuries increased (p-value for trend <0.001). In particular, patients who had any musculoskeletal condition were at much higher risk of recurrent fall-related injuries (OR, 6.20; 95% CI, 1.06 to 36.08). Conclusions: One must take into account the risk of fall-related injuries and provide prevention strategies among adults who have musculoskeletal diseases.

• Journal of Korean Physical Therapy Science
• /
• v.16 no.2
• /
• pp.19-26
• /
• 2009

Background: The purpose of this study was to investigate effects of six-week biofeedback training for prevention of falling in elderly persons. Biofeedback training for using the TETRAX system. Methods: Thirty healthy elderly persons(men=17, women=13) who were 79 years of mean age participated in sensory regulation training. They were trained for thirty minutes a day, three times per week. We measured subjects sensory regulated function by TETRAX system, and analyzed mean difference of observed variables by paired t-test between the pre and post test. Results: The first experimental group were significantly difference between pre and post test. The second control group were not significantly between the pre and post test. The third there are significant between group. Conclusion: The results of this study reveal that biofeedback training exercise will improve sensory balance function, and further studies needs to identify which specific factors are related to fall in the elderly population, and it is expected this study may contribute in reducing fall and therapeutic exercise in falling.