• 한국전문물리치료학회지
• /
• 제21권2호
• /
• pp.37-47
• /
• 2014

Falls are common after stroke and most frequently related to loss of balance while walking. Consequently, preventing falls is one of the goals of acute, rehabilitative, and chronic stroke care. The purpose of this study was to investigate the incidence and risk factors of falls and to determine how well the Falls Efficacy Scale (FES), Timed Up and Go test (TUG), and Berg Balance Scale (BBS) could distinguish between fallers and non-fallers among stroke patients during inpatient rehabilitation. One hundred and fifteen participants with at least 3 months post-stroke and able to walk at least 3 m with or without a mono cane participated in this study. Fifty-four (47%) participants reported falling, and 15 (27.8%) had a recurrent fall. Logistic regression analysis for predicting falls showed that left hemiplegia [odds ratio (OR)=4.68] and fear of falling (OR=5.99) were strong risk factors for falls. Fallers performed worse than non-fallers on the FES, TUG, and BBS (p<.05, p<.01, respectively). In the receiver operator characteristic curve analysis, the TUG demonstrated the best discriminating ability among the three assessment tools. The cut-off score was 22 seconds on the TUG for discriminating fallers from non-fallers (sensitivity=88.9%, specificity=45.9%) and 27 seconds for discriminating recurrent fallers from single fallers and non-fallers (sensitivity=71.4%, specificity=40.2%). Results suggest that there is a need for providing fall prevention and injury minimization programs for stroke patients who record over 22 seconds on the TUG.

• 동서간호학연구지
• /
• 제28권2호
• /
• pp.122-131
• /
• 2022

Purpose: This study aimed to identify the factors related to fear of falling (FOF) in different age groups from community-dwelling mid to late-adults. Methods: To identify the factors related to FOF, data of 162,684 adults over 45 years of age from 2019 Community Health Survey was analyzed using logistic regression with complex samples. Results: Factors related to FOF found in all age groups were sex, previous experience of falls, physical activity levels over moderate intensity, subjective health status, number of chronic diseases, stress, depression, and cognitive decline. In the 45-64 age group, the FOF was significantly higher in the groups of low education level and low monthly household income. In the 65-74 and over 75 age groups, the FOF was significantly higher in the groups of not living with spouse and walking not practiced. Conclusion: We suggests that understanding of risk factors and early detection of fall risk patients in each age group are necessary to establish and apply tailored fall prevention programs for prevention and management of the FOF in community-dwelling mid to late-adults.

• 보건행정학회지
• /
• 제29권2호
• /
• pp.172-183
• /
• 2019

Background: Falls are the most frequent adverse events reported in hospitals. The aim of this study was to investigate the incidence rate and characteristics of falls in patients who used comprehensive nursing care service in National Health Insurance Service Ilsan Hospital. Methods: Incidence rate of falls was investigated in patients using comprehensive nursing care service, from July 2013 to Jun 2017 and compared with those not using this service. The characteristics and risk factors for falls, and fall-related injuries were obtained. Results: Among the 62,445 patients who used the comprehensive nursing care service for 4 years, total of 672 falls were reported. The incidence rate of falls per 1,000 patients-day was 1.15. The percentage of fall-related injuries was 26.9% and that of major injury was 2.2%. Although the incidence rate of all falls was slightly higher in patients using comprehensive nursing care service than those not using this service, falls-related injuries were not correlated with the implementation of this service. Conclusion: The falls could be more frequently detected and reported in comprehensive nursing care service, but there was no difference in fall-related injuries.

• 지역사회간호학회지
• /
• 제12권3호
• /
• pp.600-608
• /
• 2001

Accidents are the fourth-leading causal factor of death among the elderly, and fall is a major type of accident (53.17%). Many cases of falls in the elderly result in delayed discovery and loss of quality of life. As the number of the elderly grows, falls will be a more important health problem. Most previous research on falls investigated prevalence. mortality, and the related factors. There are many studies proving the effect of rhythmic movements. But few researches considered linking risk factors of fall with rhythmic movements. Purpose: We want to show the changes after performing rhythmic movement program, in risk factors of falls and mobility such as flexibility, balance, muscle power and persistency in the elderly, in order to provide basic information needed for the development of fall injury prevention program for the elderly. Method: The design of this study is quasi-experimental, the equivalent control group, pretest-posttest. The subjects consist of 124 people who lived in Do-Bong-Qu. Seoul, agreed to participate in this study, and were able to follow this rhythmic movement program. About 93 % of them are from 65 to 84 years (Mean${\pm}$sd: $73.7{\pm}5.7$): 64% are female. The rhythmic movement program was designed. and performed by two community health nurses working in the Do-Bong-Gu Public Health Center, regularly twice a week from May, 4 to December, 17. in 10 senior citizens' community centers. Risk factors of fall were measured with RAFS- II (Risk Assessment for Falls Scale II) by asking about each item: mobility was measured by observing their specific movements asked by investigators. Results: 1. After performing the program during 7 months, risk factors score of falls were decreased significantly (paired-t = 4.77. p<0.01). 2. After performing the program during 7 months, flexibility (paired-t = 2.26. p=0.03) and mobility were improved (paired-t = 4.98. p<0.01). but muscle power and persistency did not change (paired-t = 0.33. p=0.74). Overall, mobility affecting the occurrence of falls was improved significantly (paired-t = 5.15. p<0.01). Conclusions: A regular rhythmic movement program can be helpful in preventing falls in the elderly. Further. we can develop a fall injury prevention program using rhythmic movement.

• 가정∙방문간호학회지
• /
• 제24권1호
• /
• pp.34-43
• /
• 2017

Purpose: The purpose of this study was to provide basic data to develop a Fall Prevention Education Program by comparing and analyzing fall experiences and the factors that influence elderly people with dementia suffering falls. Methods: The participants were 302 patients with dementia aged 60 years or older with nursing records of hospitalization in three nursing homes located in a metropolitan area. The SPSS/Win 21.0 package was used to analyze the collected data. A logistic regression analysis was performed to identify the influence factors related to fall experiences. Results: For men, fall experiences were more frequent given the following factors: overweight; high fall risk tendency; aged 90 and above; married; dementia duration period of 5 to 9 years; and taking medication for dementia. For women, the factors included age range of 80 to 89; overweight; obese; both low and high fall risk tendency; separation by death; and having spent less than 1 year in nursing homes. Conclusion: We anticipate positive results in fall prevention education programs for the elderly with dementia if the results of this study are used as basic data, and interventions are customized to consider the sex and the relevant influence factors as to fall experiences.

• Physical Therapy Rehabilitation Science
• /
• 제7권3호
• /
• pp.139-145
• /
• 2018

Objective: Older persons with diabetes mellitus (DM) are particularly more likely to have fallen in the previous year than those without DM. The purpose of this study was to investigate the relationship between the risk of falls and type 2 DM in older adults who are 65 years of age or above. Design: A systematic review. Methods: PubMed and other two databases were searched up to August 2, 2018. Observational and cohort studies evaluating fall risk in people who are 65 years of age or above with DM were included. This review extracted the following information from each study selected: first author's surname, year of publication, country, average follow-up period, sex, age at enrollment, study population, measurement variables, relative risk, 95% confidence intervals and controlled variables. Results: This review involved nine cohort studies with 3,765 older adults with DM and 12,989 older adults without DM. Six studies compared with or without DM and two studies compared fallers with non-fallers with DM. Risk factors for falls included impaired cognitive function, diabetes-related complications (peripheral nerve dysfunction, visual impairment), and physical function (balance, gait velocity, muscle strength, and severity of physical activities). Conclusions: People who are 65 years of age or above with DM have increased risk of falling caused by impaired cognitive function, peripheral nerve dysfunction, visual impairment, and physical function in community-dwellers. For adults who are 65 years of age or older with DM, research fields and clinical settings should consider therapeutic approaches to improve these risk factors for falls.

• 근관절건강학회지
• /
• 제13권1호
• /
• pp.7-19
• /
• 2006

Falls are a major sources of death and injury in elderly people. Aged-related changes in the physiological systems which contribute to the maintenance of balance are well documented in older adults. These changes coupled with age-related changes in muscle and bone are likely to contribute to an increased risk of falls in this population. Regular exercise may be one way of preventing falls and fall-related fractures. However, the optimal exercise prescription to prevent falls has not yet been defined. On the literature review of exercise intervention for fall prevention in the elderly, exercise appeared to be a useful tool in fall prevention by improving fall risk factors. The optimum exercise prescription; moderate intensity frequency of 3-4 times per week, duration of 30-60minutes can contribute to decreased hazards and number of fall. Fall prevention protocol should include safety, falling effect, enjoyment, and easiness to follow for older people. Effective exercise programs suggested for fall prevention were such as weight-bearing exercise, resistance exercise, lower muscle strength with elastic band, swiss ball exercise walking, tai chi, and yoga.

• 한국의료질향상학회지
• /
• 제15권2호
• /
• 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.

• 한국전문물리치료학회지
• /
• 제8권3호
• /
• pp.107-117
• /
• 2001

Falls are the most serious health problems in elderly population. They are a major cause of premature death, physical injury, immobility, psychosocial dysfunction, and nursing home placement. To reduce the alarming rate of falls and related excessive mortality and morbidity, efforts must be made to detect persons at risk of falling and to prevent or reduce the frequency of falls. To facilitate such approaches, it is essential to find the cause of falling (and under what conditions) of the elderly and the factors that are associated with risk of falling. This study was aimed at designing interventions that minimize risk of falling by ameliorating contributing factors while maintaining or improving patient's mobility.

• 기본간호학회지
• /
• 제21권3호
• /
• pp.264-274
• /
• 2014

Purpose: This study was done to determine inpatient fall rates in an acute hospital setting and to explore risk factors and characteristics across clinical departments. Methods: The medical records and standardized fall reports of 416 patients admitted between January 1 and December 31, 2012 were reviewed. Descriptive statistics and statistical tests were used, including: t-test, ${\chi}^2$-test, ANOVA. Results: The total fall rate per 1,000 inpatient days was 0.49. Fall rate, fall risk factors and characteristics such as age, type of fallers and mean MFS (Morse Fall Scale) differed significantly among clinical departments. Conclusions: The analysis results show that the fall rates, fall risk factors and characteristics of acute hospital inpatient falls varied significantly across clinical departments. The findings of this study suggest that hospitals should consider differences in fall related characteristics across clinical departments when implementation fall prevention strategies and interventions.