• 임상간호연구
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• 제23권3호
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• pp.388-397
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• 2017

Purpose: The purpose of this study was to explore the effects of the lower limb muscle strength exercise program during hemodialysis on the leg strength and falls efficacy (fall-related self-efficacy) of hemodialysis patients. Methods: The study was designed to be a quasi-experimental, nonequivalent control group pre and post test design. A total of 42 patients participated in the study. We applied lower limb muscle strength exercise program to the experimental group in every hemodialysis three times a week for 8 weeks. Data were analyzed using ${\chi}^2$ test, fisher's exact test, t-test and repeated measures ANOVA. Results: The mean age was 58 years old (t=-1.54, p=.132), the mean hemodialysis period was 67 months (t=1.949, p=.058) and there was no significant difference of dependent variable (t=1.17, p=.251)(t=-.89, p=.381) between the two groups before the experiment. After the experiment, leg strength was significantly improved in the experimental group compared to that of the control group (F=6.63, p=.004). However, falls efficacy was not significantly different between the experimental group and the control group (F=2.33, p=.104). Conclusion: The study results indicated that the lower limb muscle strength exercise program during hemodialysis may improve leg strength and potentially to prevent falls for hemodialysis patients. Further studies are warranted in which larger number of participants and longer duration of intervention are recommended.

• Journal of Trauma and Injury
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• 제28권4호
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• pp.248-255
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• 2015

Purpose: study of the mutual influence of the individual anatomical regions damage in patients associated with falls from heights. Methods: 561 medical reports of patients associated with falls from heights admitted to Republican Research Center of Emergency Medicine (RRCEM), in period of 2010-2013 yy, were analyzed retrospectively. Patient's age range was from 15 to 89. Treatment of these patients held in three stages: period of acute disorders of vital functions; relative stabilization period; stabilization of vital functions. The scope and content of medical diagnostic procedures performed on pre-hospital and intensive care stages. The severity of each injury was scored according to the AIS scale, the total severity of lesions was scored by points due to ISS. Digital material is treated by methods of mathematical statistics. Results: Falls from heights leads to associated injuries for 4 times more than isolated trauma, and increases according to height of fall and falling surface. Patients with TBI+chest trauma, are most serious contingent that has highest mortality and complications (36.8%). TBI+musculoskeletal system trauma are characterized by high blood loss, traumatic shock and fat embolism, forming a vicious circle. Conclusion: in patients associated with falls from heights clinical manifestations of injuries mutual aggravation syndrome will be seen. TBI leads to complication of chest trauma, delayed diagnostics of abdominal and chest trauma, aggravation of coma condition. Developing of high blood loss and fat embolism in musculoskeletal system trauma leads to shock and pulmonary embolism, which increases probability of death in the presence of abdominal or chest trauma, but abdominal trauma or chest trauma has no significant effect on the severity of the musculoskeletal system trauma.

• 간호행정학회지
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• 제17권4호
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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.

• Physical Therapy Rehabilitation Science
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• 제7권2호
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• pp.54-60
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• 2018

Objective: Persons with chronic stroke fall more often than healthy elderly individuals. The Timed Up and Go test (TUG) is used as a fall prediction tool, but only provides a result for the total measurement time. This study aimed to determine the optimal cut-off values for each of the 6 components of the TUG. Design: Retrospective study. Methods: Thirty persons with chronic stroke participated in the study. TUG evaluation was performed using a wearable miniaturized inertial sensor. Sensitivity, specificity, and predictive values were calculated using the Receiver Operating Characteristic (ROC) curve analysis for the measured values in each section. Optimal values for fall risk classification were determined. Logistic regression analysis was used to investigate the risk of future falls based on TUG. Results: The cut-off values of the 6 sections of the TUG were determined, as follows: sit-to-stand >2.00 seconds (p<0.05), forward gait >4.68 seconds (p<0.05), mid-turn >3.82 seconds (p<0.05), return gait >4.81 seconds (p<0.05), end-turn >2.95 seconds (p<0.05), and stand-to-sit >2.13 seconds (p<0.05). The risk of falling increased by 2.278 times when the mid-turn value was >3.82 seconds (p<0.05). Conclusions: The risk of falls increased by 2.28 times when the value of the mid-turn interval exceeded 3.82 seconds. Therefore, when interpreting TUG results, the predictive accuracy for falls will be higher when the measurement time for each section is analyzed, together with the total time for TUG.

• 한국직업건강간호학회지
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• 제32권2호
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• pp.79-88
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• 2023

Purpose: This study aims to identify the factors that influence the experience of falls among older adults living in the community. Methods: The study participants were 70,887 65-year-olds who participated in the 2021 Community Health Survey. The study employed the Rao-scott x 2 test to examine the variation in fall experiences based on the characteristics of the older adults. Multiple logistic regression analysis was conducted to investigate these characteristics' impact on older adults' fall experiences. Results: The proportion of subjects in fall experience was 16.6%. The factors influencing the subject's fall experience were sex (odds ratio [OR]=1.47, 95% confidence interval [CI]=1.37~1.57), age (OR=1.48, 95% CI=1.34~1.65), family structure (OR=1.23, 95% CI=1.15~1.31), body mass index (OR=1.13, 95% CI=1.06~1.20), diabetes (OR=1.12, 95% CI=1.06~1.20), depression experiences (OR=1.56, 95% CI=1.42~1.70), stress (OR=1.12, 95% CI=1.05~1.19), subjective health status (OR=1.77, 95% CI=1.63~1.92), life satisfaction (OR=1.57, 95% CI=1.41~1.76), and chewing discomfort (OR=1.29, 95% CI=1.21~1.38). Conclusion: Efforts should be made to effectively educate and develop various programs aimed at reducing falls among older adults. It is essential to emphasize the importance of continuous and active attention to falls in the older adult population.

• 성인간호학회지
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• 제27권5호
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• pp.559-571
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• 2015

Purpose: This study is to determine the predictive validity of the St. Thomas Risk Assessment Tool in Falling Elderly Inpatients (STRATIFY) for inpatients' fall risk. Methods: A literature search was performed to identify all studies published between 1946 and 2014 from periodicals indexed in Ovid Medline, Embase, CINAHL, KoreaMed, NDSL and other databases, using the following key words; 'fall', 'fall risk assessment', 'fall screening', 'mobility scale', and 'risk assessment tool'. The QUADAS-II was applied to assess the internal validity of the diagnostic studies. Fourteen studies were analyzed using meta-analysis with MetaDisc 1.4. Results: The predictive validity of STRATIFY was as follows; pooled sensitivity .75 (95% CI: 0.72~0.78), pooled specificity .69 (95% CI: 0.69~0.70) respectively. In addition, the pooled sensitivity in the study that targets only the over 65 years of age was .89 (95% CI: 0.85~0.93). Conclusion: The STRATIFY's predictive validity for fall risk is at a moderate level. Although there is a limit to interpret the results for heterogeneity between the literature, STRATIFY is an appropriate tool to apply to hospitalized patients of the elderly at a potential risk of accidental fall in a hospital.

• 성인간호학회지
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• 제27권1호
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• pp.29-38
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• 2015

Purpose: The purpose of the study was to validate fall risk assessment scales among hospitalized adult patients in South Korea using the electronic medical records by comparing sensitivity, specificity, positive predictive values, and negative predictive values of Morse Fall Scale (MFS), Bobath Memorial Hospital Fall Risk Assessment Scale (BMFRAS), and Johns Hopkins Hospital Fall Risk Assessment tool (JHFRAT). Methods: A total of 120 patients who experienced fall episodes during their hospitalization from June 2010 to December 2013 was categorized into the fall group. Another 120 patients, who didn't experience fall episodes with age, sex, clinical departments, and the type of wards matched with the fall group, were categorized to the comparison group. Data were analyzed for the comparisons of sensitivity, specificity, positive and negative predictive values, and the area under the curve of the three tools. Results: MFS at a cut-off score of 48 had .806 for ROC curves, 76.7% for sensitivity, 77.5% for specificity, 77.3% for positive predictive value, and 76.9% for negative predictive value, which were the highest values among the three fall assessment scales. Conclusion: The MFS with the highest score and the highest discrimination was evaluated to be suitable and reasonable for predicting falls of inpatients in med-surg units of university hospitals.

• 대한물리의학회지
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• 제15권1호
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• pp.33-42
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• 2020

PURPOSE: This study examined the effects of a whole body vibration-exercise program on the muscle strength, balance, and falling efficacy of super-aged women. METHODS: Thirty participants, who are over 75 years of age, were recruited. They were assigned randomly to an experimental group (n=15), which received whole body vibration exercise, and a control group (n=15), which received an exercise program that did not include vibration. The interventions lasted for four weeks, three times a day, and 25 minutes per session. To compare the effects of the intervention, a 30-second chair stand test (CST), Korean version of Berg balance scale (K-BBS), functional reach test (FRT), timed up and go test (TUG), and Korean version of the falls efficacy scale (K-FES) was used. RESULTS: The experimental group showed a significant increase (p.<05) before and after the intervention in the chair stand test (CST), Korean version of the Berg balance scale (K-BBS), functional reach test (FRT), timed up-and-go (TUG), and Korean version of the fall efficacy scale (K-FES). Compared to the control group, the experiment group showed a more significant increase (p.<05) in the CST, K-BBS, and FRT. CONCLUSION: A whole body vibration exercise program could be suggested as an effective intervention method for muscle and balance strengthening for super-aged women.

• 성인간호학회지
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• 제25권1호
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• pp.74-82
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• 2013

Purpose: The purpose of this study was to identify the fall risk factors and to evaluate the effectiveness of the Morse Fall Scale(MFS) as an assessment tool among hospitalized inpatients. Methods: The medical records of a total of 294 patients who admitted to hospital from January 1 to December 31, 2010 were reviewed. One hundred forth seven patients who had experienced fall were matched with 147 patients who have never experienced fall. The fall information was obtained from electronic medical records and fall reports. Results: There were significant differences in visual disturbances, pain, emotional disturbances, sleep disorder, urination problems and elimination disorder at admission between fallers and non-fallers. Patients who had higher MFS scores at admission were more likely to fall as compared to the patients with lower MFS scores. When falls did occur, these occurred within five days following admission, in the patient room, among patients with alert mental status, and among patients who were ambulant with some assistance. Conclusion: The findings of this study support the need of using risk assessment tool for predicting risk for falls. This finding can be used as a useful resource to develop nursing intervention strategies for fall prevention at the hospital.

• 한국간호교육학회지
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• 제23권4호
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• pp.398-408
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• 2017

Purpose: This study aims to identify the effect of pediatric fall prevention education with leaflets and picture books on the fall-related knowledge and preventive behaviors in caregivers of inpatient children. Methods: This study is a non-equivalent control group non-synchronized design. It divided 62 caregivers of inpatient children aged 5 and under into an experimental group and a control group in P general hospital located in B City. Results: Fall related knowledge score in the experimental group was increased by 2 points after the intervention and the score in the comparison group was increased by 0.1 points. The difference after the intervention in fall related knowledge scores between the two groups was statistically significant (t=7.67, p<.001). The fall related prevention behavior score of the experimental group increased by 9.3 points after the intervention, and the score of the comparison group increased by 2.5 points. The difference in the scores of fall related prevention behaviors between the two groups was statistically significant (t=5.71, p<.001). Conclusion: Pediatric inpatient fall prevention education using leaflets and picture books can improve caregivers' fall-related knowledge and preventive behaviors. In turn, this can reduce children's falls in pediatric wards in general hospitals.