精神障碍患者跌倒危险因素评估及早期干预  

Assessment of Risk Factors and Early Intervention of Tumble in Patients with Mental Disorders

作　　者：张倬秋[1] 江葳[2] 左小凤[1] 

机构地区：[1]四川大学华西医院心理卫生中心,成都610041 [2]四川大学华西医院血液透析中心,成都610041

出　　处：《华西医学》2015年第3期527-530,共4页West China Medical Journal

基　　金：四川省卫生厅科技项目(130016)~~

摘　　要：目的分析比较修订前后的自制跌倒危险因素评估量表在精神障碍患者中的应用,以指导临床工作。方法回顾性分析2012年1月1日-2013年12月31日在精神障碍病房出院的所有2 209例患者,所有患者在入院1 h内均采用"住院患者跌倒危险因素评估及护理措施表"进行评估,总分≥4分的患者表示为跌倒高危,立即进行标准化干预措施。2013年修订了评估量表,增加了双眼视力障碍、依从性低或沟通障碍、躁动不安作为跌倒的高危因素,比较2012年和2013年跌倒评分总分≥4分的患者的差异并比较干预效果。结果 2012年跌倒评分总分≥4分的患者共52例,其中男16例,女36例;年龄<65岁35例,≥65岁17例;器质性精神障碍25例,精神活性物质所致精神障碍10例,精神分裂症12例,其他5例。2013年跌倒评分总分≥4分的患者共154例,其中男58例,女96例;年龄<65岁的142例,≥65岁的12例;器质性精神障碍22例,精神活性物质所致精神障碍8例,精神分裂症120例,其他4例。2013年跌倒评分总分≥4分的患者高于2012年,且年轻患者和精神分裂症患者较多(P<0.05)。2012年发生2例跌倒不良事件,2013年无跌倒不良事件发生。结论认知障碍、依从性低、沟通障碍和躁动不安是精神障碍患者跌倒的高危因素;正确评估,早期干预能有效预防跌到的发生。Objective To compare the application of self-made tumble risk factors assessment scale before and at er its revision in patients with mental disorder, in order to guide the clinical work. Methods We retrospectively analyzed the clinical data of 2 209 patients with mental disorders who were discharged from the hospital between January 1, 2012 and December 31, 2013. All the patients in our hospital underwent the assessment by ＂table of tumble risk factors for hospitalized patients and nursing measures＂ within one hour of admission. A total score of 4 or higher meant high tumble risk, and the standardized intervention measures were taken immediately. In 2013, the assessment scale was revised, and binocular vision disorder, low compliance or communication disorders, restlessness were added as risk factors for tumble. The dif erence among patients with a tumble score of 4 or higher between the year of 2012 and 2013 was compared and analyzed. Results In 2012, 52 patients had a tumble score of 4 or higher, among whom there were 16 males and 36 females; 35 were younger than 65 years old and 17 were older than 65 years. There were 25 patients with organic mental disorders, 10 with spirit obstacle caused by active substance, 12 with schizophrenia, and 5 other cases. In 2013, 154 patients’ tumble score was 4 or higher, among whom there were 58 males and 96 females; 142 were younger than 65 years old and 12 were older than 65. Organic mental disorders occurred in 22 patients, 8 had spirit obstacle caused by active substance, 120 had schizophrenia, and there were 4 other cases. In 2013, the number of patients with a tumble score of 4 or higher were significantly more than that in 2012 and young patients with schizophrenia were also significantly more than in 2012（P 〈 0.05）. There were two cases of tumble adverse events, while no adverse events occurred in tumble in 2013. Conclusions Cognitive impairment, low compliance, communication barriers and restlessness are high risk factors for tumble in patients with menta

关 键 词：精神障碍 跌倒评估 跌倒预防 

分 类 号：R473.74[医药卫生—护理学]