社区与住院老年人跌倒的现状及影响因素  

Status and related factors of fall among the elderly in community and hospital

作　　者：刘晓燕[1] 丁霞[3] 董晨 李荣 孙驰 LIU Xiaoyan;DING Xia;DONG Chen;LI Rong;SUN Chi(Department of Geriatrics,Affiliated Hospital of Nantong University,Nantong,Jiangsu 226001,China;Clinical Medical Research Center,Affiliated Hospital of Nantong University,Nantong,Jiangsu 226001,China;Affiliated Hospital of Nantong University Medical Union Tiansheng Gang Community Health Service Center,Nantong,Jiangsu 226001,China;Nursing School,Nantong University,Nantong,Jiangsu 226001,China)

机构地区：[1]南通大学附属医院老年医学科,江苏南通市226001 [2]南通大学附属医院临床医学中心,江苏南通市226001 [3]南通大学附属医院医联体天生港社区卫生服务中心,江苏南通市226001 [4]南通大学护理学院,江苏南通市226001

出　　处：《中国康复理论与实践》2022年第4期389-398,共10页Chinese Journal of Rehabilitation Theory and Practice

基　　金：南通市科技指导项目(No.MSZ20019)。

摘　　要：目的分析社区和住院老年人跌倒的影响因素。方法2021年5月至9月,采用随机系统抽样方法在南通大学附属医院医联体天生港社区卫生服务中心抽取50例社区老年人,在老年医学科抽取50例住院老年人,分别进行面对面问卷调查,并进行老年综合评估和血液、神经肌骨B超测试。采用单变量和多变量Logistic回归分析1年内有跌倒史的社区和住院老年人的跌倒现状及影响因素情况。结果住院与社区老年人在跌倒史、Morse跌倒风险评估量表(MFS)评分、因跌倒史住院方面均有显著性差异(χ^(2)>6.250,Z=-3.132,P<0.05)。除跌倒相关因素外,年龄、生活自理能力、国际尿失禁咨询委员会尿失禁问卷表简表(ICI-Q-SF)评分、衰弱指数(FI)、身体活动快速评估(RAPA)部分2评分、健康调查简表(SF-36)评分、纽芬兰纪念大学幸福度量表(MUNSH)评分、腰臀比、臂围、腿围、红细胞计数、红细胞压积、血红蛋白和甘油三酯均与住院老年人跌倒有关(|Z|>0.462,χ^(2)=7.447,P<0.05);老年抑郁量表(GDS)-15评分、MFS评分、FI、SF-36评分和握力均与社区老年人跌倒有关(|Z|>1.758,χ^(2)=6.640,P<0.05)。多因素Logistic回归分析结果显示,住院老年人1年内有跌倒史的跌倒影响因素有年龄、MFS评分、FI、臂围、腿围、SF-36评分、血红蛋白和甘油三酯(P<0.05);社区老年人的跌倒影响因素有GDS-15评分、MFS评分、FI、握力、SF-36评分和MUNSH评分(P<0.05)。此外,住院和社区老年人发生跌倒后SF-36评分和MUNSH评分均降低(t=-3.108,Z>2.567,P<0.05)。结论住院老年人跌倒发生率、因跌倒住院率以及跌倒风险均较社区老年人高,影响因素各不相同。医护及社区、家庭成员应针对相应的影响因素进行干预,减少跌倒的发生。Objective To investigate the related factors of fall among community-dwelling and hospitalized elderly.Methods From May to September,2021,50 elderly from Tianshenggang Community Health Service Center of Medical Union of Nantong University Affiliated Hospital and 50 elderly in the first ward of Geriatrics Department of Nantong University Affiliated Hospital were selected by random systematic sampling method.Face-to-face questionnaire survey was conducted respectively.All the participants underwent a comprehensive geriatric assessment and blood,neuromusculoskeletal B-ultrasound tests.Univariate and multivariate Logistic regression were used to analyze the status and related factors of falls among community and hospitalized elderly with a history of falls within one year.Results There were significant differences in fall history,the score of Morse Fall Scale(MFS)and hospitalization due to fall history between the hospitalized elderly and the community-dwelling elderly(χ^(2)>6.250,Z=-3.132,P<0.05).In addition to fall related factors,age,ability of self-care,the score of International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form(ICI-Q-SF),frailty index(FI),the score of Rapid Assessment of Physical Activity(RAPA)part 2,the score of Short Form of Health Survey(SF-36),the score of Memorial University of Newfoudland Scale of Happiness(MUNSH),waist-to-hip ratio,arm and leg circumferences,red blood cell count,hemoglobin and triglyceride were the related factors of fall in hospitalized elderly(|Z|>0.462,χ^(2)=7.447,P<0.05).The scores of Geriatric Depression Scale(GDS)-15,MFS,FI and SF-36,and grip strength were the related factors of fall in community-dwelling elderly(|Z|>1.758,χ^(2)=6.640,P<0.05).Multivariate Logistic regression analysis showed that the risk factors for falls in hospitalized elderly within one year were age,the score of MFS,FI,arm and leg circumferences,the score of SF-36,hemoglobin and triglyceride.The related factors of falls in community-dwelling elderly included the score

关 键 词：社区 住院 老年人 跌倒 影响因素 

分 类 号：R592[医药卫生—老年医学]