跌倒恐惧对老年糖尿病患者生活空间移动的影响及阈值效应研究  

Impact of fear of falling on life-space mobility and its threshold effect in elderly diabetic patients

作　　者：张海燕 于卫华 张利 邓曼 杨侠 张雨溪 Zhang Haiyan;Yu Weihua;Zhang Li;Deng Man;Yang Xia;Zhang Yuxi(School of Nursing,Anhui Medical University,Hefei 230001,China)

机构地区：[1]安徽医科大学护理学院,安徽合肥230001 [2]安徽医科大学第三附属医院,安徽合肥230001

出　　处：《护理学杂志》2023年第20期20-24,共5页Journal of Nursing Science

基　　金：科技部重点研发计划项目(2020YFC2008802);安徽医科大学研究生科研与实践创新项目(YJS20230066);安徽医科大学护理学院研究生青苗培育项目(hlqm12023040)。

摘　　要：目的 探讨跌倒恐惧对老年糖尿病患者生活空间移动性的影响及阈值效应。方法 对435例老年糖尿病患者采用一般资料问卷、修订版跌倒效能量表(测评跌倒恐惧)、生活空间评估表进行调查,行单因素分析、分层logistic回归分析、建立平滑拟合曲线分析阈值效应,探索影响因素与影响程度。结果 患者生活空间移动得分59.13±14.14,45.7%存在生活空间移动受限。跌倒效能得分7.55±1.44。分层logistic回归分析显示,跌倒恐惧、户外环境感知、糖尿病并发症是生活空间移动受限的主要影响因素(均P<0.05)。拟合曲线及阈值效应分析显示,跌倒效能得分≤6.50时生活空间移动水平不受影响(P>0.05),跌倒效能得分>6.50分时生活空间移动水平随跌倒效能得分的增加而增加(P<0.05)。结论 老年糖尿病患者生活空间移动受限比例较高,跌倒效能处于中等水平,跌倒效能得分>6.50可作为患者具有活动自信心的节点,制定安全活动干预措施还应综合考虑环境与糖尿病并发症的影响。Objective To investigate the effect of fear of falling(FOF)on life-space mobility(LSM)and its threshold effect in older adults with diabetes mellitus(DM).Methods A total of 435 elderly DM patients were investigated using a general information questionnaire,the Modified Falls Efficacy Scale(MFES)(to measure FOF),and the Life-Space Assessment(LSA)scale.Univariate analysis,hierarchical logistic regression analysis,and smoothed fitted curve were used to analyze threshold effects and explore the influencing factors and degree of influence.Results The LSA score was 59.13±14.14,and 45.7%of the participants had LSM restriction.The FOF score was 7.55±1.44.Hierarchical logistic regression analysis showed that FOF,perception of the outdoor environment and diabetic complications were the main factors influencing LSM restriction(all P<0.05).The fitted curve and threshold effect analysis showed that the level of LSM was not affected by FOF score≤6.50(P>0.05),and it was increased with increasing FOF score>6.50(P<0.05).Conclusion Older DM adults have a high proportion of impaired LSM and a medium level of FOF.FOF score>6.50 can be used as a cut-off value for predicting confidence in activities among older DM patients,and the influence of the environment and diabetes complications should be taken into account when developing safe activity interventions.

关 键 词：老年人 糖尿病 跌倒恐惧 生活空间移动性 阈值效应 影响因素 调查分析 

分 类 号：R473.5[医药卫生—护理学] R471[医药卫生—临床医学]