健康教育及环境评估对预防老年跌倒的效果观察

Effect of health education and environmental assessment on prevention of falls among the elderly

目的通过健康教育及居家环境评估提升老年人的防跌倒知识和技能,去除老年人致跌高危行为,改善居家环境,降低社区老年人跌倒伤害发生率。方法抽取位于虹口区南、中、北的6个居委共1306个无精神疾病、无肢体障碍的60岁及以上的老年人,随机分为干预组和对照组,对干预组的老人干预一年半,主要包含健康教育、环境评估与改造等措施,对照组未采取任何干预措施。结果干预后,干预组跌倒发生率为11.62%,低于对照组的15.03%,差异有统计学意义(P<0.05);干预后,干预组"跌倒是可以预防的"认知的正确率为94.76%,高于对照组的82.44%,差异有统计学意义(P<0.01);干预组认为"适当的体育活动可以减少老年人跌倒"的百分率为54.83%,高于对照组的40.98%,差异有统计学意义(P<0.01);居家环境有明显的改善,其中"浴缸/淋浴房无防滑垫"由干预前的72.38%下降为干预后的24.29%、"浴缸/淋浴房旁无扶手"由87.96%降为72.67%,差异均有统计学意义(P<0.01)。结论健康教育、环境评估是有效预防老年跌倒的重要手段。

Objective To improve the anti-fall knowledge and skills through health education and home environment assessment among the elderly,and reduce the incidence of fall.Methods A total of 1306 elderly people aged 60 and over who had no mental illness and no physical disabilities in 6 neighborhood communities in the south,middle and north of Hongkou District were selected.Then they were randomly divided into intervention group and control group.The intervention was carried out for one and a half years,and mainly including health education,environmental assessment and transformation measures,the control group did not take any intervention measures.Results The incidence of falls in the intervention group was 11.62%after intervention,which was lower than that of the control group(15.03%).The difference was statistically significant(P<0.05).After the intervention,the correct rate of recognition to"falling is preventable"was 94.76%in the intervention group,which was higher than the control group(82.44%).The difference was statistically significant(P<0.01).The percentage of"appropriate physical activity can reduce the fall of the elderly"in intervention group was54.83%,higher than that of the control group(40.98%),and the difference was statistically significant(P<0.01).The home environment had been significantly improved,including"no anti-slip mat in the bathtub/shower room"from 72.38%to 24.29%after the intervention,"bathtub"/No handrails next to the shower room decreased from 87.96%to 72.67%,the difference was statistically significant(P<0.01).Conclusion Health education and environmental assessment are important measurements to prevent falls in old age effectively.