老年跌倒骨折患者跌倒恐惧体验的纵向质性研究

Experience of fear of falling in elderly patients with fall-induced fracture:a longitudinal qualitative study

目的探讨老年跌倒骨折患者跌倒恐惧体验的变化,为制订有效的针对性护理干预措施提供参考。方法采用纵向质性研究方法,以目的抽样法选取骨科病房16例老年跌倒骨折患者进行半结构式访谈,并对资料进行横断面和纵向分析。结果共提炼出3个主题及8个亚主题:跌倒恐惧情绪体验的变化(负向情绪发展,正向情绪调节),跌倒恐惧认知体验的变化(成因多元化,自我效能降低),跌倒恐惧应对体验的变化(保持谨慎态度,树立康复信心,提升知识储备,寻求外部支持)。结论老年人跌倒恐惧体验是一个复杂的现象,呈现动态的变化过程,临床医护人员在跌倒预防计划中应早期识别存在跌倒恐惧的老年人,并通过多学科团队实施预防性护理干预。

Objective To explore the change of fear of falling experience in elderly patients with fall-induced fracture,so as to provide reference for developing effective and targeted nursing intervention.Methods The longitudinal qualitative research method was used,and 16 elderly patients with fall-induced fracture in orthopedic department were selected by purpose sampling to conduct semi-structured interview,then the interview data were analyzed cross-sectionally and longitudinally.Results A total of 3 themes and 8 sub-themes were extracted:change in emotional experience of fear of falling(negative emotion development,positive emotion regulation),change in cognitive experience of fear of falling(diversification of causes,decreased self-efficacy),change in coping experience of fear of falling(maintain cautious attitude,build confidence in recovery,improve knowledge reserve,seek external support).Conclusion The experience of fear of falling in the elderly is a complex phenomenon with dynamic change.Clinical medical staff should identify the elderly with fear of falling early and conduct preventive nursing intervention through a multidisciplinary team.