前馈控制在老年脑小血管病步态障碍患者跌倒管理中的应用研究

The application of feedforward control in the fall management of elderly patients with gait disorders caused by cerebral small vessel disease

目的探讨前馈控制在老年脑小血管病步态障碍患者跌倒管理中的应用效果。方法采用便利抽样法选取老年脑小血管病步态障碍患者330例,分为观察组和对照组。对照组实施常规跌倒管理,观察组实施基于前馈控制的跌倒管理模式,建立院内外协同跌倒管理,实现预防跌倒的全程照护。比较两组患者跌倒事件发生率、跌倒所致的损伤程度、患者预防跌倒知信行评分,护士预防跌倒知信行评分。结果患者住院期间、出院后6个月,观察组跌倒事件发生率、跌倒所致损伤程度低于对照组,且观察组患者对预防跌倒的知信行水平高于对照组;护士在前馈控制实施半年后预防跌倒知信行水平高于实施前,差异有统计学意义(P<0.01或P<0.05)。结论神经内科老年脑小血管病步态障碍患者中实施基于前馈控制的跌倒管理,可明显降低跌倒事件的发生率及跌倒损伤程度,有效提高患者及护士预防跌倒的知信行水平,有利于实现患者安全管理目标。

Objective To explore the effect of feedforward control in the fall management of elderly patients with cerebral small vessel disease(CSVD)and gait disorder.Methods A total of 330 elderly CSVD patients with gait disorder were selected and divided into the observation group and the control group by convenient sampling method.The control group implemented the routine fall management,and based on feedforward control,the observation group implemented the fall prevention management mode,established the coordinated fall management inside and outside the hospital,and achieved the whole process of fall prevention care.The rate of fall events,the degree of injury caused by falls,the scores of patients and nurses on knowledge,attitude and practice of fall prevention were compared between the two groups.Results During hospitalization and 6 months after discharge,the rate of fall events and the degree of injury after fall in the observation group were lower than those in the control group,and the level of knowledge,attitude and practice on fall prevention in the observation group was higher than that in the control group.After feedforward control was implemented for half a year,the nurses'level of knowledge,attitude and practice on fall prevention was higher than the initial stage,and the difference was statistically significant(P<0.01 or P<0.05).Conclusion The implementation of feedforward control based fall prevention management in elderly CSVD patients with gait disorder in neurology department can significantly reduce the incidence of fall events and the degree of fall injury,effectively improve the knowledge,attitude and practice level of patients and nurses to prevent falls,and is conducive to achieving the goal of patient safety management.