Can an evidence-based fall prevention program be translated for use in culturally diverse communities?

Older adult falls are a significant public health problem,but one that is amenable to preventive interventions.1,2 Despite the progress made in identifying risk factors,developing efficacious health-related interventions,and promoting evidencebased programs in the community,much work remains before these strategies are broadly available and effectively used to reduce fall-related injuries.3 As Newton and ScottFindlay4 have pointed out,the translation of basic scientific knowledge into clinical studies,and the transformation of clinical studies into improvements in health services and public health practices,remain major obstacles to widespread adoption.

Development of a fall prevention protocol for replication in a virtual environment

Several effective fall prevention exercise programs address the problem of falls. The primary challenge is not to develop effective programs, but to find ways to motivate older people to begin and maintain these programs while delivering these programs to as many older adults as possible. This short-term pilot study collected preliminary data on the design and testing of a balance rehabilitation protocol that could be replicated in a virtual gaming environment like the Wii Fit. The protocol, based on evidence- based practice, focused on strength, endurance, and functional reach. Eight older adults participated in twelve one hour sessions with an occupational therapist and exercise professional. Outcome measures included the Modified Falls Efficacy Scale, Life Space Questionnaire, and postural sway. Results suggest that the protocol was effective in improving postural sway (as measured by a force plate), reducing fear of falling, and increasing perceived life space.

Fall Prevention Education Reduces the Falling Rate on the Osteoporosis Patients Treated with Zoledronic Acid

Objective: Falls are one of the most common direct causes of fractures which are major causes of morbidity and mortality in osteoporosis patient. There are many factors related to falls, by interfering of fall prevention education on the patients with osteoporosis, our study is to investigate whether fall prevention education can reduce the falling rate on the osteoporosis patients treated with zoledronic acid. Methods: A total of 178 eligible female patients who first visited our osteoporosis department during January 2016 to June 2017 were invited to participate in this study, and all participants were randomly divided into an observation group (92 cases) and an intervention group (86 cases). All patients were administrated zoledronic acid once and received a questionnaire survey about factors related to falls at the beginning and a year later. The patients in the observation group only received regular orders of adopting a healthy lifestyle while those in the intervention group received fall prevention assessment and education, and a telephone follow-up and reinforced fall prevention education a month after discharge. A year later, relevant data regarding the falls of each patient of both groups during the year and the data of the questionnaire survey were collected for intergroup comparison. Results: The difference of the improvement of fall risk factors between the two groups is statistically significant (P Conclusion: For an osteoporosis patient treated with zoledronic acid, fall prevention education is an effective method to reduce the risk of falling, which would result in a lower risk of fractures and a better prognosis.

Proposal of Walking to Prevent a Fall of a Planetary Exploration Legged Rover Using Effect of Loose Soil Caused by a Propagation of Vibration

In this study,a walking method that prevents a fall of the planetary exploration-legged rover is proposed.In the proposed walking method,the leg is sunk by giving vibration to the ground.The posture of the rover is changed to prevent a fall of the rover by sinking the leg.First,the relationship between the kind of vibration and the subsidence of the leg is confirmed.In this experimental result,the leg is shown to be easy to sink to the ground by giving vibration.Moreover,the larger the vibratory force is,the easier the leg sinks to the ground.Finally,the legged testbed walks on the loose ground with a slope using the proposed walking method.In this experimental result,the testbed is difficult to fall down when it uses the proposed walking.Moreover,the angle of a slope that the testbed can walk becomes large by using the proposed walking.

Hourly Rounding and Fall Prevention among the Elderly in Long Term Care: A change Process

Long term care facilities have a rising rate of falls and fall related injuries with increasing cost and more hospitalization.Hourly rounding®is an evidenced based intervention that is proactive for nursing staff to be able to identify patient’s needs.This helps with positive fall prevention out­come.This project focused on process improvement efforts for 10 weeks and examining the education and implementation of an evidenced-based hourly rounding program that assisted in reducing the number of falls in the pilot unit.The implementation of the intervention took place in a long-term care facility located in Dallas,Georgia.The hourly rounding tools used in this project were the Studer Group hourly rounding log and competency checklist with permission.Twenty staff members were in­cluded in the sample,age 18 years and 60 years.The unit has 41 residents who were included in the pilot case study design.Staff members were first educated regarding hourly rounding and documentation on the hourly rounding log was done two days before implementation and the pre and post fall rate was retrieved from the facilities fall database.Competency checklist was completed prior to implementation and post implementa­tion to evaluate staff understanding of the main tenets of the 4 P’s(potty,pain,possession,and position).For this project,descriptive statistics was used to help determine fall rates.Minitab was used to analyzed data and to determine if it was clinically significant.In the ten weeks following the hourly rounding implementation,participants performed hourly rounding by incorporating it to each resident’s daily routine and documented their rounds on the log sheet.The results indicated that it is statistically signifi­cant and with a P-values=-<0.0001 and t-value=-5.81.

Clinical Characteristics and Prevention Strategies of Falls in Hospitalized Patients with Chronic Kidney Disease

Objectives: To analyze the clinical features of falls in hospitalized patients with chronic kidney disease (CKD), and to provide basis for preventing the occurrence of falls in hospitalized patients with CKD. Method: A retrospective study was conducted to analyze the 27 adverse events of falls in hospitalized patients from the department of nephrology in Peking University Shenzhen Hospital during May 2009 and May 2019. Results: Among the 27 patients with falls, people over 65 years old accounted for 55.56%;74.07% of the patients had caregivers;the peak period of falls was from June to August, accounting for 40.74%, mainly occurring from 7:00 to 8:00, 12:00 to 13:30 and 19:00 to 21:00;the locations of falls were mostly near the bed and in the bathroom, accounting for 33.33% and 22.22%, respectively;suffering from anemia, hypoproteinemia, abnormal serum potassium, calcium-phosphorus metabolism disorders accompanied by abnormal parathyroid hormone and hypertension accounted for 88.89%, 85.19%, 29.63%, 96.30% and 81.48% respectively. The inpatients on dialysis therapy accounted for 66.67%. Conclusion: The occurrence of falls in hospitalized patients with CKD was not only related to age, caregivers, time, months, locations or other conventional factors, but also the complications and dialysis therapies. To effectively reduce the occurrence of falls, it’s necessary to enhance the sense of safety and responsibility of caregivers. Besides, nurses should strengthen the inspection of wards for inpatients engaging in some intensive activities, and nurses should also pay more attention to the inpatients with anemia, hypoproteinemia, calcium-phosphorus metabolism disorders and those on dialysis therapies.

Cultural Sensitivity of a Community-Based Falls Prevention Program Targeting Older Arab American

Falls are a frequent and costly cause of injuries and functional decline in the elderly. Tai Chi is a cost-effective strategy for preventing falls in older adults. Many senior centers have introduced Tai Chi programs to increase mobility and decrease the risk of falls. However, the practice has yet to be widely disseminated to ethnic minorities who are not culturally connected to Tai Chi. This paper describes implementation barriers and recruitment and retention challenges of Arab American participants in a Tai Chi intervention-based health promotion program, including issues related to community organization and staffing, recruitment and retention, need for building relationships, need for translation and interpreters, and cultural barriers & misconceptions. Understanding and paying adequate attention to these challenges may help facilitate in planning other health promotion interventions targeting Arab American population.

肿瘤患者跌倒风险感知量表的编制及信效度检验

目的编制肿瘤患者跌倒风险感知量表并检验信效度,为肿瘤患者跌倒防范提供自评工具。方法通过文献回顾、专家函询、小组讨论等方式构建量表,选取407例肿瘤患者进行调查,检验量表信效度。结果肿瘤患者跌倒风险感知量表包括跌倒认知易感知性(5个条目)、生理状况易感知性(12个条目)、个人活动易感知性(5个条目)、环境因素易感知性(5个条目)、跌倒严重性感知(3个条目)5个维度共30个条目。探索性因子分析提取5个公因子,累计方差贡献率66.746%。量表总的Cronbach′sα系数为0.926,折半信度为0.672,各维度Cronbach′sα系数为0.914~0.970,折半信度为0.877~0.963。量表水平的内容效度指数为0.867,条目水平的内容效度指数为0.813~1.000。验证性因子分析结果显示,χ^(2)/df=1.845,RMSEA=0.059,GFI=0.840,CFI=0.971,NFI=0.939,AGFI=0.811,模型适配良好;AVE平方根均显著大于相关系数,各维度之间有显著相关性(均P<0.05)。结论肿瘤患者跌倒风险感知量表信效度良好,可用于肿瘤患者跌倒风险感知的评估。

预防住院病人跌倒智能预警体系的构建与应用效果评价

目的:探讨构建的智能预警体系在预防住院病人跌倒中的应用效果。方法:回顾性调取智能预警体系构建前(2019年11月—2020年10月)的住院病人为对照组,选取智能预警体系构建后(2021年4月—2022年3月)的住院病人为观察组。对照组依据住院病人跌倒管理质量评价标准要求,落实住院病人跌倒管理。观察组在对照组的基础上构建预防住院病人跌倒的智能预警体系并应用,比较两组住院病人跌倒管理落实率及单项正确率、跌倒发生率。结果:两组病人跌倒护理质量管理评价标准单项正确率及落实率观察组均高于对照组(P<0.01),观察组跌倒发生率低于对照组(P<0.05)。结论:构建高效、安全的跌倒智能预警体系,通过高危筛查、实时监控、预警提示、反馈处理的信息化管理模式,有效提高了护士对病人跌倒风险管理的及时性、准确性,实现临床护理管理的智能化、高效化、精细化、科学化,确保病人安全。

基于“安全-支持-合作”模式的高危跌倒护理方案在神经内科中的应用效果

目的 探讨基于“安全-支持-合作”模式的高危跌倒护理方案在神经内科的应用效果。方法 选取2022年3月至2023年3月在钦州市第二人民医院神经内科接受治疗的患者200例,随机分为对照组和观察组,每组100例,给予对照组常规护理,观察组于对照组基础上行基于“安全-支持-合作”模式的高危跌倒护理方案,对比2组护理方法对患者跌倒预防自我管理能力(《预防跌倒自我管理行为调查问卷》评价)、跌倒风险(Morese跌倒评估量表评估)、跌倒发生率、护理满意度(纽卡斯尔护理服务满意度量表评价)的影响。结果 2组护理前的《预防跌倒自我管理行为调查问卷》、跌倒风险比较,差异无统计学意义(P>0.05);2组护理后的《预防跌倒自我管理行为调查问卷》高于护理前,且观察组高于对照组;跌倒风险则低于护理前,且观察组低于对照组(P<0.05)。观察组跌倒发生率低于对照组(P<0.05)。观察组护理满意度高于对照组(P<0.05)。结论 基于“安全-支持-合作”模式的高危跌倒护理方案应用于神经内科中可有效改善患者跌倒预防自我管理能力,降低跌倒风险,减少跌倒的发生,并提高患者护理满意度。

住院患者跌倒预防相关临床实践指南的质量评价及推荐意见总结

目的对国内外住院患者跌倒预防相关临床实践指南进行质量评价和推荐意见总结。方法系统检索国内外指南网、医学文献数据库以及专业学术网站,应用相应评价工具对纳入指南和专家共识进行质量评价,并汇总相关推荐内容。检索时限为建库至2022年12月13日。结果共纳入9篇指南和5篇专家共识,9篇指南在AGREE II 6个领域得分为范围和目的94.03%、清晰性73.86%、参与人员76.07%、严谨性80.19%、应用性69.34%、独立性63.88%,其中5篇为A级推荐、4篇为B级推荐;3篇专家共识中的质量评价结果中条目1~6均为“是”,其余2篇条目1~4均为“是”,条目5~6分别为“否”和“不清楚”,5篇专家共识质量评价结果均为“纳入”。经内容整理,住院患者跌倒预防相关内容包括环境改善、跌倒风险评估、跌倒干预及跌倒后处理、药物审查、物理训练、保护器具的使用、营养支持、健康宣教8个方面,28项内容。结论本研究纳入的住院患者跌倒预防指南整体质量较好但仍有待提高,对临床护理人员预防患者跌倒、提高护理质量有一定的指导意义。

PDCA循环管理模式用于预防住院患者跌倒效果分析

目的分析PDCA循环管理模式用于预防住院患者跌倒的效果。方法选取医院2022年6月至2023年9月收治的住院患者70例,随机分为观察组和对照组,各35例。对照组行常规管理模式,观察组行PDCA循环管理模。结果与对照组比较,观察组护士防范跌倒考核分数、患者防跌倒知识知晓率、护理质量评分显著升高(P<0.05),跌倒率显著降低(P<0.05)。结论PDCA循环管理模式用于预防住院患者跌倒的效果好,可有效提升护理人员应对应急情况的能力,提升患者防跌倒认知,强化护理服务质量。

一种酿酒车间用窖池防跌落安全防护装置的设计与实现

分析了一种酿酒车间用窖池防跌落安全防护装置,其主要包括防护布和框架等部分;其中,框架由主梁和插梁组成,主梁的末端可插入到插梁的插口内并通过插钉实现相对固定,主梁和插梁上均设置有卡扣、万向轮和插孔。防护布主要由高强度的无纺布组成,防护布的尺寸略小于框架的尺寸,并与窖池上口的尺寸相当;防护布的四边均设置有卡环,并于框架上对应设置的卡扣配合使用。该装置的结构简单、设计合理、可方便拆卸、组合与移动;同时,该装置主要布置在空窖池的上方,以实现防止酿酒工人跌落到窖池内的安全事故,也可以有效防止杂物进入空窖池以及窖池内部窖泥的水分散失。

结合案例情景模拟在康复科高危跌倒患者跌倒管理中的应用

目的探讨结合案例情景模拟在康复科高危跌倒患者跌倒管理中的应用。方法选择2020年1~12月皖南医学院第二附属医院康复医学科住院治疗的高危跌倒患者70例为研究对象,采用抽签法随机分为干预组和对照组,每组35例。对照组给予常规预防跌倒知识和技能教育,干预组在对照组基础上实施结合案例情景模拟教育。比较两组患者防跌倒知识和行为水平、跌倒发生率及伤害发生情况的差异。结果干预前,两组预防跌倒知识和行为得分比较,差异均无统计学意义(P>0.05);干预后,干预组预防跌倒知识得分、行为得分均高于对照组(P<0.05),干预组干预前后预防跌倒知识差值、行为差值均高于对照组,差异均有统计学意义(P<0.05)。干预后,患者跌倒发生率从1.18%降至0.146%,差异有统计学意义(P<0.05);2级以上伤害发生率从75%降至0。结论结合案例情景模拟能提高康复科高危跌倒患者防跌倒知识及技能水平,降低跌倒发生率和2级及以上伤害发生率,值得临床推广使用。

计划行为理论视角下老年住院患者跌倒预防行为意向的质性研究

目的基于计划行为理论探讨老年住院患者跌倒预防行为意向,旨在为老年住院患者制定跌倒预防临床干预方案提供依据。方法基于计划行为理论框架制定访谈提纲,于2024年1-2月选择武汉市中心医院神经内科、康复医学科和老年科的14例老年患者为研究对象,进行半结构化访谈,采用内容分析法对资料进行分析。结果共提取出3个主题和9个子主题。分别为:患者跌倒预防态度不一(积极态度、消极态度);患者跌倒预防行为受多方力量支持(医护支持、家属支持、周围群体支持);患者跌倒预防意向受多种因素影响(跌倒预防知识缺乏、性格特征、害怕跌倒后增加家人负担、担忧跌倒后的不良后果)。结论医护人员应纠正患者消极态度,充分调动家庭支持系统,制定个性化跌倒干预方案,从而促使患者跌倒预防意向转变与行为发生,降低跌倒发生率。

社区老年人跌倒预防自我管理体验的Meta整合

目的了解社区老年人跌倒预防自我管理的真实体验,为开展针对性跌倒自我管理干预提供依据。方法文献检索中英文数据库中有关老年人跌倒自我管理体验和经历的质性研究,检索时限从建库至2023年8月1日。采用澳大利亚JBI循证卫生保健中心对质性研究质量评价标准评价文献,依据主题分析法对符合评价标准的质性研究进行Meta整合。结果共纳入8篇文献,提炼34个结果,归纳形成11个类别,整合成4个研究结果,即复杂的情绪和行为、跌倒预防自我管理行为促进因素、跌倒预防自我管理面临的阻碍、心理支持和专业医疗支持需求。结论社区老年人在跌倒预防自我管理过程中面临复杂的情绪行为以及困难和挑战,医护人员需关注其应对方式、内心体验和需求,完善医疗和社会支持系统,促进社区老年人跌倒预防自我管理行为。

强化回授教育在精神分裂症患者跌倒预防中的应用

目的探讨强化回授教育在长期住院的精神分裂症患者跌倒预防中的应用价值,以指导临床干预措施的拟定,降低患者跌倒发生风险。方法采用便利抽样法,选择2021年7月至2022年10月在江西省某医院长期住院的精神分裂症患者84例作为研究对象,使用随机数字表法将其分为对照组(n=42)与观察组(n=42)。对照组给予常规健康教育,观察组采用强化回授教育,采用一般情况调查表、医院自制长期住院的精神分裂症患者跌倒预防知识技能掌握情况调查表及Morse跌倒风险评估量表(MFS)比较干预前后两组患者跌倒预防知识技能掌握情况及跌倒风险评分,同时比较干预完成后6个月内两组患者跌倒发生率。结果干预后,两组患者的跌倒预防知识技能管理评分均比干预前有所提高,且观察组高于对照组(P<0.05);干预后,两组患者MFS评分均较干预前有所降低,且观察组低于对照组(P<0.05);干预完成6个月后,观察组跌倒发生率为2.38%,低于对照组的19.05%,差异有统计学意义(P<0.05)。结论针对长期住院的精神分裂症患者实施强化回授教育,可使其有效掌握跌倒预防知识技能,降低患者跌倒风险,减少跌倒的发生率。

基于智能化的防跌倒预警及自动呼救产品设计研究

老年人安全问题已成为全球性难题,老人生活系列产品的实用、智能化研究已成为当前的研究热点。该文通过对比国内外相关产品的研究现状和发展动态,分析现有产品存在的问题与不足;通过产品研发分析,对跌倒监测产品进行展望;以产品创新为前提,以功能聚焦和适老化为特色,以“互联网+健康管理”为切入点,设计一款智能防跌倒预警及自动呼救腕环,促进健康老龄化。

近十年跌倒预防运动干预相关研究热点的可视化分析

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