住院老年患者跌倒风险与风险感知的差异性研究

doi:10.3761/j.issn.0254-1769.2023.019.003

摘要/Abstract

摘要：

目的分析住院老年患者跌倒风险与风险感知的差异，为完善跌倒评估策略，提高住院老年患者跌倒感知的准确性，精准防范患者跌倒提供参考。方法 2022年12月—2023年2月，便利选取在杭州市某三级甲等医院住院的468例老年患者作为调查对象，采用一般资料调查表、老年人跌倒风险感知问卷和Morse评估量表进行调查，全面分析跌倒风险与跌倒风险感知的差异。结果住院老年患者跌倒风险评分为45.0（30.0，55.0）分，呈较高水平，跌倒风险感知评分为62.5（47.3，75.0）分，呈中等水平；不同风险等级的住院老年患者其风险感知评分无显著性差异（H=4.048，P>0.05）；跌倒高风险组中存在感知不足的患者169例（67.6%），跌倒中风险组中存在感知不足的患者38例（32.8%），感知过度的患者35例（30.2%），跌倒低风险组中存在感知过度的患者66例（64.7%）；跌倒风险和风险感知的影响因素基本相似，分析结果显示，年龄、吸烟、饮酒、视力、活动方式、睡眠、医疗支付方式和近3个月跌倒史是住院老年患者跌倒风险的影响因素（P<0.05），年龄、文化程度、饮酒、睡眠和近3个月跌倒史是住院老年患者跌倒风险感知的影响因素（P<0.05）。主要差异为文化程度与风险感知相关，而与跌倒风险无关。结论住院老年患者的跌倒风险较高，同时存在跌倒感知偏差问题，建议在跌倒的预防中不仅要评估住院老年患者的跌倒风险，更要评估住院老年患者对自身风险的感知，实现个体化、精准化防护。

关键词: 住院患者, 老年人, 跌倒风险, 风险感知, 安全护理

Abstract:

Objective The differences between fall risk and risk perception of hospitalized elderly patients were analyzed to provide references for improving fall assessment strategies，improving the accuracy of fall perception of hospitalized elderly patients，and accurately preventing falls. Methods A total of 468 hospitalized elderly patients in Zhejiang province were recruited from December 2022 to February 2023. The general information questionnaire，the Fall Risk Perception Scale for Older Adults and Morse Fall Scale were used to investigate the difference between fall risk and risk perception. Results In this group，the fall risk was 45.0（30.0，55.0），showing a high level，and the fall risk perception was 62.5（47.3，75.0），showing a medium level. There was no significant difference in the risk perception scores of hospitalized elderly patients with different risk levels（H=4.048，P>0.05）. There were 169 cases（67.6%） of under-perception in the high-risk group，38 cases（32.8%） of under-perception in the middle risk group，35 cases（30.2%） of over-perception in the middle risk group，and 66 cases（64.7%） of over-perception in the low risk group. The factors affecting fall risk and risk perception are basically similar. Univariate analysis showed that age，smoking，drinking，vision，activity pattern，sleep，medical payment and fall history in the last 3 months were influencing factors of fall risk in hospitalized elderly patients（P<0.05），and age，education level，drinking，sleep and fall history in the last 3 months were influencing factors of fall risk perception in hospitalized elderly patients（P<0.05）. The main difference was that education was related to risk perception，but not to fall risk. Conclusion Elderly hospitalized patients have a higher risk of falling，and there are problems of fall perception bias. It is suggested that in the prevention of falls，it is not only necessary to evaluate the fall risk of elderly hospitalized patients，but also to evaluate the perception of their own risk，so as to achieve individualized and precise protection.

Key words: Inpatients, Aged, Fall Risk, Risk Perception, Safety Care

杨欣, 姚梅琪, 张玉萍, 沈旭慧, 鲍冠君, 毕燕, 郭芝廷, 陈昊天. 住院老年患者跌倒风险与风险感知的差异性研究[J]. 中华护理杂志, 2023, 58(19): 2326-2332.

YANG Xin, YAO Meiqi, ZHANG Yuping, SHEN Xuhui, BAO Guanjun, BI Yan, GUO Zhiting, CHEN Haotian. Differences between fall risk and fall risk perception among hospitalized elderly patients[J]. Chinese Journal of Nursing, 2023, 58(19): 2326-2332.

图/表 2

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