跌倒恐惧对社区老年2型糖尿病患者跌倒警觉度的影响研究

doi:10.3761/j.issn.0254-1769.2026.01.003

摘要/Abstract

摘要：

目的探讨跌倒恐惧对社区老年2型糖尿病患者跌倒警觉度的影响及阈值效应，为预防老年人跌倒提供依据。方法便利选取2025年3—7月昆山市某社区卫生服务中心250例老年2型糖尿病患者作为调查对象。采用一般资料调查表、老年人跌倒警觉度量表、修订版跌倒恐惧量表进行调查，通过分层线性回归探究跌倒恐惧对社区老年2型糖尿病患者跌倒警觉度的影响，并进行阈值效应分析。结果回收有效问卷245份，有效问卷回收率为98.00%。社区老年2型糖尿病患者跌倒恐惧得分为（36.34±11.46）分，跌倒警觉度得分为（56.87±15.47）分。分层线性回归分析结果显示，跌倒恐惧可独立解释社区老年2型糖尿病患者跌倒警觉度9.7%的变异度。拟合曲线结果提示，跌倒恐惧和跌倒警觉度呈非线性关系（P<0.001），跌倒恐惧得分<32分时，跌倒警觉度随跌倒恐惧得分的增加而降低（P<0.05）。结论社区老年2型糖尿病患者跌倒警觉度处于较高水平，跌倒恐惧呈中等程度，且跌倒恐惧与跌倒警觉度存在非线性关联，当跌倒恐惧<32分时，可将其作为心理干预切入点，通过缓解跌倒恐惧提升患者的跌倒警觉度。

关键词: 老年人, 2型糖尿病, 跌倒恐惧, 跌倒警觉度, 阈值效应, 护理

Abstract:

Objective To investigate the impact and threshold effect of fear of falling on self-awareness of falls in community-dwelling older adults with type 2 diabetes，providing a basis for fall prevention. Methods A convenience sample of 250 older patients with type 2 diabetes from a community health center in Kunshan was surveyed between March and July 2025. Data were collected using a general information questionnaire，the Self-Awareness of Falls in Elderly Scale，and Fear of Falling Questionnaire-Reversed Scale. Multiple linear regression was used to analyze the impact of fear of falling on self-awareness of falls，followed by threshold effect analysis. Results A total of 245 valid questionnaires were collected，yielding a response rate of 98.0%. The mean score for fear of falling was（36.34 ± 11.46） points，and the self-awareness of falls score was（56.87 ± 15.47） points. Fear of falling independently explained 9.7% of the variance in self-awareness of falls. Fitting curve results revealed a nonlinear relationship between fear of falling and self-awareness of falls（P<0.001）. When the fear of falling score was below 32 points，self-awareness of falls decreased as the fear of falling score increased（P<0.05）. Conclusion Community-dwelling elderly patients with type 2 diabetes have a relatively high level of self-awareness of falls and a moderate level of fear of falling. A non-linear association exists between fear of falling and self-awareness of falls. When fear of falling is <32 points，it can be used as a starting point for psychological interventions to improve patients’ self-awareness of falls by alleviating fear of falling.

Key words: Aged, Type 2 Diabetes, Fear of Falling, Falls Self-Awareness, Threshold Effect, Nursing Care

陆沁怡, 陆程倩, 赵亚芬, 金学勤. 跌倒恐惧对社区老年2型糖尿病患者跌倒警觉度的影响研究[J]. 中华护理杂志, 2026, 61(1): 23-29.

LU Qinyi, LU Chengqian, ZHAO Yafen, JIN Xueqin. The impact of fear of falling on self-awareness of falls in community-dwelling older adults with type 2 diabetes[J]. Chinese Journal of Nursing, 2026, 61(1): 23-29.

图/表 4

表1 社区老年2型糖尿病患者的一般资料及跌倒警觉度的单因素分析（n=245）

Table 1 Univariate analysis of general data and self-awareness of falls in elderly community-dwelling patients with type 2 diabetes（n=245）

表2 自变量赋值方式

Table 2 Assignment of independent variables

表3 社区老年2型糖尿病患者跌倒警觉度的线性回归分析（n=245）

Table 3 Linear regression analysis of self-awareness of falls in elderly community-dwelling patients with type 2 diabetes（n=245）

表4 跌倒恐惧与跌倒警觉度的阈值效应分析结果（n=245）

Table 4 Results of threshold effect analysis between fear of falling and self-awareness of falls（n=245）

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