中国全科医学 ›› 2022, Vol. 25 ›› Issue (34): 4286-4291.DOI: 10.12114/j.issn.1007-9572.2022.0367

所属专题: 跌倒最新文章合集 老年问题最新文章合集

• 论著·人群健康研究 • 上一篇    下一篇

社区跌倒高风险老年人防跌倒项目参与意愿及其影响因素研究

程萌1, 王健2,*(), 李志鹏3, 赵琦4, 孙晓明5   

  1. 1.201100 上海市老年医学中心全科医学科
    2.200032 上海市,复旦大学附属中山医院全科医学科
    3.200336 上海市疾病预防控制中心结核病防治科
    4.200032 上海市,复旦大学公共卫生学院社会医学教研室
    5.200032 上海市,复旦大学上海医学院全科学系
  • 收稿日期:2022-05-20 修回日期:2022-08-07 出版日期:2022-12-05 发布日期:2022-09-19
  • 通讯作者: 王健
  • 程萌和王健共同为第一作者 程萌,王健,李志鹏,等.社区跌倒高风险老年人防跌倒项目参与意愿及其影响因素研究[J].中国全科医学,2022,25(34):4286-4291.[www.chinagp.net]
    作者贡献:
    孙晓明提出概念;王健负责调查开展、方法学实施、项目管理、论文撰写、资金提供;程萌撰写论文初稿;李志鹏、赵琦负责形式分析。
  • 基金资助:
    上海市卫健委面上项目(201840124)——基于老年跌倒风险指数的社区老年防跌倒干预模式的建立与评价

Participation Intention in Fall-prevention Project and Related Influencing Factors in Community-living Elderly Residents at High Risk of Falls

CHENG Meng1, WANG Jian2,*(), LI Zhipeng3, ZHAO Qi4, SUN Xiaoming5   

  1. 1.General Practice Department, Shanghai Geriatric Center, Shanghai 201100, China
    2.General Practice Department, Zhongshan Hospital, Fudan University, Shanghai 200032, China
    3.Department of Tuberculosis Prevention and Treatment, Shanghai Municipal Center for Disease Control & Prevention, Shanghai 200336, China
    4.Department of Social Medicine, School of Public Health, Fudan University, Shanghai 200032, China
    5.General Practice Department, Shanghai Medical College, Fudan University, Shanghai 200032, China
  • Received:2022-05-20 Revised:2022-08-07 Published:2022-12-05 Online:2022-09-19
  • Contact: WANG Jian
  • About author:
    CHENG M, WANG J, LI Z P, et al. Participation intention in fall-prevention project and related influencing factors in community-living elderly residents at high risk of falls[J]. Chinese General Practice, 2022, 25 (34) : 4286-4291.

摘要: 背景 随着人口老龄化进程加快,老年人防跌倒项目的开展刻不容缓。我国防跌倒项目虽有零星开展,但以运动干预为主要内容的综合性防跌倒项目较少见,而针对社区跌倒高风险老年人综合性防跌倒项目参与意愿的调查尚未见报道。 目的 了解跌倒高风险老年人参与综合性防跌倒项目的意愿,分析其影响因素,为综合性防跌倒项目的实施提供理论依据。 方法 根据经济和地理位置分别抽取上海市浦东新区塘桥社区(中心城区)、青浦区赵巷社区(远郊)、崇明区港沿社区(远郊)为研究现场,使用跌倒风险初筛量表(FROP-Com Screen)对2018—2019年在3个社区参加体检的5 426例≥65岁老年人进行初筛,纳入FROP-Com Screen评分>3分,即有跌倒风险的老年人;进一步使用修订版社区老年人跌倒风险评估工具(MFROP-Com Tool)评估有跌倒风险老年人,纳入MFROP-Com Tool总分≥11.5分,即跌倒高风险老年人。本研究所用调查问卷由6部分构成:基本情况调查表、FROP-Com Screen、MFROP-Com Tool、自行设计的跌倒情况调查表、患者健康问卷(PHQ-9)、广泛性焦虑量表(GAD-7)。 结果 本研究共纳入318例跌倒高风险老年人,其中62例(19.5%)认为跌倒不可预防。地面光滑〔73例(23.0%)〕、注意力不集中〔64例(20.1%)〕和身体不适〔59例(18.6%)〕是调查对象认为导致跌倒的前3位原因。318例跌倒高风险老年人中,214例(67.3%)表示愿意参加防跌倒项目。不同居住地区、文化程度、助行器使用情况、睡眠质量自评情况、慢性病种数、足部疾病情况、运动爱好、近1年跌倒情况、对跌倒是否可预防认知情况的老年人参加防跌倒项目的意愿比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,市区老年人〔OR(95%CI)=7.828(2.898,21.149)〕、喜欢运动的老年人〔OR(95%CI)=3.474(1.703,7.087)〕、近1年发生过跌倒的老年人〔OR(95%CI)=2.806(1.364,5.773)〕和认为跌倒可预防的老年人〔OR(95%CI)=4.124(1.749,9.726)〕更倾向参加防跌倒项目(P<0.05)。 结论 跌倒高风险老年人对于防跌倒的认识有一定局限性,大部分跌倒高风险老人愿意参加综合性防跌倒项目。为了更好地实施综合性防跌倒项目,需进一步改善跌倒高风险老年人对防跌倒的认知,提升其防跌倒项目参与意愿。

关键词: 老年人, 老年人保健服务, 跌倒, 健康态度, 影响因素分析

Abstract:

Background

With the aging of the population, it is essential to implement fall prevention programs for the elderly. Although China has carried out fall prevention programs sporadically, among which comprehensive fall prevention programs centered on exercise intervention are rare, and there have been no investigations about the willingness of elderly people at high risk of falls in the community to participate in comprehensive fall prevention programs.

Objective

To examine the intention of community-living elderly residents at high risk of falls to participate in comprehensive fall-prevention programs, and associated factors, providing a theoretical basis for the implementation of such programs.

Methods

By economic level and geographical location, we selected three communities from Shanghai as research settings, namely, Tangqiao Community in Pudong New Area (central urban area) , Zhaoxiang Community in Qingpu District (outer suburb) and Gangyan Community in Chongming County (outer suburb) . Elderly people aged 65 and above who participated in physical examinations in the three communities from 2018 to 2019 were invited to attend a survey using a questionnaire consisting of demographics, FROP-Com Screen, MFROP-Com Tool, self-designed fall risk questionnaire, Patient Health Questionnaire-9 (PHQ-9) , and Generalized Anxiety Disorder scale (GAD-7) . Individuals with the FROP-Com Screen scale score >3 points were identified with risk of falls, among whom those with total score of MFROP-Com Tool≥11.5 points (high risk of falls) were included finally.

Results

In total, 318 cases were detected with high risk of falls, among whom 62 (19.5%) thought falls were unpreventable. Slippery floor〔73 respondents (23.0%) 〕, inattention〔64 respondents (20.1%) 〕and physical discomfort〔64 respondents (20.1%) 〕were reported to be the three leading causes of falls. Two hundred and fourteen (67.3%) were willing to participate in fall prevention programs. The level of intention to participate in fall prevention programs differed significantly in the participants according to living setting, educational level, use of a walker, self-assessed sleep quality, number of chronic diseases, foot disease prevalence, exercise habits, history of falls in the past year, and cognition of whether falls can be prevented (P<0.05) . Binary Logistic regression analysis showed that living in urban area〔OR (95%CI) =7.828 (2.898, 21.149) 〕, having an exercise habit〔OR (95%CI) =3.474 (1.703, 7.087) 〕, previous history of falls〔OR (95%CI) =2.806 (1.364, 5.773) 〕, and having an idea of falls are preventable〔OR (95%CI) =4.124 (1.749, 9.726) 〕 were associated with higher level of intention to participate in an fall prevention program (P<0.05) .

Conclusion

In general, the community-living elderly residents with high risk of falls had limited understanding of fall prevention, but most of them were willing to participate in fall prevention programs. To promote the implementation of comprehensive fall prevention programs, it is necessary to improve their awareness of fall prevention and enhance their willingness to participate.

Key words: Aged, Health services for the aged, Falls, Attitude to health, Root cause analysis