南台灣某鄉三個社區中老年人跌倒相關因素

Abstract

跌倒會對老人生理、心理及社會成本等方面產生負面影響，且台灣人口老化情形與老人跌倒發生情形正逐年增加，因此老年人跌倒預防工作更是刻不容緩。 本研究採用縱貫性研究設計，探討研究對象的跌倒相關變項及跌倒發生情形的變化趨勢，以及研究對象的社會人口學變項，與各個時間點跌倒相關變項與跌倒發生情形的變化趨勢之關係，並瞭解不同時間點的跌倒預測因子。 研究對象來自南台灣某鄉三個社區，共129位45歲以上中、老年人，追蹤30個月期間共接受三次調查，內容包括社會人口學變項、跌倒相關變項與跌倒發生情形，並進行資料分析。 結果發現，接受此跌倒預防介入計畫的中、老年人，其跌倒相關變項有改善或維持的趨勢，也能維持跌倒發生情形使其不惡化。此外，跌倒婚姻狀態顯著影響跌倒預防知識、信念及行為的變化趨勢；平衡與步態表現則會因輔具使用狀態而有顯著不同的變化趨勢。本研究亦發現跌倒預測因子包括跌倒預防知識、行為、肌力、屈膝起立及二十公尺行走等。 建議未來在老人福利政策規畫與健康促進活動推廣時，需留意影響老人跌倒相關變項及跌倒發生情形之社會人口學變項，設計合適的介入策略，且可多加強跌倒預防知識的提升、跌倒預防行為的建立以及肌力、平衡及步態能力的訓練。

Falls among the elderly would lead to many physical, mental and social-cost problems. The aging speed of Taiwan's population structure and the fall prevalence of elderly are increasing with the rising years, so that the fall prevention is an urgent need for the elderly. The aim of this study was to investigate the trends between the fall correlates and falls among middle-aged and elderly people by longitudinal perspective, and to figure out the relationships between the fall correlates and the incidence of falls at each time point during the study. 129 middle-aged and elderly people from three communities in southern Taiwan were selected to participate in the fall prevention program. Data for analysis were collected during the 30 months before and after the intervention. The results showed that the fall prevetion program has improved the trends of the fall correlates while maintained the fall incidences with the increasing time. Overall, the marital status has influenced the knowledge, self-efficacy, and behaviors of fall prevention while the assistive devices affected the balance and gait. The fall correlates at each time point have encompassed the knowledge and behaviors of fall prevention, muscle strength of lower limbs, timed chair rise and 20-meters walking. The fall prevention program could provide a well delay effect in fall correlates and falls for community-dwelling elderly. In the forthcoming future, designing the politics of elderly welfare and popularizing the health promotion programs should consider individual characteristics; especially, designing the intervention of fall prevention should aim to improve the knowledge and behaviors of fall prevention, muscle strength of lower limbs, balance, and gait.