16週跌倒預防介入對社區及安養機構老人之成效初探

Abstract

目標：本研究旨在提昇老人對於跌倒預防的知識、信念、自我效能、身體功能及降低跌倒發生率。方法：本研究採前後測(pre-post test)設計，研究對象以立意取樣台北市北區某安養機構及南區某老人服務中心之老人，於介入前後進行前後測問卷，並進行16週防跌衛教與運動課程、居家環境安全訪視及課程的過程性評價。結果：介入後機構組老人防跌的知識、自我效能以及下肢肌力都有顯著進步；社區組老人的防跌信念、自我效能及下肢肌力、反應能力、握力等皆有顯著進步；跌倒年發生率方面，介入後機構組之年發生率降低9.96%，社區組顯著降低28.0%。此外，兩組老人對課程均相當滿意，可見此介入課程及模式是有效且值得推廣的。結論：本研究成果可提供基層實務工作者從事健康促進計畫時作為參考，建議未來相關研究可參考本計畫推動模式，並增加控制組，進一步確認各介入要素之成效，以期造福更多的台灣老人。

Objective: The purposes of the fall prevention program were to increase olderpeople's knowledge, belief, self-efficacy, and physical function related to fall prevention. In addition, the prevalence rate of fall was expected to decrease. Methods: A pre-post research design and purposeful sampling was employed in the study. Participants were recruited from an elderly institution and a community center for elderly in northern Taiwan. The intervention program contains 16-week sections, including health education, exercise training, and safety inspection of home environment. A process evaluation was also conducted. Result: Study results indicate that the scores of knowledge, self-efficacy related to fall-prevention and muscle strength of lower limbs were significantly increased among elderly institutionalized residents, after fall-preventive intervention. Among community-dwelling seniors, not only the scores of belief, self-efficacy related to fall-prevention were significantly improved, but also did the reaction speed, muscle strength of lower limbs and hand grasp. Yearly fall prevalence rate was decreased 9.96% and28% for elderly institutionalized residents and community-dwelling seniors, respectively. In addition, participants of both groups felt satisfied with the fall-preventive program. Conclusions: The preliminary results reveal the effectiveness of implementing fall-preventive program in institution as well as community. Further studies are needed to include a control group to identify effective elements.