跌倒風險篩檢簡表應用於社區中老年人之研究

Abstract

本研究目的是透過跌倒風險篩檢簡表應用於社區中老年人之研究，用於篩檢『中老人年跌倒的風險』，並探討其信度與效度，而決定最佳切點分數，並區辨具有跌倒風險的社區中老年人。 研究對象為臺灣29個社區的保命防跌班學員，總計為669位50歲以上中老年人，本研究的跌倒風險篩檢簡表共有14題，總分範圍為0-14分，若得分越高，表示跌倒的可能性越高。 研究結果發現，跌倒風險篩檢簡表之信度檢定，內部一致性良好。可以有效預測跌倒組與未跌倒組，4分為最佳切點分數，兼具敏感性及特異性。應用重複跌倒個案的篩選，4到6分敏感性與特異性均達70％以上，若用4分或5分當作切點分數，其敏感性均達9成以上，但5分特異性較高，達84.68％。若欲進一步減少人力評估或檢查，則切點分數可提高至6分，雖然敏感性70％，但特異性達88.5％。 本研究工具簡單易操作，可供衛生專業人員利用短時間篩檢出跌倒高危險族群，利於公共衛生上推廣。Through application of a short-form fall-risk screening tool for community-dwelling elderly people, this study aims to carry out fall-risk screening for community-dwelling elderly people and discuss its reliability and validity so that the best cut-off point can be determined and the community-dwelling elderly people with fall risk can be identified. The research subjects are 669 elderly people who are over 50 years of age from 29 communities’ life-saving and anti-fall classes in Taiwan. The short-form fall-risk screening tool in this study has 14 questions with score between 0 and 14; the higher score represents higher probability of falling. The research results show that the short-form fall-risk screening tool’s reliability test has good internal consistency. It is able to effectively predict the falling group and non-falling group. The score of 4 is the best cut-off point with sensitivity and specificity. With the application of repeat falling case, both sensitivity and specificity are over 70% for score between 4 and 6. If we use the score of 4 or 5 as cut-off point, the sensitivity is over 90%; however, the score of 5 has higher specificity with 84.68%. For the purpose of reducing assessment or inspection manpower, the cut-off point can be increased to score of 6, with sensitivity of 70% and high specificity of 88.5%. The tool used in this study is easy to operate and it can help the health and care professionals to identify the high fall-risk group in a timely manner so that it is also conductive to the promotion of public health.