Do older adults with cancer fall more often? A comparative analysis of falls in those with and without cancer.
Do older adults with cancer fall more often? A comparative analysis of falls in those with and without cancer.
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DOI：
10.1188/13.onf.e69-e78
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发表时间：
2013-03-01
影响因子：
1.9
通讯作者：
Given, Charles W
中科院分区：
文献类型：
--
作者：
Spoelstra, Sandra L;Given, Barbara A;Given, Charles W
目的/目的：研究癌症史是否增加了社区老年人跌倒的可能性，以及癌症类型、分期或确诊后的时间是否增加了福尔斯的可能性。设计：一项纵向、回顾性、队列研究。使用最小数据集-家庭护理和密歇根州癌症登记处的数据，将862名年龄在65岁或以上的老年癌症患者与8,617名无癌症的老年人进行比较。对福尔斯的报告进行了90-180天的检查。主要研究变量：癌症、福尔斯、患者特征、合并症、药物、疼痛、体重减轻、视力、记忆回忆和活动，以及癌症类型、分期和诊断后的时间。结果：老年癌症患者跌倒的发生率为33%，而非癌症患者为29%（p < 0.00）。有癌症史的人比没有癌症的人更容易跌倒（调整后的比值比1.16; 95%置信区间[1.02，1.33]; p = 0.03）。癌症的类型和分期对跌倒率没有影响，癌症确诊后的时间越长，跌倒的几率也越小。结论：老年癌症患者的跌倒率高于非癌症患者。护理启示：护士需要评估跌倒风险，并在癌症确诊时采取预防措施。当护理老年癌症患者时，护士应该意识到福尔斯的风险增加。医护人员也应该意识到在癌症治疗期间该人群中福尔斯跌倒的风险增加。基于证据的跌倒预防措施应纳入老年癌症幸存者的护理计划。
PURPOSE/OBJECTIVES: To examine whether a history of cancer increased the likelihood of a fall in community-dwelling older adults, and if cancer type, stage, or time since diagnosis increased falls.DESIGN: A longitudinal, retrospective, cohort study.SETTING: A home- and community-based waiver program in Michigan.SAMPLE: 862 older adults aged 65 years or older with cancer compared to 8,617 older adults without cancer using data from the Minimum Data Set-Home Care and Michigan cancer registry.METHODS: Reports of falls were examined for 90-180 days. Generalized estimating equations were used to compare differences between the groups.MAIN RESEARCH VARIABLES: Cancer, falls, patient characteristics, comorbidities, medications, pain, weight loss, vision, memory recall, and activities, as well as cancer type, stage, and time since diagnosis.FINDINGS: A fall occurred at a rate of 33% in older adults with cancer compared to 29% without cancer (p < 0.00). Those with a history of cancer were more likely to fall than those without cancer (adjusted odds ratio 1.16; 95% confidence interval [1.02, 1.33]; p = 0.03). No differences in fall rates were determined by cancer type or stage, and the odds of a fall did not increase when adding time since cancer diagnosis.CONCLUSIONS: The fall rate was higher in older adults with cancer than in older adults without cancer.IMPLICATIONS FOR NURSING: Nurses need to assess fall risk and initiate fall prevention measures for older adults at the time of cancer diagnosis.KNOWLEDGE TRANSLATION: When caring for older adults with cancer, nurses should be aware of an increased risk for falls. Healthcare staff also should be aware of an increased risk for falls in that population during cancer treatment. Evidence-based fall prevention measures should be included in care plans for older adult cancer survivors.