Fall Risk, Supports and Services, and Falls Following a Nursing Home Discharge.
Fall Risk, Supports and Services, and Falls Following a Nursing Home Discharge.
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跌倒风险、支持和服务以及疗养院出院后跌倒。
DOI：
10.1093/geront/gnx133
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Arling,Greg
中科院分区：
文献类型：
--
作者：
Noureldin,Marwa;Hass,Zachary;Abrahamson,Kathleen;Arling,Greg
背景和目的跌倒是老年人发病率和死亡率的主要来源，然而，在养老院（NH）到社区过渡期间，对跌倒的发生知之甚少。本研究旨在探讨是否存在的支持和服务的影响之间的关系下降相关的危险因素和跌倒发生后NH discharge.Research Design and MethodsParticipants在明尼苏达州返回社区倡议谁是协助实现社区出院（N= 1459）包括研究样本。主要结局为出院后30天内发生跌倒。因子分析被用来估计潜在的模型从感兴趣的变量。估计的结构方程模型（SEM），以确定新兴的潜在变量和福尔斯之间的关系。Results15%的参与者下降30天内NH放电。跌倒相关风险因素的因素分析产生了三个潜在变量：跌倒关注/历史;日常生活活动障碍;和使用高风险药物。一个支持/服务的潜在变量也出现了，包括照顾者的支持频率，药物管理援助，耐用的医疗设备的使用，出院地点，并收到家庭健康或熟练的护理服务。在SEM模型中，高风险药物的使用和跌倒问题/病史对跌倒有直接的积极影响。接受支持/服务并没有直接影响下降，但是，它减少了高风险药物使用对下降的影响（p<0.05）。讨论和含义在一个国家实施的过渡计划的背景下，调查结果强调了支持/服务在减轻药物相关的风险下降后NH出院的重要性。
Background and ObjectivesFalls are a major source of morbidity and mortality among older adults; however, little is known regarding fall occurrence during a nursing home (NH) to community transition. This study sought to examine whether the presence of supports and services impacts the relationship between fall-related risk factors and fall occurrence post NH discharge.Research Design and MethodsParticipants in the Minnesota Return to Community Initiative who were assisted in achieving a community discharge (N= 1459) comprised the study sample. The main outcome was fall occurrence within 30 days of discharge. Factor analyses were used to estimate latent models from variables of interest. A structural equation model (SEM) was estimated to determine the relationship between the emerging latent variables and falls.ResultsFifteen percent of participants fell within 30 days of NH discharge. Factor analysis of fall-related risk factors produced three latent variables: fall concerns/history; activities of daily living impairments; and use of high-risk medications. A supports/services latent variable also emerged that included caregiver support frequency, medication management assistance, durable medical equipment use, discharge location, and receipt of home health or skilled nursing services. In the SEM model, high-risk medications use and fall concerns/history had direct positive effects on falling. Receiving supports/services did not affect falling directly; however, it reduced the effect of high-risk medication use on falling (p< .05).Discussion and ImplicationsWithin the context of a state-implemented transition program, findings highlight the importance of supports/services in mitigating against medication-related risk of falling post NH discharge.
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10.1017/s071498081000070x
发表时间：
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影响因子：
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