Evaluation of Tailored Falls Education on Older Adults' Behavior Following Hospitalization.
Evaluation of Tailored Falls Education on Older Adults' Behavior Following Hospitalization.
复制标题
定制跌倒教育对老年人住院后行为的评估。
DOI：
10.1111/jgs.16053
复制
发表时间：
2019
影响因子：
6.3
通讯作者：
Hill,Anne-Marie
中科院分区：
文献类型：
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作者：
Naseri,Chiara;McPhail,StevenM;Haines,TerrenceP;Morris,MegE;Etherton-Beer,Christopher;Shorr,Ronald;Flicker,Leon;Bulsara,Max;Netto,Julie;Lee,Den-ChingA;Francis-Coad,Jacqueline;Waldron,Nicholas;Boudville,Amanda;Hill,Anne-Marie
众所周知，最近出院的成年人有功能下降和福尔斯的风险。本研究评估了一个定制的教育计划，在医院提供的老年人参与跌倒预防策略在6个月内出院后的效果。METHODSA过程评估的随机对照试验，旨在改善老年人跌倒预防行为出院后。参与者（n = 390）年龄在60岁及以上，认知功能良好（10项简明精神测试评分中大于7分），从澳大利亚珀斯的三家医院康复病房出院回家。主要结果是参与跌倒预防策略，包括协助日常活动，家庭改造和锻炼。采用广义线性模型对数据进行分析。有76.4%（n = 292）的参与者完成了最终访谈（n = 149干预组，n = 143对照组）。两组在预防跌倒策略方面没有显著差异，包括接受工具性日常生活活动（IADL）援助（调整后的比值比[AOR] = 1.3 [95%置信区间{CI} = 0.7 - 2.1];P= .3），完成房屋改造（AOR = 1.2 [95% CI = 0.7 - 1.9];P= .4）和运动（AOR = 1.3 [95% CI = 0.7 - 2.2];P= .3）。两组中ADL需求未得到满足的比例都很高，与入院时的基线水平相比，6个月时参与者的依赖水平仍然较高。所有参与者在出院后进行锻炼的比例增加了30%;然而，平均锻炼时间从基线时的每周3小时减少到6个月随访时的每周1小时（SD =每周1.12小时）。需要进一步的研究来评估老年人在出院回家后改变行为的能力，这可能使他们能够更安全地恢复独立性。J Am Geriatr Soc 67：2274-2281，2019
BACKGROUNDOlder adults recently discharged from the hospital are known to be at risk of functional decline and falls. This study evaluated the effect of a tailored education program provided in the hospital on older adult engagement in fall prevention strategies within 6 months after hospital discharge.METHODSA process evaluation of a randomized controlled trial that aimed to improve older adult fall prevention behaviors after hospital discharge. Participants (n = 390) were aged 60 years and older with good cognitive function (greater than 7 of 10 Abbreviated Mental Test Score), discharged home from three hospital rehabilitation wards in Perth, Australia. The primary outcomes were engagement in fall prevention strategies, including assistance with daily activities, home modifications, and exercise. Data were analyzed using generalized linear modeling.RESULTSThere were 76.4% (n = 292) of participants who completed the final interview (n = 149 intervention, n = 143 control). There were no significant differences between groups in engagement in fall prevention strategies, including receiving instrumental activity of daily living (IADL) assistance (adjusted odds ratio [AOR] = 1.3 [95% confidence interval {CI} = 0.7‐2.1];P= .3), completion of home modifications (AOR = 1.2 [95% CI = 0.7‐1.9];P= .4), and exercise (AOR = 1.3 [95% CI = 0.7‐2.2];P= .3). There was a high proportion of unmet ADL needs within both groups, and levels of participant dependency remained higher at 6 months compared to baseline levels at admission. The proportion of all participants who engaged in exercise following hospital discharge increased by 30%; however, the mean duration of exercise reduced from 3 hours per week at baseline to 1 hour per week at 6‐month follow‐up (SD = 1.12 hours per week).CONCLUSIONTailored education did not increase older adult engagement in fall prevention strategies after hospital discharge compared to usual care. Further research is required to evaluate older adults’ capacity to change their behaviors once they return home from hospital, which may enable a safer recovery of their independence.J Am Geriatr Soc 67:2274–2281, 2019