The development of the fall risk assessment tool in the institutionalized elderly

这项为期三年的研究项目的目的是开发住院老年人跌倒风险评估工具。在第一年，我们回顾了关于老年人跌倒危险因素的研究文章。我们每年使用手持式测功机、跟骨超声骨密度仪和姿势摆动来测量住院老年人的等长最大伸膝力量。然后，我们将这些数据与社区居住的老年人进行了比较。在第二年，我们调查了在疗养院和扩展护理设施中遇到跌倒的护士，询问护士是否预测到了患者跌倒的情况以及护士确定的危险因素。定性研究的结果被整合到评估工具中。此外，我们还对跌倒的老年人进行了分析。去年，我们进行了一项前瞻性研究，对11所院校的评估工具进行了评估。纸笔工具由活动能力、视力、认知功能、护士预测跌倒、触发事件等8个因素组成，以5为界点排除触发事件，其敏感度为68.2%，特异度为74.0%。跌倒的相对危险性最高的是护士的预测(RR：6.5)，其次是跌倒病史(RR：5.6)、辅助排除(RR：3.0)、认知功能低下(RR：2.6)。研究结果与以往研究结果一致，表明该评估工具在识别高危老年人方面是有效的。

The purpose of this three-year research project was to develop the fall risk assessment tool in the institutionalized elderly. In the first year, we reviewed research articles dealing with risk factors of falls in the elderly. We measured the isometric maximal knee-extension strength of the institutionalized elderly every year using a hand-held dynamometer, ultrasound bone densitometry of calcaneus, and postural sways. Then, we compared these data with community-residing elderly. In the second year, we surveyed nurses who encountered falls in the nursing home and extended care facility and asked if the nurse predicted the fall of the patient and risk factors identified by the nurse. The result of the qualitative study was integrated in the assessment tool. In addition, we analyzed elderly who had fallen. In the last year, we conducted a prospective study to evaluate the assessment tool in the eleven institutions. The paper and pencil tool consisted of eight elements including, mobility, vision, cognitive function, nurses' prediction to predict falls, trigger events, etc.The sensitivity of the tool was 68.2%, and the specificity was 74.0% using the cutoff point of 5 excluding trigger events. The highest relative risk of falls was nurses' prediction (RR : 6.5), followed by the history of falls (RR : 5.6), the assistance of elimination (RR : 3.0), and lowed cognitive function (RR : 2.6). The results are consistent with previous studies, the assessment tool was effective in identifying high risk elderly.