乌鲁木齐养老机构老年人跌倒风险评估及护理干预研究

发布时间：2018-05-26 09:45

本文选题：养老机构 + 老年人　；参考：《新疆医科大学》2017年硕士论文

【摘要】：目的:1)了解乌鲁木齐市养老机构内老年人跌倒特征、相关因素。2)针对乌鲁木齐市养老机构老年人开展和实施恰当的预防跌倒的措施并评价其效果。3)针对乌鲁木齐市养老机构护理(照护)人员进行预防老年人跌倒的技能培训并评价其效果。方法:1)第一部分为横断面调查研究,从乌鲁木齐市登记在册的养老机构中随机抽取8家养老机构(4家公办,4家民办),分层随机整群抽取符合纳入、排除标准的老年人和在职护理(照护)人员作为研究对象,了解乌鲁木齐市养老机构内老年人跌倒的特征及相关因素。2)第二部分为随机对照试验性研究,将养老机构分为大型和中、小型两种规模,采用随机数字表法,将不同规模的养老机构随机等分为干预组和对照组。两组分别从大型和中、小型养老机构中随机抽取符合纳入标准的老年人及在职护理(照护)人员。干预组采用综合护理干预措施,对照组采用大众集体健康教育。不同方法干预后,对两组老年人的跌倒发生率、防跌倒认知水平、行为进行效果评价及对护理(照护)人员预防老年人跌倒知识、态度、行为进行评价。结果:1)496例老年人中有232例老年人发生339次跌倒,跌倒发生率为46.8%;男女跌倒发生率分别为35.8%和64.2%,女性跌倒发生率高于男性,差异有统计学意义(P0.05);跌倒发生率与年龄的增长成正比(P0.01);Logistic回归分析显示,视力、慢性病的长期服药、动态、家具是否固定、浴室是否有固定扶手是老年人跌倒的危险因素,体育锻炼是保护因素。2)不同护理干预后,两组老年人跌倒发生率、防止跌倒的认知水平及行为比较,干预组显著优于对照组,差异有统计学意义(P0.01)。3)不同护理干预后,两组护理(照护)人员对预防老年人跌倒知、信、行比较,干预组显著优于对照组,差异有统计学意义(P0.01)。结论:1)乌鲁木齐市养老机构老年人跌倒发生率较高,跌倒发生与多种危险因素有关,应重视养老机构老年人跌倒的预防,制定有针对性的护理措施,减少跌倒的发生。2)综合护理干预能够有效地降低养老机构老年人跌倒发生率及提高老年人防跌倒认知情水平、促进老年人防止跌倒的行为改变。3)综合护理培训有效提高干预组护理(照护)人员对预防老年人跌倒知识、态度、行为的得分。
[Abstract]:Objective: to understand the fall characteristics of the elderly in Urumqi pension institutions. Related factors. 2) to carry out and implement appropriate measures to prevent fall and evaluate its effect for the elderly in Urumqi City. 3) to prevent the elderly from falling by nursing (care) staff in Urumqi. Skills training and evaluation of their effectiveness. Methods: the first part was a cross-sectional investigation. 8 pension institutions were randomly selected from the registered pension institutions in Urumqi, 4 public pension institutions and 4 private organizations were randomly selected, and stratified random cluster extraction was carried out in accordance with the inclusion. Exclusion of the standard elderly and in-service nursing (care) as the study object, to understand the elderly fall in Urumqi pension institutions and related factors. 2) the second part is a randomized controlled trial study. The pension institutions were divided into large, medium and small size, and were randomly divided into intervention group and control group by random digital table method. The two groups were randomly selected from large, medium and small pension institutions to meet the inclusion criteria. Comprehensive nursing intervention was used in the intervention group and mass collective health education was used in the control group. After intervention with different methods, the incidence of fall, cognitive level of prevention of fall, behavior and knowledge, attitude and behavior of nursing staff in the prevention of fall were evaluated. Results out of 496 cases, 232 cases had 339 falls, the incidence of falls was 46.8%, the incidence of falls was 35.8% in males and 64.2% in females, and the incidence of falls in females was higher than that in males. Logistic regression analysis showed that visual acuity, long-term medication of chronic diseases, dynamics, fixed furniture, fixed handrails in bathroom were the risk factors of fall in the elderly. Physical exercise was a protective factor. 2) after different nursing interventions, the incidence of falls, cognitive level and behavior of the two groups were significantly better than those of the control group, and the difference was statistically significant after different nursing interventions. Compared with the two groups, the intervention group was significantly better than the control group, and the difference was statistically significant (P 0.01). Conclusion: (1) the incidence of falls in the aged in Urumqi is high, and the fall is related to many risk factors. The prevention of falls in the elderly in the institutions should be paid more attention to, and the corresponding nursing measures should be taken. The comprehensive nursing intervention can effectively reduce the incidence of fall and improve the cognitive level of the elderly. 3) Comprehensive nursing training can effectively improve the scores of nursing staff's knowledge, attitude and behavior on the prevention of falls in the intervention group.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R47

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