老年心血管疾病患者跌倒及其相关危险因素调查研究

发布时间：2018-07-24 11:51

【摘要】：目的通过问卷调查及数据分析了解老年心血管疾病患者跌倒的流行特征,并探讨引起老年心血管疾病患者跌倒的主要危险因素。方法采用便利抽样原则,在青岛市某三甲医院心内科选取年龄在60岁以上的患者为调查对象,选入468人。调查员为作者本人及经过统一培训的五位护理本科三年级学生。调查表的内容包括一般资料调查、疾病史、生活习惯(吸烟、饮酒、是否运动等)、跌倒效能评估、平衡障碍情况(起立-行走实验量表)、日常生活能力、智力、抑郁情况。应用SPSS17.0软件进行数据的录入和分析。结果1.跌倒的分布在调查的468名患者中,179名患者(占38.25%)在过去12个月内有跌倒情况的发生,共跌倒370次。发生跌倒的女性有109名,占总跌倒人数的60.89%,男性发生跌倒的人数较女性少(70人,占39.11%)。不同性别发生跌倒的差异有统计学意义(c2=6.15,P0.05)。发生跌倒的老年人年龄为75.51±7.46(岁),未发生跌倒的老年人年龄为74.03±7.10(岁),经过检验发现两组在年龄上的差别有统计学意义(P0.05),即年龄越大越容易发生跌倒。跌倒的时间多发生在冬季,地点多发生在室内。2.跌倒的后果跌倒不仅对患者的身体构成了伤害,加重患者的经济负担,还影响患者的心理健康。271次跌倒后患者发生不同程度的受伤状况,最常见的为一级损伤,有5.9%的患者在跌倒后发生了骨折甚至死亡;45.4%的患者跌倒后出现生活不能自理的情况;尽管81.6%的患者在跌倒后没有留下后遗症,但是仍有一部分患者在跌倒后不能痊愈,其中有8次跌倒后患者有长达90天以上生活不能自理的情况,对日常生活造成严重影响。66.22%的患者在跌倒后出现了害怕跌倒的心理,跌倒对患者心理的影响持续时间更长,危害更大。3.跌倒的危险因素跌倒是内因和外因共同起作用的结果。经过单因素分析,有25个因素有统计学意义;在多因素分析中将变量分组纳入不同的logitic回归模型,分别研究人口统计学、健康和体能、平衡功能、疾病、药物、行为及心理、环境等因素与跌倒的关系。经统计学分析,女性、高龄、步态异常、日常生活能力低下、抑郁、颈动脉窦过敏、体位性低血压、房颤、病程长、服多种药物、对跌倒的恐惧心理、居家环境不安全等是跌倒的危险因素。结论1.老年心血管疾病患者跌倒发生率较高。2.老年心血管疾病患者跌倒后果严重。3.老年心血管疾病患者跌倒是内因和外因共同作用的结果,包括生物、心理、社会和环境等多方面的因素
[Abstract]:Objective to investigate the epidemic characteristics of falls in elderly patients with cardiovascular disease by questionnaire and data analysis, and to explore the main risk factors of falls in elderly patients with cardiovascular disease. Methods the convenient sampling principle was adopted and 468 patients aged over 60 were selected from the Department of Cardiology of a third Class A Hospital in Qingdao. The investigator is the author himself and five junior nursing undergraduate students who have received unified training. The contents of the questionnaire included general data survey, disease history, life habits (smoking, drinking, exercise, etc.), fall efficacy assessment, balance disorder (standing-walking test scale), daily life ability, intelligence, depression. SPSS17.0 software is used to input and analyze data. Result 1. Fall occurred in 179 (38.25%) of 468 patients in the past 12 months, with a total of 370 falls. There were 109 women (60.89%) who fell, and the number of men (39.11%) was less than that of women (70 women). There were significant differences in the occurrence of falls between different genders (c2m6.15 P 0.05). The age of the elderly who fell down was 75.51 卤7.46 (years), and that of the elderly who did not fall was 74.03 卤7.10 (years). The difference in age between the two groups was statistically significant (P0.05), that is, the older the age, the more prone to fall. The time of fall occurred mostly in winter, and the location occurred in indoor. 2. 2. The result of fall is not only the injury to the patient's body, but also the financial burden of the patient, and the psychological health of the patient. 271 times after the fall, the patient has different degree of injury, the most common injury is the first grade injury. Although 51.6% of the patients had no sequelae after the fall, some of the patients could not recover from the fall, while 45.4% of the patients had suffered from fracture or even death after the fall, and 45.4% of the patients had been unable to take care of themselves after the fall, although 81.6% of the patients did not have any sequelae after the fall, but some of the patients could not recover from the fall. In 8 cases, the patients were unable to take care of themselves for more than 90 days after falling, which had a serious impact on daily life. 66.22% of the patients had a fear of falling after the fall, and the impact of falling on the patients' psychology lasted longer than that of the patients. The danger is greater. The risk factor of fall is the combination of internal and external factors. After univariate analysis, 25 factors were statistically significant. In multivariate analysis, variables were grouped into different logitic regression models to study demography, health and fitness, balance function, disease, drugs, behavior and psychology, respectively. The relationship between environmental factors and falls. By statistical analysis, female, old age, abnormal gait, low daily living ability, depression, carotid sinus hypersensitivity, postural hypotension, atrial fibrillation, long course of disease, multiple drugs, fear of falling, Insecurity at home is a risk factor for falls. Conclusion 1. The incidence of fall in elderly patients with cardiovascular disease was higher. 2. 2. Elderly patients with cardiovascular disease fall serious consequences. 3. Falls in elderly patients with cardiovascular disease are the result of a combination of internal and external causes, including biological, psychological, social and environmental factors
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.5

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