| OBJECTIVE:Falling is a common and serious health event for the elderly,family,and society.Qinghai province and Shanxi Province in the western regions of our country,because of the development of the foundation is weak,the traffic is not convenient and the environment of bad weather and other reasons,the health level of the overall social and economic development and residents is still relatively backward,the effect of carrying out health intervention and health promotion to be improved.After the Kadoorie charitable foundation in partnership with the State Planning Commission,the China Center for Disease Control and prevention of maternal and child health centers in the region has led the implementation,the implementation of the "improve the ability of township hospitals and rural community health promotion(?)","rural community health promotion(?)" and "community participation in rural elderly health" a series of health intervention project,this study provides a basis for the rural elderly fall prevention.The fall has a clear diagnosis,easy short intervention and effective time characteristics,this research takes the fall as the evaluation index,through horizontal comparison before and after the village and of the project and non project villages compared to explore the risk factors of falls in elderly people in rural areas and effective interventions fall to provide scientific reference for the strategy the prevention for the rural elderly.METHOD:8 projects in Qinghai province and Shanxi province township,according to the matching principle of the elderly population with similar structure were selected 16 project villages(village project)and 16 non project villages(control Village)a research group.The subjects were rural residents aged over 1 years and aged 60 and over,with a total of 1848 people.The survey mainly adopts the method of inquiring by household,and the questionnaire used is a self-made questionnaire for the fall of the elderly in the Midwest rural areas,which covers general situations,falls and falls.Dual core check input method is used to input data,effectively control the quality of data.The data entry of this survey is carried out by Epidata software,and all the data analysis process is done by using the universal SPSS 20.0 statistical software.The incidence of falls as the evaluation index,the longitudinal comparison project fall prevention intervention effect,and non project comparison project fall prevention intervention effect,from two dimensions and fully understand the epidemiological characteristics and fall of rural elderly Midwest in China mainly occurred in the consequences of fall risk factors and protective factors,fall and provide practical experience for the elderly in rural areas of the Midwest fall prevention control,provide scientific basis for the implementation of the medium-term effect of project evaluation.RESULTS:The elderly in rural areas have their epidemiological characteristics of Midwest falls;the survey results showed that:two the survey of a total of 1848 people,the number of 268 people fall,the incidence of falls 14.5%,the incidence of falls below the national average level.Chi square test results showed that:Qinghai province and Shanxi Province,the fall rate distribution difference was statistically significant(?2=17.258,p=0.000),the county of Tianjun County,Datong County,Hunyuan county and Yonghe County between fall distribution difference was statistically significant(?2=48.909,p=0.000).Among the 1848 middle-aged and elderly people,the Spring Festival falls 64 people,accounting for 24.5%;summer falls 99 people,accounting for 37.9%;fall 59 people,accounting for 22.6%;winter fall 39 people,accounting for 14.9%.It can be seen that falls often occur during the spring and summer season.In a year(2014 September-2015September),the number of falls 1 times or more was 268,and the incidence of falls was 14.5%.Morning(6:00-10:00)fall 74 people,accounting for 40%;noon(10:00-14:00)fall 54 people,accounting for 29.2%;afternoon(14:00-18:00)fall 44 people,accounting for 23.8%;night fall 13 people,accounting for 7%.It can be seen that falls happen frequently in the morning and noon.66 people fell in the house,accounting for 27.8%;fell 72.2%outside the house.Thus,the incidence of falls outside the house is much higher than in the house.The over 95 people,accounting for 35.8%;and 106 people,accounting for 40%;the collision of 12 people,accounting for 4.5%;miss one's step 11 people,accounting for 4.2%;a drop of 4,accounting for 1.5%;sudden unexplained fall 32 people,accounting for 12.1%;the other 5 people,accounting for 1.9%.Thus,the main causes of falls are slips and trips.The head injured 39 people,accounting for the total number of falls 17.8%;neck injured 3 people,accounting for the total number of fall 1.4%;face injured 32 people,accounted for 14.6%of the number of falls,chest injured 5 people,accounting for the total number of falls 2.3%;abdomen/waist injured 27 people,accounting for 12.3%of the number of total fall;hip injury 1 people,accounting for 0.5%of the total number of falls;upper limb injured 54 people,accounting for the total number of fall 24.7%;lower extremity injuries of 100 people,accounting for the total number of falls 45.7%;spinal injured 4 people,accounting for the total number of 1.8%falls.It can be seen that the injured parts of the fall are mainly lower limb(45.7%)and upper limb(24.7%).Among them,less than 5 minutes away from the ground 186 people,accounting for 75.9%;5-15 minutes away from the ground 46 people,accounting for 18.8%;15-60 minutes away from the ground 11 people,accounting for 4.5%;more than 1 hours away from the ground 2 people,accounting for 0.8%.As a result,most of the fallen people left the falls within 5 minutes(75.9%).1848 elderly people in the survey,one year(2014 September-2015 September)occurred more than 1 times and falling number for 268 people,130 people fall after cured,accounted for 56.8%;fall injury caused by relief of 79 people,accounting for 34.5%;persistent/deterioration of 1 people,accounting for 0.4%;8 people there are complications,accounting for 3.5%;in which 11 people with disabilities,accounting for 4.8%.This shows that most falls can be cured(56.8%),and a few can cause disability(4.8%).According to the influencing factors of falls,it was found that there were no statistically significant differences between the 1848 middle-aged and elderly people in Qinghai and Shanxi provinces(?2=1.840,p=0.175).The main risk factors of sex is not fall;there were significant differences between the incidence of falls and the nation(?2= 59.073,p = 0.000),the incidence of falls in high order for Hui(22.8%),Han(17.1%)and Tibetan(3%).Results:in fall prevention intervention process,Hui is a key focus for fall prevention;chi square test results show that the marriage between fall and no statistically significant correlation(?2=2.918,p=0.404).The main influencing factors of marital status is not falling down;fall and fall between the crowd culture degree was not statistically correlation(?2=0.257,p=0.968);and there was a fall test related occupation(?2=45.035,p=0.000);living between fall and no statistically significant correlation(?2=5.392,p=0.145);no significant difference between the number of fall age(F=2.396,P=0.066);multivariate Logistic regression models diseases of the circulatory system,(OR=2.745,P=0.000),diseases of the genitourinary system(OR=3.428,P=0.007)and ear and mastoid diseases(OR=16.139,P=0.023)There was statistical significance with the occurrence of falls,is a major risk factor for falls;edible anti-allergic drugs(OR=8.509,P=0.015),cardiovascular drugs(OR=2.095,P=0.000)and traditional Chinese medicine or Chinese medicine(OR=1.947,P=0.000)had statistical significance with the occurrence of falls.The project fell through a longitudinal evaluation of intervention effect analysis,results showed that:1179 people were investigated before intervention,fall 210,the incidence of falls 17.81%,intervention survey of 848 people,755 people fall,the incidence of falls 10.97%,fall two,before and after the intervention the incidence was statistically difference(?2= 8.176.p=0.000),the incidence of falls was significantly decreased.The incidence of falls before intervention was 16.13%in two provinces and 9.25%in Shanxi.The incidence of falls was 11.87%before intervention.The incidence of falls before intervention in Qinghai was 22.40%.The intervention effect of Qinghai province is better than that of Shanxi province.Assessment of the effect of fall intervention in counties:the order of the intervention effect is Yonghe County,Datong County,Tianjun county and Hunyuan county.Project and non project fell horizontal comparison,the occurrence of the results showed that:two project survey number 848 people,93 people fall,the incidence of falls 11%,non project survey number 1000 people,175 people fall,the incidence of falls 17.5%.Chi square test showed that there was a significant difference between the points of the project and the non project points(?2=15.976,p=0.000),and the implementation of the project had a significant effect on fall intervention,which effectively reduced the incidence of falls.CONCLUSION:Residents in rural areas is one of an important target group for health education and health promotion practice shows that promoting projects in rural areas to carry out health education and health,which can effectively improve the health knowledge of rural residents,health awareness and skills,gradually promote the healthy behavior of the.The comprehensive intervention of fall can reduce the incidence of falls among the rural elderly in two provinces of Shanxi and Qinghai.Reducing the incidence of falls requires the joint efforts of society,family and individuals.Through a series of fall intervention measures for the elderly in the Midwest,we hope that we can finally find a low cost and high benefit fall intervention model for the elderly in the rural community,thus promoting the health of the elderly in rural areas. |
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