Study On The Status And Influencing Factors About Fear Of Falling In Community-dwelling Older Adults With Stroke

ObjectiveTo define the status of the fear of falling,the risk of falling at home and the ability of daily living(ADL)in community-dwelling older adults with stroke,and analyze the influencing factors of fear of falling,explore the correlation between the fear of falling,the risk of falling at home and the ADL,and aim to provide the basis for the scientific formulation of the intervention measures for fear of falling in elderly patients with stroke,promote the establishment and perfection of aged care service system.MethodsIt was a cross-sectional survey,totally 314 elderly with stroke were investigated from three Community health service centers in ZhengZhou from October 2016 to September 2017.The tools including a demographic data questionnaire,the modified Survey of Activities and Fear of Falling in the Elderly(mSAFFE),Home Falls and Accidents Screening Tool(HOME FAST),Barthel Index(BI),Short Portable Mental Status Questionnaire(SPMSQ).Data entry by Epidata3.1 and statistical analysis by SPSS17.0.Statistical methods including Descriptive analysis,T-test,ANOVA,Multiple stepwise regression and stratified stepwise regression,Partial and Pearson correlation analysis.Results1.The total score of fear of falling was 35.55±4.32,the mean score of item was 2.09±0.25,the dimension of social capacity score was the highest 2.44±0.36,ADL and IADL dimension score was the lowest 1.99±0.40.Stratified stepwise regression showed that risk of falling at home,ADL,course of disease,main caregiver,activity,rehabilitation guidance,type of stroke,history of falling,and multiple disease coexistence were the major influential factor,which can represent 64.6% of the variance,the risk of falling at home can explain additional 12.4% alone.2.The total score of falling risk at home was 15.13±2.05,the mean score of item was 0.89±0.12.the dimension of home environment score was the lowest 0.55±0.10.Multivariate stepwise regression analysis showed: ADL,education level,type of stroke,rehabilitation guidance,source of economic and medical insurance type were the major influential factor,which can explain 34.5% of the variance.3.The total score of ADL was 80.14±10.71,and 73.6% patients were mild dysfunction.4.The results of correlation analysis showed that the fear of falling was negatively correlated with the risk of falling at home,fear of falling was negatively correlated with ADL.Conclusion1.The level of fear of falling of community-dwelling older adults with stroke was the high level,Influence factors including the risk of falling at home,ADL,course of disease,main caregiver,activity,rehabilitation guidance,type of stroke,the history of falling and multiple disease coexistence.2.The community-dwelling older adults with stroke have a high risk of falling at home,especially the problem of family environment.Influence factors including education level,type of stroke,rehabilitation guidance,source of economic and medical insurance type.3.To reduce the risk factors of falling at home among the community-dwelling older adults with stroke,and to improve ADL level is expected to enhance the state of fear of falling.