Investigation And Analysis Of The Status Quo And Risk Factors Of Falls In Elderly Patients With Chronic Diseases At Home

Objective:To understand the current situation of falls in elderly patients with chronic diseases at home,and analyze the risk factors leading to falls in elderly patients with chronic diseases at home,so as to provide reference for the formulation of falls prevention measures for elderly patients with chronic diseases at home.Methods:In this study,two communities in an urban area of jinan city were selected as investigation units.478 home-based elderly patients over 60 years old with chronic diseases were selected as research objects by convenience sampling method.The investigators are nurses with unified training and rich experience in community work.The contents of the questionnaire include general information survey,health status,prevalence of falls,daily living activities,fall effectiveness,cognitive status of falls,knowledge demand for falls,and home environment,etc.SPSS20.0 software was used for data statistical analysis,and the adoption rate,composition ratio,mean and standard deviation were used to describe the general information,daily life activity ability,fall effectiveness,fall cognitive status,fall knowledge demand,home environment and fall status.One-way analysis of falls was conducted by chi-square test and t-test,and multivariate analysis was conducted by logistic regression analysis,with P < 0.05 as statistically significant difference.Results:1.General information and health statusAmong the respondents,273 were female(57.1 %)and 205 were male(42.9%).Age: 60~90(71.57±5.72)years old,most of the respondents had good visual hearing,good defecation control,normal sleep and feeling.98.4% of the respondents had normal daily activity ability,while 0.8% of the respondents had decreased daily activity ability and 0.8% of the respondents had functional impairment.The efficacy score of 87.4% of the respondents was 10 points,and they were confident enough to complete daily activities.122(25.5 per cent)had frequent toilet visits.There were 319 patients with one chronic disease,accounting for 66.7%.The number of patients with more than one type of disease was 159(33.3%).Circulatory diseases accounted for the largest number(368 patients,accounting for 77.0%),followed by endocrine and nutritional metabolic diseases(159 patients,accounting for 33.3%).Of the respondents,242(50.6%)took two drugs,42(8.8%)took three drugs,and 29(6.1%)took four or more drugs.Antihypertensive drugs(248 patients,51.9%),followed by antihypertensive drugs(110 patients,23.0%),lipid-regulating drugs(95 patients,19.9%),and hypoglycemic drugs(75 patients,15.7%).2.Current situation of fallsOf the 478 respondents,49 had falls,and the incidence of falls was 10.3%.The number of women(28,57.1%)was higher than men(21,42.9%).The age range with the most falls was 70~79 years old(24 persons,accounting for 49.0%).The largest number of falls occurred in the morning(17,accounting for 34.7%).The main location of the fall was outdoor(33 people,accounting for 67.3%).3.Consequences of falls8 people were disabled after falling,accounting for 16.3%;Fourteen patients(28.6%)suffered fractures.4 patients had hematoma,accounting for 8.2%.3 persons were grazed,accounting for 6.1%;There were 23 patients with frequent discomfort at the injured site,accounting for 46.9%.14 patients recovered more than 3 months after falling,accounting for 28.6%.There were 53.1%(26)of those who fell had negative emotions due to falling,and 65.3%(32)of those who fell were afraid of falling again.4.Risk factors for fallsBy single factor analysis,20 factors were screened out as having statistical differences: age,economy,medical treatment charge payment,living conditions,caregivers,walking ability,vision,hearing,fecal incontinence,urinary incontinence,sleep status,number of chronic diseases,paresthesia,foot disease,number of frequent toilet,medication,daily life activities ability,fall down efficiency,the environment that occupy the home,and knowledge demand.The results of multi-factor analysis showed that there were 5 risk factors of falling,including vision loss,insomnia,frequent toilet use,number of chronic diseases ?4,and decreased ability of daily life activities.The protective factor for falls is the high demand for knowledge of falls.Conclusions:The incidence of falls in elderly patients with chronic diseases at home is higher.Falls affect the physical and mental health of home-based elderly patients with chronic diseases,and bring disability,fracture,hematoma and other consequences to home-based elderly patients with chronic diseases,leading to their fear of falling.The risk factors for falls of home-based elderly patients with chronic diseases were visual impairment,insomnia,frequent toilet use,number of chronic diseases ?4,and decreased ability of daily life activities.The protective factor for falls is the high demand for knowledge of falls.