- 期刊
住院老年精神病人跌倒危險因子分析－回溯性病例對照研究
Risk Factors for Falls in a Psycho-geriatric Inpatient Unit: A Retrospective Case-control Study
摘要
本研究目的係以病例對照研究法分析老年精神病人跌倒之危險因子，資料回溯自2004年1月至2007年6月北部某醫學中心老年精神科病房年齡65歲（含）以上之意外事件、病歷記錄及護理記錄，發現跌倒者有83位，並以發生跌倒當時同一病房經配對控制年齡及住院天數等二變項後列為對照組收案84位，經多變項邏輯式迴歸分析，結果發現跌倒組激躁行為之跌倒風險(odds ratio, OR)為對照組的4.02倍；跌倒發生前24小時服用藥種類多者之跌倒風險(OR)為對照組的1.28倍；Depakine每日劑量也具有統計上之意義。因此，本研究以激躁行為、多重用藥及Depakine每日高劑量等變項為老年精神病人跌倒之危險因子，故而臨床上護理人員早期評估確認病人的跌倒危險因子，提供適當的防範指導與措施，並夥同病人主要照顧者及其他工作人員，方能降低跌倒之風險。
並列摘要
This study was to analyze the risk factors of falls in a psycho-geriatric inpatient unit. A retrospective case-control study was conducted from January 2004 to June 2007. Data, including ages over or equal to 65 years were collected from a medical chart, incidents reports and nursing records. There were 83 fallers and matching controls were ages, and pre-event length of stay during the incidents of fall in the same unit. There were 84 in the control group. Data were analyzed by multivariate logistic regression. The results found that the odds ratio (OR) of the agitated behaviors in the fall group compared with the control group was 4.02. The OR of the poly-drugs (within 24 hours) was 1.28, and daily dosages of depakine were also significantly different. In conclusion, agitated behaviors, poly-drugs, and depakine dosages were found to increase the risks of fall among psycho-geriatric inpatients. The study suggested that nurses to define the risk factors of fall by assessing early among elderly patients who had the potential to reduce the incidents of fall. To prevent future falls, appropriate education and interventions should be provided for patients as well as to the core caregivers and team workers.