獨居老人跌倒情形、步態、居家環境及身體功能評估

Fall, Gait, Home Environment, and Physical Function in Living Alone Older Adults

傅麗蘭(Li-Lan Fu) ； 楊政峰(Jeng-Fang Yang)

《中華民國物理治療學會雜誌》 24卷2期 (1999/03) Pp. 53-62

https://doi.org/10.29616/JPTAROC.199903.0001

摘要

本研究針對台南市安平區獨居老人之跌倒情形、步態、居家環境及身體功能進行居家訪視評估，希望可以更了解此一特殊的族群，進而發展出最好的醫療照護。本研究調查的對象為台南市安平區獨居老人，根據戶籍資料有95位，社區居民另提供5位共有100位獨居老人，但只有46位老人完成評估，其中2位因長期或短期記憶不佳的受測者不在資料分析的樣本內，54位未接受評估的原因包括因病住院、死亡、遷徙、拒訪、為不符合本研究獨居之定義。研究結果顯示：44位受測者平均年齡為75.0±5.1歲，男性(68.2%)多於女性(31.6%)，外省籍(57%)多於本省籍(43%)。對健康狀況的自我認知為良好或非常良好者有59.1%，實際看門診次數每月一次或少於一次者有77.3%，顯示其健康狀況並不差。多數仍有固定談話的對象，僅少數可能整天沒有與人交談，可知獨居老人仍有其社會生活。大部分的老人，對於將來無法自主行動時，仍表示不願接受機構式照顧，勉強可接受的是居家照顧。對於目前獨居生活，最需要協助者為有人陪同聊天。居家環境最常出現問題的前三位是房門入口有門檻、階梯高度大於15公分、及燈光太暗或刺眼。步態評估最常出現的問題分別是腳著地時前足度與地面夾角不足、步伐遲滯緩慢、及缺乏前進動力。在基本及進階日常生活功能分別有43位及29位可以完全獨立。本研究的跌倒發生率為32%，平均年齡73.9歲，跌倒的地點以門或入口處發生跌倒比例最高，達45%。包括年齡、步態、居家環境、及身體功能在跌倒者及非跌倒者之間的差異並無統計學上之意義。

關鍵字

獨居老人 ； 跌倒 ； 環境評估

並列摘要

The present study investigated the fall frequency, gait performance, home environment and physical function of living alone older adults in Tainan municipal, district of An-Ping. There are 95 living alone older adults according to the household record. Residents of this area supplied a list of another five persons who met our criteria but were not on the list at the begginning of the investigation. Forty-six sugjects finished all assessments. Reasons for not finishing the assessment included sickness, death, relocation, rejection, or not meeting our criteria for living alone. Two subjects were excluded from data analysis due to poor long-term and short-term memories. The average age was 75±5.1 years and range from 66 to 87 years. There were 30 males and 14 females. About 59% of all subjects rated their health status as good or very good. Seventy- seven percent of subjects visited their doctor one or less per month. About 86.4% of subjects have more than one person to talk to. Fifty percent of subjects would choose home care and only 9% would choose institutional care once they can’t live alone. Most subjects reported that having somebody to talk to was the most urgent service they need. The top three home environment problems were step before entrance, steps higher than 15cm, and poor lighting in the room. The top three gait problems were a smaller angle between forefoot and ground during heel strike, slower pace, and lack of forward propulsion. Thirty two percent of subjects reported episodes of falls and 45% of the falls happened at the doorway or entrance. There are no statistically significant difference in age, gait, home environment, and physical function between fallers and nonfallers. Identify the need for bealth care and risk factors of falls in living alone older adults required further investigation.

並列關鍵字

Living alone older adults ； Fall ； Gait ； Home environment