新型“防滑小紅襪”對老年住院患者跌倒預(yù)防的臨床研究

高燕飛 章妙玉 鐘玲玲

[摘要] 目的 探討新型“防滑小紅襪”對老年住院患者跌倒的預(yù)防作用。 方法 選擇2015年12月～2017年6月在本院老年科、心血管科和神經(jīng)內(nèi)科住院的老年患者600例為研究對象，隨機(jī)分為試驗組與對照組各300例。對照組給予常規(guī)干預(yù)，試驗組在此基礎(chǔ)上應(yīng)用新型“防滑小紅襪”，比較住院期間兩組患者跌倒發(fā)生率、跌倒傷害程度，預(yù)防跌倒知識、態(tài)度及行為評分。 結(jié)果 試驗組住院期間1例發(fā)生跌倒，發(fā)生率0.3%，對照組9例發(fā)生跌倒，發(fā)生率3.0%。兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。試驗組1例跌倒，為1級，對照組3例1級，4例2級，2例3級，差異有統(tǒng)計學(xué)意義（P<0.05）。干預(yù)后，試驗組的預(yù)防跌倒知識、態(tài)度、行為得分均顯著高于對照組，差異有統(tǒng)計學(xué)意義（P<0.05）。 結(jié)論 老年住院患者應(yīng)用新型“防滑小紅襪”能夠有效預(yù)防住院期間跌倒發(fā)生率，降低跌倒傷害程度，改善預(yù)防跌倒知識、態(tài)度及行為。

[關(guān)鍵詞] 防滑小紅襪;老年住院患者;跌倒;預(yù)防

[中圖分類號] R472? ? ? ? ? [文獻(xiàn)標(biāo)識碼] B? ? ? ? ? [文章編號] 1673-9701（2019）09-0153-04

[Abstract] Objective To explore the effect of the new type "slip-resistant small red sock" on the fall prevention in elderly inpatients. Methods A total of 600 elderly patients who were hospitalized in the Department of Geriatrics， Department of Cardiology and and Department of Neurology in our hospital from December 2015 to June 2017 were selected as study subjects and were randomly divided into the experimental group and the control group， with 300 cases in each group. The control group was given routine intervention， and the experimental group was given the new type "slip-resistant red small socks" on this basis. The incidence rate of falls， the degree of fall injury， and the scores of the knowledge， attitudes， and behaviors of fall prevention were compared between the two groups during hospitalization. Results One case fell during the hospitalization in the experimental group， and the incidence rate was 0.3%， while in the control group， 9 cases fell， and the incidence rate was 3.0%， the difference between the two groups was statistically significant （P<0.05）. One case fell in the experimental group， which was level 1， in the control group， 3 cases were level 1， 4 cases were level 2， and 2 cases were level 3， and the difference was statistically significant （P<0.05）. After the intervention， the scores of fall prevention knowledge， attitude and behavior in the experimental group were significantly higher than those in the control group， and the differences were statistically significant（P<0.05）. Conclusion The application of the new type “slip-resistant small red socks” for the elderly inpatients can effectively prevent the incidence rate of falls during hospitalization， reduce the degree of fall injury， and improve the knowledge， attitudes and behaviors of fall prevention.

[Key words] Slip-resistant small red sock; Elderly inpatients; Fall; Prevention

老年住院患者跌倒常常涉及多個專科，以內(nèi)科老年住院患者居多。老年住院患者容易跌倒與患者機(jī)體衰老、神經(jīng)系統(tǒng)退行性改變、控制能力下降等有關(guān)。跌倒影響老年患者的健康，甚至危及生命，是最常見的醫(yī)院內(nèi)不良事件。老年人跌倒后容易導(dǎo)致髖部骨折，6個月內(nèi)死亡率高達(dá)20%～24%，50%喪失獨立生活能力。根據(jù)美國疾病預(yù)防和控制中心統(tǒng)計，65歲以上老年人中，每年約有1/3的人曾經(jīng)跌倒[1]。我國已于1999年進(jìn)入老齡社會，是世界上老年人口最多的國家。民政部2014年6月發(fā)布的《2013年社會服務(wù)發(fā)展統(tǒng)計公報》顯示，截至2013年底，全國60歲及以上老年人口20 243萬人，占總?cè)丝诘?4.9%，其中65歲及以上人口13 161萬人，占總?cè)丝诘?.7%[2]。高茂龍等[3]通過循證醫(yī)學(xué)Meta 分析的方法，得出我國老年人跌倒的發(fā)生率是18.3%。隨著老年人的增加，跌倒將會對醫(yī)療服務(wù)體系造成更嚴(yán)重的經(jīng)濟(jì)沖擊。鞋過大或鞋底摩擦力小是滑倒的主要原因，“穿著適宜的鞋具”已被作為一個要素列入各國的跌倒干預(yù)技術(shù)指南。澳大利亞維多利亞州采用“防滑襪”和一系列的運動干預(yù)措施，讓高風(fēng)險患者在住院期間穿“防滑襪”，并結(jié)合相關(guān)的運動、走路技巧培訓(xùn)，確?；颊咦≡浩陂g的行走安全。有研究認(rèn)為對老年住院患者采用新型“防滑小紅襪”為主的綜合干預(yù)措施，有可能大幅度減少跌倒的發(fā)生，并能減少因為跌倒而產(chǎn)生的一系列的醫(yī)療護(hù)理費用和法律糾紛。本研究將新型“防滑小紅襪”用于老年住院患者，探討其對老年患者跌倒的預(yù)防作用，現(xiàn)報道如下。