多元跌倒預防計畫對改善老人跌倒相關變項和生活品質之成效探討

Abstract

目的：本研究目的在探討以多元策略實施跌倒預防計畫後，對於改善老人的跌倒預防知識、信念、自我效能、預防行為、發生率、身體功能及其生活品質之成效。方法：本研究為準實驗設計(quasi-experimental design)，研究對象為南部某鄉鎮之社區老人為實驗組，同縣另一鄉鎮之老人為控制組。本研究對象於前測時實驗組121人、控制組66人，共計187人。後測時人數實驗組為115人、控制組為55人，共計有170人。結果：介入後，實驗組老人較控制組老人之跌倒預防知識、信念以及自我效能均有效提升，但跌倒預防行為中僅床邊放置手電筒一項有顯著改變，跌倒發生率則估計降低28.5%。實驗組老人在20秒屈膝起立、下肢肌力、握力、反應時間、平衡能力等身體功能項目之後測得分皆顯著高於控制組。實驗組老人在SF-36所測量的生活品質各變項於後測得分亦顯著優於控制組，但在身體疼痛(BP)以及心理健康(MH)兩變項未達統計上顯著差異。結論：本研究發現採取多元介入策略之跌倒預防計畫確實可改善老年人的跌倒預防知識、信念、自我效能、身體功能，並改善其生活品質，並對於跌倒發生率有中等偏微弱程度的效果量，但有部分結果變項並未有顯著介入效果，後續研究宜擴大推廣，加大樣本數以進一步驗證成效，以造福更多的台灣老人。

This study describe the implementation and the effects of a multifactorial fall prevention trial on knowledge, belief, self-efficacy, behaviors, incidence of falls, physical function, and health-related quality of life. Method: A quasi-experimental design was employed in the study. 121 elders in experimental group were recruited from a rural area in south Taiwan, and 66 counterparts were recruited from the other rural area in the same county. Results: The experimental group showed significantly more positive results in the scores of knowledge, belief, and self-efficacy, and in the improvement of sit-to-stand times, muscle strength of lower limbs, hand grasp, reaction time, and balance after intervention than the control group. The experimental group experienced a 28.5% reduction in falls, and the only significantly improvement of fall-related behaviors was putting a flashlight nearby the bed. The scores of health-related quality of life were significantly higher in the experimental group except bodily pain (BP) and mental health (MH). Conclusion: Multifactorial fall prevention programs were effective in improving knowledge, belief, self-efficacy, physical function, and health-related quality of life. However, there is only moderate effects in reducing incidence.