比較五種跌倒風險量表應用於住院病患的差異

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題名:	比較五種跌倒風險量表應用於住院病患的差異 Comparison of five fall-risk assessment tools in hospitalized patients in an acute-care hospital
作者:	李昱君 Li, Yu-Jyun
貢獻者:	林茂榮
關鍵詞:	急性醫院;病人安全;病患跌倒;跌倒風險評估;跌倒風險量表 acute care hospital;patient safety;patient falls;falls-risk assessment tool;falls-risk assessment scale
日期:	2017-07-10
上傳時間:	2020-08-19 15:45:49 (UTC+8)
摘要:	要執行預防措施以降低住院病患發生跌倒，必須能準確篩檢出住院病患之跌倒高風險群，才能進一步執行預防跌倒措施，降低住院病患的跌倒發生率。我們設計病例對照研究，收集跌倒者與非跌倒者進行分析，比較北區某區域教學醫院自行發展的En-Chu-Kong fall risk scale(ECKFRS)及其他四種國際間常用的跌倒風險評估量表，包括St. Thomas Risk Assessment Tool in Falling Elderly Inpatients (STRATIFY)、Morse量表、Hendrich量表以及Johns Hopkins fall risk assessment tool (JHFRAT)，評估急性醫療院所住院病患之跌倒分數及風險差異。卡方分配及Student’s t-test分析結果顯示，不論使用五種量表中的任何一種，跌倒者的跌倒風險分數與高風險群之比例皆顯著高於非跌倒者。邏輯斯迴歸模式比較五種跌倒風險量表的跌倒勝算比時，ECKFRS量表的勝算比為7.7 (95%信賴區間3.4-17.2)，Hendirch量表次之(勝算比3.9，95%信賴區間2.7-5.8)，Morse量表的跌倒勝算比為2.8(95%信賴區間2.1-3.7)，而JHFRAT量表的跌倒勝算比為3.7(95%信賴區間2.7-5.2)。當評估對象為65歲以上的病患時，JHFRAT量表的勝算比4.2最高(95%信賴區間2.3-7.6)。比較使用五種跌倒風險量表需要的時間，使用STRATIFY量表所需平均時間最短為12.3秒，JHFRAT量表所需平均時間最長為51.6秒。由於這五種跌倒風險量表的跌倒勝算比會因評估對象的不同而有所差異，未來仍須將做進一步的信效度測試，才能驗證不同的跌倒風險量表預測住院病患跌倒之成效。 It is essential to understand the predictive accuracy of falls risk assessment tools in order to implement effective falls prevention strategies to hospitalized patients. The purpose of this study was to compare the ability of differentiating the fall risk amongst five tools commonly used in an acute care hospital inpatient population. The five falls risk assessment tools include En-Chu-Kong Fall Risk Scale (ECKFRS), St. Thomas Risk Assessment Tool in Falling Elderly Inpatients (STRATIFY), Morse fall scale, Hendrich Fall Risk Assessment Tool, and Johns Hopkins Hospital Fall Risk Assessment Tool (JHFRAT). This study retrospectively studied falls using case-control study design. The average risk scores obtained using all five tools for cases (fallers) are higher than controls (non-fallers). The proportion of high-risk patients in the case group is also higher than it in the control group. Amongst the five fall-risk assessment scales, the ECKFRS had the highest odds ratio (OR) (OR: 7.7, 95% confidence interval (CI):3.4-17.2) on predicting falls followed by Hendirch (OR: 3.9, 95% CI:2.7,5.8). The OR of STRATIFY was 3.2 (95% CI:2.3-4.5), Morse was 2.8 (95% CI: 2.1-3.7) and JHFRAT was 3.7 (95% CI:2.3-4.5). For predicting a fall in the age group of 65 years or older, the JHFRAT had highest OR (OR:4.2, 95% CI :2.3-7.6). The findings also suggested STRATIFY requires the least amount of completion time (mean: 12.3 seconds), whereas JHFRAT requires the longest amount of completion time (mean: 51.6 seconds). According the different OR on predicting fall owing to the different study subjects, it is necessary to further assess reliability and validity in future studies to verify the effectiveness of the falls risk scale.
描述:	碩士指導教授:林茂榮委員:鄭綺委員:張光華
資料類型:	thesis
顯示於類別:	[傷害防治學研究所] 碩博士論文

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