老年住院患者跌倒警觉度的研究进展
Research Progress of Fall Alertness in Elderly Hospital Patients
DOI: 10.12677/ns.2025.1410233, PDF,   
作者: 杜双双, 赵苗苗, 康亦凡：湖北中医药大学护理学院，湖北 武汉；王 莉*, 张心怡：武汉市中西医结合医院，护理部，湖北 武汉
关键词: 老年住院患者；跌倒警觉度；跌倒风险；自我意识；综述；Elderly Hospitalized Patients； Fall Alertness； Fall Risk； Self-Awareness； Review
摘要: 老年住院患者的跌倒问题已成为全球性的健康挑战，不仅导致患者的身体损伤，还可能引发长期卧床不起、生活质量显著下降甚至危及生命安全。因此，针对这一群体跌倒警觉度的深入研究尤为迫切。本文综合探讨老年住院患者跌倒警觉度的核心概念、现有评估工具的应用、关键影响因素分析以及有效的干预策略，旨在通过全面综述，促进对老年住院患者跌倒问题的深入理解，并为制定针对性的预防与干预措施提供科学依据。
Abstract: Falls in elderly hospital patients constitute a global health challenge, which is not only directly related to the physical injury of the patients, but also may lead to long-term bedridden, a significant decline in the quality of life and even a serious threat to life safety. Therefore, an in-depth study of fall alertness in this group is particularly urgent and important. The purpose of this article is to comprehensively explore the core concepts of fall alertness in elderly hospitalized patients, the application of existing assessment tools, the analysis of key influencing factors, and effective intervention strategies. By comprehensively reviewing these aspects, it is hoped to promote a deeper understanding of falls in elderly hospitalized patients and to provide a scientific basis for the development of targeted preventive and intervention measures.
文章引用：杜双双, 王莉, 张心怡, 赵苗苗, 康亦凡. 老年住院患者跌倒警觉度的研究进展[J]. 护理学, 2025, 14(10): 1745-1752. https://doi.org/10.12677/ns.2025.1410233

参考文献

[1] 陈小润, 罗莉, 黄葭燕. 基于哈顿模型的老年住院患者跌倒特征分析及防跌倒建议[J]. 复旦学报(医学版), 2024, 51(4): 552-557.
[2] Shyu, M., Huang, H., Wu, M. and Chang, H. (2018) Development and Validation of the Self-Awareness of Falls in Elderly Scale among Elderly Inpatients. Clinical Nursing Research, 27, 105-120. [Google Scholar] [CrossRef] [PubMed]
[3] 韩清波, 钟媛, 张巧玲, 等. 老年住院患者复合跌倒风险评分表的构建及应用研究[J]. 护理学杂志, 2024, 39(1): 56-59, 71.
[4] 蔡伦, 林岑, 周鼒, 等. 老年人跌倒的公共卫生研究进展[J]. 中国老年学杂志, 2018, 38(9): 2265-2268.
[5] Rao, W., Zong, Q., Lok, G.K.I., Wang, S., An, F., Ungvari, G.S., et al. (2018) Prevalence of Falls in Adult and Older Adult Psychiatric Patients in China: A Systematic Review and Comprehensive Meta-Analysis of Observational Studies. Psychiatry Research, 266, 18-25. [Google Scholar] [CrossRef] [PubMed]
[6] Montero-Odasso, M., Van Der Velde, N., Martin, F.C., et al. (2022) World Guidelines for Falls Prevention and Management for Older Adults: A Global Initiative. Age and Ageing, 51, afac205.
[7] Christiansen, T.L., Lipsitz, S., Scanlan, M., Yu, S.P., Lindros, M.E., Leung, W.Y., et al. (2020) Patient Activation Related to Fall Prevention: A Multisite Study. The Joint Commission Journal on Quality and Patient Safety, 46, 129-135. [Google Scholar] [CrossRef] [PubMed]
[8] de Jong, L.D., Francis-Coad, J., Waldron, N., Ingram, K., McPhail, S.M., Etherton-Beer, C., et al. (2021) Does Free-Text Information in Falls Incident Reports Assist to Explain How and Why the Falls Occurred in a Hospital Setting? Journal of Patient Safety, 17, e1472-e1479. [Google Scholar] [CrossRef] [PubMed]
[9] 周园, 李凌, 曹晓文. 老年患者对预防跌倒的认知及依从性调查分析[J]. 护理学杂志, 2013, 28(17): 37-39.
[10] Dolan, H., Slebodnik, M. and Taylor‐Piliae, R. (2022) Older Adults’ Perceptions of Their Fall Risk in the Hospital: An Integrative Review. Journal of Clinical Nursing, 31, 2418-2436. [Google Scholar] [CrossRef] [PubMed]
[11] 赵云龙, 王学民, 薛然婷, 等. 基于复杂性度量的大脑警觉度分析[J]. 生物医学工程学杂志, 2015, 32(4): 725-729.
[12] 鲍冠君, 刘苑菲, 罗烨, 等. 住院病人跌倒风险感知研究进展[J]. 护理研究, 2022, 36(19): 3468-3472.
[13] 田露, 陈英. 老年患者跌倒自我管理研究进展[J]. 中国护理管理, 2019, 19(6): 919-923.
[14] Mihaljcic, T., Haines, T.P., Ponsford, J.L. and Stolwyk, R.J. (2017) Investigating the Relationship between Reduced Self-Awareness of Falls Risk, Rehabilitation Engagement and Falls in Older Adults. Archives of Gerontology and Geriatrics, 69, 38-44. [Google Scholar] [CrossRef] [PubMed]
[15] Mihaljcic, T., Haines, T.P., Ponsford, J.L. and Stolwyk, R.J. (2015) Self-Awareness of Falls Risk among Elderly Patients: Characterizing Awareness Deficits and Exploring Associated Factors. Archives of Physical Medicine and Rehabilitation, 96, 2145-2152. [Google Scholar] [CrossRef] [PubMed]
[16] Kumai, K., Kawabata, N., Meguro, K., Takada, J., Nakamura, K. and Yamaguchi, S. (2021) Mental and Physical Self-Awareness of Alzheimer Patients: Decreased Awareness of Amnesia and Increased Fear of Falling Compared to Views of Families: The Tajiri and Wakuya Projects. Dementia and Geriatric Cognitive Disorders, 50, 96-102. [Google Scholar] [CrossRef] [PubMed]
[17] 崔梦影, 王颖, 蔡悦, 等. 住院老年患者跌倒警觉度现状及影响因素研究[J]. 护理学杂志, 2023, 38(17): 10-13.
[18] 何细飞, 刘清华, 王曼, 等. 老年人跌倒警觉度量表在老年住院病人中的信效度检验[J]. 护理研究, 2023, 37(1): 47-51.
[19] 吕磊, 车腾雨, 成杰, 等. 老年脑卒中住院病人跌倒警觉度现状及影响因素[J]. 护理研究, 2025, 39(11): 1917-1923.
[20] 李志宏, 赵志艳, 哈琳, 等. 心血管内科老年跌倒高危病人警觉度现状及影响因素[J]. 护理研究, 2024, 38(20): 3730-3734.
[21] 邓潇, 李德威, 伍祯, 等. 农村老年高血压患者跌倒警觉度现状及影响因素研究[J]. 护理学杂志, 2024, 39(22): 103-106, 111.
[22] Bower, E.S., Wetherell, J.L., Merz, C.C., Petkus, A.J., Malcarne, V.L. and Lenze, E.J. (2015) A New Measure of Fear of Falling: Psychometric Properties of the Fear of Falling Questionnaire Revised (FFQ-R). International Psychogeriatrics, 27, 1121-1133. [Google Scholar] [CrossRef] [PubMed]
[23] 王蕾, 王颖, 鲁志卉, 等. 修订版跌倒恐惧问卷的汉化及信效度研究[J]. 护理研究, 2022, 36(7): 1134-1138.
[24] Mihaljcic, T., Haines, T.P., Ponsford, J.L. and Stolwyk, R.J. (2014) Development of a New Self-Awareness of Falls Risk Measure (SAFRM). Archives of Gerontology and Geriatrics, 59, 249-256. [Google Scholar] [CrossRef] [PubMed]
[25] Chen, W., Li, Y., Tung, T., Chen, C. and Tsai, C. (2021) The Relationship between Falling and Fear of Falling among Community-Dwelling Elderly. Medicine, 100, e26492. [Google Scholar] [CrossRef] [PubMed]
[26] Castle, S.C. (2019) Despite Active Public Health Campaigns, Death from Falls Increased 30% in the Past Decade: Is Ageism Part of the Barrier to Self-Awareness? Clinics in Geriatric Medicine, 35, 147-159. [Google Scholar] [CrossRef] [PubMed]
[27] 栗欢, 柏晓玲, 郭世鸿, 等. 老年脑卒中住院患者跌倒警觉度现状及影响因素研究[J]. 当代护士(下旬刊), 2024, 31(10): 123-127.
[28] 王越, 刘鲁蓉. 1990-2019年中国老年人跌倒发生与死亡趋势及其年龄-时期-队列模型分析[J]. 中国循证医学杂志, 2024, 24(7): 783-791.
[29] Shyamala, T., Wong, S., Andiappan, A., Au Eong, K., Bakshi, A., Boey, D., et al. (2015) Health Promotion Board-Ministry of Health Clinical Practice Guidelines: Falls Prevention among Older Adults Living in the Community. Singapore Medical Journal, 56, 298-301. [Google Scholar] [CrossRef] [PubMed]
[30] 仵三娟, 杨辉, 陈洋洁, 等. 脑卒中住院病人及其照顾者预防跌倒知识和行为现状调查及影响因素分析[J]. 护理研究, 2020, 34(12): 2198-2202.
[31] 聂作婷, 陈龙, 曾凯, 等. 老年人跌倒风险感知研究现状及其对老年人主动跌倒预防的启示[J]. 中国全科医学, 2024, 27(19): 2395-2400.
[32] Ouyang, P. and Sun, W. (2018) The Association between Depressive Symptoms and Fall Accidents among Middle-Aged and Elderly People in China. Environmental Health and Preventive Medicine, 23, 1-8. [Google Scholar] [CrossRef] [PubMed]
[33] E, J., Mihailovic, A., Kuo, P., West, S.K., Friedman, D.S., Gitlin, L.N., et al. (2020) Characterizing the Impact of Fear of Falling on Activity and Falls in Older Adults with Glaucoma. Journal of the American Geriatrics Society, 68, 1847-1851. [Google Scholar] [CrossRef] [PubMed]
[34] Turner, N., Jones, D., Dawson, P. and Tait, B. (2019) The Perceptions and Rehabilitation Experience of Older People after Falling in the Hospital. Rehabilitation Nursing, 44, 141-150. [Google Scholar] [CrossRef] [PubMed]
[35] 张雨欣, 张开利. 老年人恐惧跌倒相关性活动限制的研究进展[J]. 中华护理杂志, 2023, 58(1): 112-116.
[36] 吴凡, 绳宇. 社会支持网络、自我效能及健康促进行为对老年人影响的路径分析[J]. 中华护理杂志, 2019, 54(11): 1701-1706.
[37] 朱杉杉, 毛盼, 王璐, 等. 预防老年病人跌倒并减少跌倒损伤的循证护理实践[J]. 护理研究, 2024, 38(17): 3160-3165.
[38] Khong, L.A.M., Berlach, R.G., Hill, K.D. and Hill, A. (2017) Can Peer Education Improve Beliefs, Knowledge, Motivation and Intention to Engage in Falls Prevention Amongst Community-Dwelling Older Adults? European Journal of Ageing, 14, 243-255. [Google Scholar] [CrossRef] [PubMed]
[39] 王倩, 王燕. 国内外预防患者跌倒护理方法研究进展[J]. 护理学杂志, 2013, 28(5): 87-90.
[40] 徐永能, 黄巧, 卢少萍, 等. 护患互动健康信念模式在预防住院老年病人跌倒中的应用效果[J]. 护理研究, 2020, 34(7): 1300-1304.
[41] 魏曾曾, 杜峰, 王同. 同伴教育在老年患者跌倒预防中的效果评价[J]. 当代护士(中旬刊), 2021, 28(1): 135-136.
[42] Frith, J. (2017) Fall Prevention: Empowering People through Online Education. The Annals of Family Medicine, 15, 482-482. [Google Scholar] [CrossRef] [PubMed]
[43] Noublanche, F., Simon, R., Ben-Sadoun, G. and Annweiler, C. (2022) Physical Activity and Fall Prevention in Geriatric Inpatients in an Acute Care Unit (AGIR Study): Protocol for a Usability Study. JMIR Research Protocols, 11, e32288. [Google Scholar] [CrossRef] [PubMed]
[44] 周巧, 颜笛玉. 奥塔戈运动锻炼项目对跌倒恐惧老年患者的应用效果[J]. 中国临床护理, 2021, 13(1): 30-31+35.
[45] 韩琼, 李家华, 吴林静, 等. 运动康复预防老年住院患者跌倒的最佳证据总结[J]. 中国医药科学, 2024, 14(19): 118-123.
[46] 马晓玲, 尚开健, 卫鹏. 老年综合评估在跌倒预防和生存质量改善中的应用[J]. 临床医药实践, 2022, 31(5): 391-393.
[47] 陈小燕, 沈小华, 张洁, 等. 游戏化策略结合情景视频教育在老年慢性病患者跌倒预防中的应用[J]. 健康研究, 2025, 45(3): 344-348.
[48] 李冬云. 综合护理干预预防老年高血压或糖尿病患者跌倒的效果分析[J]. 中国地方病防治杂志, 2017, 32(5): 588.
[49] Pfeiffer, K., Kampe, K., Klenk, J., Rapp, K., Kohler, M., Albrecht, D., et al. (2020) Effects of an Intervention to Reduce Fear of Falling and Increase Physical Activity during Hip and Pelvic Fracture Rehabilitation. Age and Ageing, 49, 771-778. [Google Scholar] [CrossRef] [PubMed]

为你推荐