社區長者預防跌倒介入之成效

Effects of a Fall Prevention Program on Community Dwelling Elderly

本研究旨在了解社區長者參與防跌教室之成效，並透過問卷及相關身體評估項目檢查，了解個案預防跌倒之知識、態度、行為與身體評估項目的改變進行探討。本研究為單組前後測介入性研究設計，採立意取樣，有效樣本為172人，平均年齡為66.4歲（SD＝8.06），79.1％為女性，研究工具含基本資料表、簡易身體項目評估表和防跌知識、態度與行為問卷，前測在介入開始的前一週完成，研究介入為2個月內完成12回防跌衛教與運動課程，課程完成後一週進行後測。研究結果發現參與者在身體評估項目包括腰圍（t＝-2.79，p＝.006）、腰臀比（t＝-2.09，p=.038）、屈膝起立測驗（t＝-5.55，p＝.000）、20公尺行走時間（t＝4.63，p＝.000）、上肢柔軟度（χ^2＝64.21，p＝.019）、計時起走（χ^2＝188.86，p＝.000）以及單足站立平衡檢查（左腳χ^2＝37.81，p＝.000）均顯著進步。同時，防跌知識（t＝4.41，p＝.000）、態度（t＝3.66，p＝.000）與行為（t＝4.23，p＝.000）亦有顯著改善。進一步分析發現女性的防跌態度改善程度明顯優於男性（t＝4.96， p＝.027），有配偶者之防跌行為比無配偶者顯著進步（t＝6.54，p＝.012）；國高中職程度（F＝3.29，p＜.05）及無運動習慣者（F＝6.31，p＜.01）腰圍減少最多，無運動習慣比有運動習慣者上肢柔軟度明顯提升（F＝7.11，p＜.01），過去一年無跌倒者平衡改善優於曾跌倒者（χ^2＝4.44，p＜.05）。結果顯示藉由防跌教室教育與運動課程之執行能有效改善社區長者跌倒之危險因素，並加強長者對預防跌倒之認知、態度及行為。期望該介入能有效降低跌倒事故之發生，進而達到老年健康促進之目標。The purpose of this study was to examine the effect of a fall prevention educational program on improvement of physical function, and fall prevention knowledge, attitude and behavior among community dwelling elderly. The study design was a one-group pretest-posttest with purposive sampling. The total sample of 172 elderly were enrolled with an average age of 66.4 (SD=8.06) years old and 79.1% of female. Measurements included demographic data, physical assessment and a questionnaire of fall prevention knowledge, attitude, and behavior. Pretest was performed one week before the intervention. The fall prevention educational program contained 12 lecture sessions and 12 exercise sessions within two months. Posttest was carried out one week after the intervention program. The results showed that participants had better waist circumference (t=-2.79, p=.006), waist to hip ratio (t=-2.09, p=.038), squat down-stand up test (t=-5.55, p=.000), 20-meter walk time (t=4.63, p=.000), upper extremity flexibility (χ2=64.21, p=.019), timed up-and-go test (χ2=188.86, p=.000) and the one-leg standing balance test (χ2=37.81, p=.000). In addition, participants had significant improvement on fall prevention knowledge (t=4.41, p=.000), attitude (t=3.66, p=.000), and behavior (t=4.23, p=.000). Females had significantly improved fall prevention attitude than their counterparts (t=4.96, p=.027). Elders with spouse also practiced better fall prevention behaviors than those without (t=6.54, p=.012). Elders with a high school educational level (F=3.29, p<.05) or without exercise habit (F=6.31, p<.01) had significantly reduced waist circumference. Those without exercise habit had significantly improved their upper extremity flexibility (F=7.11, p<.01) than whose without. Participants without fall experience had a better improved balance test (χ2=4.44, p<.05) than those who used to fall in the last year. In conclusion, the fall prevention educational program can reduce the risk of fall among community elderly and further possibly achieve the goal of health promotion.