腦中風急性後期病人居家環境改造後跌倒發生率相關分析

Correlation Analysis of the Incidence of Falls in Patients with Acute Stroke after Home Environment Modification

目的：過去研究支持透過建議居家環境改造，可有效改變中風病人之行為增進居家安全性。本研究目的在於探討透過居家環境改造是否可有效降低腦中風急性後期照護(post-acute care, PAC)病人出院後跌倒率與傷害率。方法：研究設計採回溯性研究(retrospective)，蒐集2017年1月1日到2018年7月31日期間中部某區域教學醫院PAC的出院病人資料，調查分析其返家後一年內跌倒發生率及傷害率。結果：PAC病人為跌倒高風險者(n=62)進行居家改造(n=36)，與沒有進行居家改造(n=26)者相比，其返家後跌倒發生率有顯著差異(p=0.040)；PAC病人進行居家改造者(n=36)，返家後有無跌倒，兩組間改造之平均扶手長度無顯著差異(p=0.521)，平均改造花費金額也無顯著差異(p=0.751)。結論：腦中風急性後期計畫對於中風病人返家後跌倒發生率確實有顯著降低；進行居家環境改造者相較於無改造者其跌倒率也顯著降低；至於改造的扶手長度與花費的總金額對於是否跌倒之間差異不顯著。

Objectives. Injuries caused by falls are the biggest threat to patients with stroke. Studies have indicated that suggesting a change in home environment can effectively change a patient’s behavior and improve home safety. The purpose of this study was to explore whether recommendations for home environment improvement can effectively reduce the rates of fall-related injury after discharge from a post-acute care (PAC) program.
Methods. This was a retrospective case-control study based on data on patients discharged from a PAC program at a teaching hospital in central Taiwan from January 1, 2017, to July 31, 2018, Data included fall and injury rates.
Results. Patients discharged from the PAC program had a high risk of falling (n=62). The incidence of falls differed significantly between those with (n=36) and without home improvements (n=26) (p=0.040). No significant difference was observed in the average handrail length between patients with and without falling after returning home (p=0.521), and there was no significant difference in the average cost of home improvement (p=0.751).
Conclusion. The PAC program significantly reduced the incidence of falls among patients with stroke after they had returned home. However, the fall rate among patients who performed home improvement was significantly lower than the rate among patients who did not.