预防老年人跌倒的意外挑战:一项基于急诊科的跌倒预防转诊试点项目的混合方法研究

Suzanne F.M. van Wijck, C. Rizzo, Netsanet Tsegai, T. Raybould, Shan W Liu
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引用次数: 2

摘要

目的:我们试图确定急诊科(ED)转诊后随访预防跌倒项目的比率和挑战。方法:我们进行了一个试点ED跌倒转诊项目的混合方法研究。年龄较大(≥65岁)的因跌倒相关损伤就诊于急诊科的患者被纳入研究。我们在急诊科进行了半结构化访谈,并将跌倒患者转介到门诊预防跌倒项目。我们评估了定量结果,包括6个月死亡率和跌倒复发率,并进行了随访电话访谈。结果:入组100例老年患者,转诊22例。没有人(0%)参加该计划。6个月后,死亡率为8.5%,28%的患者复发跌倒。定性数据显示,预防跌倒的挑战是:1)实际考虑;2)相互竞争的健康问题;3)对跌倒风险的认识。结论:我们的病人在门诊跌倒项目中没有随访。我们的病人有很高的反复跌倒率。后续访谈显示,仅仅是急诊科转诊不足以克服参加预防跌倒诊所的挑战。积极解决秋季门诊随访的障碍是提高门诊秋季门诊显示率的必要条件。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Unexpected challenges to preventing falls in older adults: a mixed methods study of an emergency department-based falls prevention referral pilot project
Objective: We sought to determine the rate and challenges to follow-up with a fall prevention program after an Emergency Department (ED) based referral. Methods: We conducted a mixed-methods study of a pilot ED falls referral program. Older ( ≥ 65) patients who presented to the ED with fall-related injury were enrolled. We held semi-structured interviews in the ED and referred fall patients to an outpatient fall prevention program. We assessed quantitative outcomes, including 6-month mortality and recurrence of falls, and conducted follow-up phone interviews. Results: One hundred geriatric patients patients were enrolled and 22 were referred. None (0%) participated in the program. After 6 months, the mortality rate was 8.5% and 28% of the patients had recurrent falls. Qualitative data revealed that challenges to fall prevention were 1) practical considerations, 2) competing health issues, and 3) perceptions of fall risk. Conclusion: None of our patients followed up in an outpatient falls program. Our patients had a high rate of recurrent falls. Follow-up interviews revealed that ED referral alone is not enough to overcome challenges to participation in a fall prevention clinic. Actively addressing barriers to fall clinic follow-up is necessary to improve outpatient fall clinic show rates.
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