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首页> 外文期刊>International journal of older people nursing >Activity restriction vs. self-direction: Hospitalised older adults' response to fear of falling
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Activity restriction vs. self-direction: Hospitalised older adults' response to fear of falling

机译：活动限制与自我指导：住院老年人对跌倒恐惧的反应

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Background: Functional decline is a common complication in hospitalised older adults, associated with low mobility and physical activity. Fear of falling may contribute to limited mobility and physical activity, and loss of physical function. An understanding of this relationship, as well as contributing factors, may inform the development of safe, function-promoting interventions. Aim: To describe fear of falling in hospitalised older adults and its relationship with patient characteristics and physical function and explore patient views of associated factors. Design: combined quantitative and qualitative approach using chart extraction, observation and interviews of older adults. Methods: (i) correlations and analysis of variance methods; (ii) content and thematic analysis; and (iii) evaluation of convergence, complementarity and dissonance of quantitative and qualitative data. Results: Depressed older persons were more likely to describe fear of falling (r = 0.47, P = 0.002). Fear of falling was associated with the loss of physical function from admission to discharge (F = 7.6, P = 0.009). The participant response to fear of falling was activity restriction vs. self-direction. Participants described the following factors, organised by social-ecological framework, to be considered when developing alternatives to activity restriction: intrapersonal, interpersonal, environmental and policy. Conclusion: Fear of falling plays a significant role in restricting physical activity and function. A multifactorial approach may provide a viable alternative to activity restriction, by facilitating self-direction and functional recovery. Implications for practice: Interventions to prevent falls and activities to promote functional mobility are ideally developed in tandem, with attention paid to the physical and social environment. Preventing hospital-acquired disability may require a shift in organisational values around safety, from a soley protective approach to one that reflects an enabling philosophy emphasising independence and self-direction. Such a paradigm shift would demonstrate a valuing not only of the absence of falls but also the preservation and restoration of function.
机译：背景：功能下降是住院老年人的常见并发症，与行动不便和体育锻炼有关。害怕跌倒可能会导致行动不便和身体活动受限，以及身体机能丧失。对这种关系以及影响因素的理解可能会为安全，促进功能的干预措施的发展提供信息。目的：描述对住院老年人坠落的恐惧及其与患者特征和身体机能的关系，并探讨患者对相关因素的看法。设计：采用图表提取，观察和采访老年人的定量和定性相结合的方法。方法：（i）方差方法的相关性和分析; （ii）内容和主题分析; （iii）评估定量和定性数据的收敛性，互补性和不一致性。结果：沮丧的老年人更有可能描述跌倒的恐惧感（r = 0.47，P = 0.002）。害怕跌倒与从入院到出院的身体功能丧失有关（F = 7.6，P = 0.009）。参与者对跌倒恐惧的反应是活动限制与自我指导。参与者描述了以下因素，这些因素是根据社会生态学框架组织的，在制定替代活动限制的方法时应予以考虑：人际，人际，环境和政策。结论：跌倒的恐惧在限制身体活动和功能中起着重要作用。通过促进自我指导和功能恢复，多因素方法可以为活动限制提供可行的替代方法。对实践的影响：预防摔倒的干预措施和促进功能性活动的活动是理想地同时发展的，同时要注意身体和社会环境。预防医院获得性残疾可能需要从安全性角度出发，将组织价值观从单一的保护方法转变为反映强调独立性和自我指导性的扶持性哲学的方法。这样的范式转变将证明不仅重视跌倒，而且重视功能的保存和恢复。

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