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目的了解上海市徐汇区城市社区老年人跌倒发生和认知的情况,并探索不同预防跌倒干预策略的有效性。方法采用社区干预试验的方法,设1个对照组不施加与一般人群不同的措施,3个干预组分别施加安全教育、改善环境和社区服务的叠加措施,干预前后分别开展一次问卷调查,分析干预前后跌倒发生、认知情况的变化及原因。结果干预前4组跌倒发生率为8.6%~12.6%,4组间跌倒发生率、认知率无差异。干预后4组间跌倒发生率有差异,用Bonferroni法进行校正的两两比较后发现,3个干预组的跌倒发生率(5.2%、5.1%、4.9%)都低于对照组(10.8%),P<0.008,而3个干预组间则无差异;同时除“改善家居环境可以预防跌倒”一题外,3个干预组的跌倒相关知识、行为和环境的认知率都明显高于对照组。结论上海市徐汇区城市社区老年人的跌倒发生率较高,认知率较低。开展安全教育、改善环境和社区服务的干预措施能降低城市社区老年人跌倒发生率,短期内安全教育可发挥关键性作用。
Objective To understand the incidence and cognition of the elderly in urban communities in Xuhui District, Shanghai and to explore the effectiveness of different intervention strategies to prevent falls. Methods A community intervention trial was conducted in which one control group did not impose different measures than the general population. Three intervention groups respectively applied safety education to improve the environmental and community service superposition measures. Before and after the intervention, a questionnaire survey was conducted to analyze the interventions Before and after the fall, the cognitive changes and reasons. Results The incidence of falls in the 4 groups before intervention was 8.6% ~ 12.6%. There was no difference in the incidence of falls between the 4 groups. The incidence of falls between the four groups after intervention was different, and any pairwise comparisons using the Bonferroni method showed that the incidence of falls in the three intervention groups (5.2%, 5.1%, 4.9%) was lower than that in the control group (10.8%) , P <0.008, while there was no difference among the three intervention groups. In addition to the one question of “improving the home environment to prevent falls”, the recognition rates of fall related knowledge, behavior and environment in three intervention groups were significantly higher In the control group. Conclusion The incidence of falls among the elderly in urban communities of Xuhui District, Shanghai is high, and the cognitive rate is low. Interventions to improve safety education and improve environment and community services can reduce the incidence of falls among the elderly in urban communities and safety education can play a key role in the short term.