Effect of community education on reducing fall-related injuries in older people
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摘要: 目的 了解本地区老年人跌倒在老年人院前急救中所占比例及跌倒后受伤情况,探讨老年人常见病与跌倒之间的关系及社区宣教在降低老年人跌倒致创伤方面的作用。 方法 采用回顾性对照研究的方法,研究对象为2013年1月—2014年12月南昌市青云谱区内所有因跌倒相关问题呼救“120”的老年人,按时间段将其分为2组,对照组:2013年1月1日—12月31日;实验组:2014年1月1日—12月31日,2014年在青云谱区所辖50个社区进行了老年人跌倒危险因素及跌倒后救护相关知识的宣教,收集2组跌倒老年人院前急救病例,并对其在医院内检查、诊断、住院、手术情况继续进行追踪。 结果 2014年与2013年相比,青云谱区老年人增加了0.64%,呼救“120”的老年人增加了8.45%,然而经过社区宣教,因跌倒相关问题呼救“120”的老年人减少了14.75%;2组呼救“120”时间对比,差异有统计学意义(χ2=10.444,P=0.034),老年人跌倒至呼救“120”的时间明显提前;2组创伤人数对比,差异有统计学意义(χ2=6.162,P=0.046),社区宣教后跌倒致颅脑伤及骨折人数显著减少,但扭伤及肌肉拉伤有所增加;2组患病情况对比,差异无统计学意义(χ2=11.15,P=0.266),社区宣教不能改变跌倒老年人所患基础病种类;但某些疾病与跌倒关系密切。 结论 社区宣教可以降低跌倒致创伤率,尽早的专业救护和治疗可以减少不必要的二次损伤及合并症的发生。跌倒老年人患多有心脑血管疾病、骨关节疾病、神经疾病、糖尿病、肺部感染疾病,特别是高血压,宣教时应把这些老年人作为重点,这样社区宣教才能达到预期效果。宣教内容除跌倒高危因素外,还应有跌倒致创伤的常用救护措施,其中要包括骨折、颅脑伤、颈髓伤的救护。Abstract: Objective To investigate the rate of the fall among all the older people making a call to the emergency medical services,and fall-related injuries,explore the relations between the common diseases in the elderly and the fall,and evaluate the role of community education in reducing fall-related injuries in older people. Methods A prospective case-control study method was adopt.The older people making a call to the emergency medical services on account of the fall in Qingyunpu District of Nanchang city between January,2013 and December,2014 were enrolled and were divided into control group(between January 1,2013 and December 31,2013) and experimental group(between January 1,2014 and December 31,2014) according to the time period.50 among 72 communities in Qingyunpu district were randomly sampled to carry out the community educations of risk factors of falls and the first aid knowledge about the fall in 2014.The older patients making a call to the emergency medical services on account of the fall were followed up to investigate the examinations,diagnosis,admission and surgical treatments in the hospitals. Results When compared with 2013,the amount of elderly people increased by 0.64%,the rate of elderly people making a call to the emergency medical services increased by 8.45%,however,the rate of older people making a call to the emergency medical services on account of the fall decreased by 14.75% in 2014.The call time was different between the two groups(χ2=10.444,P=0.034);the time from the fall to making a call to the emergency medical services shorted obviously.The amount of older people with trauma was significant different(χ2=6.162,P=0.046),the patients with craniocerebral injury or bone fracture decreased clearly,but sprains and muscle strains increased,the difference in the types of diseases was not significant(χ2=11.15,P=0.266).The community education did not change the types of illness in elderly people;but some senile diseases were obviously correlated to the fall. Conclusion The community education can reduce the rate of injury caused by the falls,the early professional rescue and treatment can reduce the incidence of secondary injuries and complications.The fall commonly occurs to the older people with cardiovascular and cerebrovascular illness,bone and joint diseases,neurological diseases,diabetes,lung infection diseases,especially hypertension,and thus the community education should pay more attentions to them.The contents of education should include high risk factors of falls,common first aid measures for the injury such as fracture,brain injury and spinal cord injury caused by the fall.
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Key words:
- Older people /
- Falls /
- Prehospital emergency care /
- Trauma /
- Community education
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