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Abstract
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OBJECTIVE: The purpose of this qualitative study was to identify features related to perception of falls among older adults living at home in a metropolitan area.
Methods: The participants comprised 10 older adults (4 men; 6 women; from 8 families) over 75 years of age who were currently receiving medication at a clinic in Tokyo. Data were collected through home observation visits and semi-structured interviews regarding falls and near-falls in the home, fall prevention measures, and the experience of their friends in relation to falls. All interviews were recorded and transcribed. Descriptions concerning perception of falls were extracted and then analyzed using the KJ method.
Results: Based on the analysis, we identified the following relationships regarding perception of falls among older adults living at home: "Fall prevention measures" was the opposite of "No fall prevention measures"; "Fall prevention measures" was associated with "Experience of their friends", "Image of falls", "Awareness of aging", "Perception of carefulness", and "Perception of carelessness"; and "No fall prevention measures" was associated with "Perception of safety". "Carelessness" and "Misunderstanding" were also identified as descriptors related to perception of falls.
Conclusion: "Fall prevention measures" was primarily associated with anxiety and fear of falls, awareness of aging, and fall risk, whereas "No fall prevention measures" was associated with falls self-efficacy, overconfidence, and a priority on convenience. These issues should be considered when developing health education programs that promote the prevention of falls in older adults living at home.
目的：本研究では，在宅高齢者の自宅内転倒に対する意識の特徴を質的に明らかにすることを目的とした．
方法：対象者は，東京都内の一在宅療養支援診療所を受診している都内在住の日常生活が自立している75歳以上8世帯10名（男性4名，女性6名）であった．訪問調査にて，半構造化面接によるインタビューと観察を実施した．インタビュー内容は，自宅内における転倒や転倒しそうになった経験，転倒しないようにしていること，知人の転倒経験であった．内容は録音し，逐語録を作成した．転倒に対する意識を抽出し，KJ法を用い分析した．
結果：都市部における在宅高齢者の自宅内転倒に対する意識には，〈注意・気をつけている〉があり，対立する関連に〈気をつけていることはない〉があった．〈注意・気をつけている〉と関連した意識は〈他人の転倒経験〉，〈転倒のイメージ〉，〈衰えがわかる〉，〈気をつけようと思う〉，〈あっ，危ないと思う〉で，〈気をつけていることはない〉と関連したのは〈安全・大丈夫と思っている〉の意識であった．また，〈つい，うっかり〉，〈誤解がある〉の意識もあった．
結論：〈注意・気をつけている〉は，主に転倒不安や恐怖感，老性自覚，転倒の危険性と関連し，〈気をつけていることはない〉は，転倒自己効力感，過信や利便性を優先する意識と関連していた．転倒予防の健康教育においては，これらの高齢者の意識を考慮することが重要である． |