Citation

Nohara S, Tsutsui H, Watanabe M, Uchigashima H. Jpn. J. Fall Prev. 2014; 1(1): 31-36.

Vernacular Title

初回転倒時と再転倒時における機能的自立度の比較と退院前訪問指導，試験外泊，家族指導との関係性

Copyright

(Copyright © 2014, Japanese Society for Fall Prevention)

DOI

10.11335/tentouyobou.1.1_31

PMID

unavailable

Abstract

Objective】The goals of the study were to compare the degree of functional independence of patients after an initial fall and a second fall, and to evaluate the effects of home guidance before discharge, out-of-hospital trial (a few days spent at home before formal discharge), and instructions for family members on functional independence.

Methods】The subjects were 12 inpatients who were previously hospitalized due to bone fracture from an initial fall and were hospitalized again due to a second fall. The outcome measures included the length of hospital stay, the Functional Independence Measure (FIM) score on admission and at discharge, discharge destination, and the frequencies of home guidance before discharge, out-of-hospital trial, and instructions for family members.

Results】The hospital stay and FIM on admission and at discharge did not differ between the first and second falls. The rate of discharge to home was lower after the second fall, and the frequencies of home guidance before discharge, out-of-hospital trial, and instructions for family members decreased during hospitalization for the second fall.

Conclusion】There was no difference in the recovery of activities of patients after the first and second fall, but the rate of discharge to home was lower after the second fall. The most common cause of this difference might be the fear of falling, which suggests that sufficient home guidance before discharge, out-of-hospital trial, and instructions for family members should be provided.

Language: ja

Vernacular Abstract

目的】本研究は，初回転倒時と再転倒時における患者の機能的自立度の比較と，退院前訪問指導，試験外泊，家族 指導が及ぼす影響について調査する事を目的とした。【方法】対象は，初回転倒による骨折で入退院を経た後に，再転倒により再入院となった患者12 例である。調査項 目として，在院日数，入退院時におけるFunctional independence measure（以下，FIM），転帰先とした。さらに，退院前訪問指導，試験外泊，家族指導の実施率についても調査した。【結果】平均在院日数，入退院時FIM に関して有意差は認められなかった。転帰先では，再転倒時において自宅復帰 の割合が減少していた。また，退院前訪問指導，試験外泊，家族指導の実施率に関しても再転倒時に減少していた。【結論】初回転倒時と再転倒時において，活動性は同程度に回復したにも関わらず，再転倒時では自宅復帰の割合が 減少していた。要因として，転倒恐怖感の影響が考えられ，退院前訪問指導，試験外泊，家族指導を充実させる必要性が示された。