การหกล้ม ความกลัวการหกล้ม และการจำกัดกิจกรรมเนื่องจากกลัวหกล้ม ในผู้สูงอายุไทยที่อาศัยอยู่ในชุมชนชานเมืองเชียงใหม่
คำสำคัญ:
หกล้ม, กลัวหกล้ม, การจำกัดกิจกรรม, ผู้สูงอายุ, ชุมชนชานเมืองบทคัดย่อ
การศึกษาครั้งนี้เป็นการวิจัยแบบภาคตัดขวาง เพื่อศึกษาความชุกของการหกล้ม ความกลัวการหกล้ม การจำกัดกิจกรรมเนื่องจากกลัวหกล้ม และปัจจัยที่เกี่ยวข้องกับการหกล้มและความกลัวการหกล้มในผู้สูงอายุที่อาศัยอยู่ในชุมชนชานเมือง จังหวัดเชียงใหม่ กลุ่มตัวอย่างเป็นอาสาสมัครผู้สูงอายุที่มีอายุ 60 ปีขึ้นไป จำนวน 142 คน เก็บข้อมูลโดยการสัมภาษณ์ เครื่องมือที่ใช้ในการเก็บรวบรวม ได้แก่ แบบสอบถามข้อมูลส่วนบุคคล แบบทดสอบสมรรถภาพสมองเบื้องต้น ประวัติการหกล้ม แบบวัดความกลัวการหกล้ม แบบสอบถามภาวะความกลัวการหกล้ม แบบประเมินความเป็นกังวลว่าจะหกล้ม แบบประเมินภาวะซึมเศร้า แบบประเมินภาวะวิตกกังวลในผู้สูงอายุ และแบบประเมินสมรรถนะการทำงานของขา วิเคราะห์ข้อมูลโดยใช้สถิติพรรณนา วิเคราะห์หาความสัมพันธ์โดยใช้สถิติ Univariate และ Multivariate Binary Logistic Regression
ผลการวิจัยพบว่า ผู้สูงอายุร้อยละ 73.9 เป็นเพศหญิง อายุเฉลี่ย 70.69 ปี (SD=7.44) ร้อยละ 32.6 หกล้มในช่วง 1 ปีที่ผ่านมา ร้อยละ 76.1 กลัวหกล้ม ผู้สูงอายุร้อยละ 58.5 เคยจำกัดการทำกิจกรรมต่าง ๆเนื่องจากกลัวการหกล้ม โดยปัญหาในการมองเห็น ความกลัวการหกล้ม และจำนวนยาที่ใช้ในปัจจุบัน สามารถร่วมกันทำนายการเกิดการหกล้มได้ 73.40% [X2(4, n=139)=14.96, p<.01] ทั้งนี้มีเพียงความกลัวการหกล้มปัจจัยเดียว ที่มีความสัมพันธ์กับการหกล้ม (B=-1.28,p<.01) และพบว่า เพศหญิง มีประวัติการหกล้มในรอบ 1 ปีที่ผ่านมา มีความวิตกกังวล และความสามารถในการทำงานของขาสูง สามารถร่วมกันทำนายความกลัวการหกล้มได้ 80.10% [X2(4, n=141)=22.80, p<.01] โดยตัวแปรเพศหญิง (B=1.30, p<.01) มีประวัติการหกล้มในรอบ 1 ปีที่ผ่านมา (B=-1.47, p<.01) และมีความวิตกกังวล (B=1.31, p<.05) มีความสัมพันธ์กับความกลัวการหกล้ม ผลการศึกษาครั้งนี้สามารถนำไปใช้เป็นแนวทางในการประเมินปัจจัยที่เกี่ยวข้องกับการหกล้มและความกลัวการหกล้มและนำไปใช้ออกแบบโปรแกรมสำหรับป้องกันการหกล้มและลดความกลัวการหกล้มในผู้สูงอายุที่อาศัยอยู่ในชุมชนชานเมืองได้
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References
1. Zhao YL, Alderden J, Lind B, Stibrany J. Risk factors for falls in homebound community-dwelling older adults. Public Health Nurs. 2019;36(6):772-8.
2. Pitchai P, Dedhia HB, Bhandari N, Krishnan D, D'Souza NRJ, Bellara JM. Prevalence, risk factors, circumstances for falls and level of functional independence among geriatric population - A descriptive study. Indian J Public Health. 2019;63(1):21-6.
3. Jung D, Kang Y, Kim MY, Ma RW, Bhandari P. Zero-inflated poisson modeling of fall risk factors in community-dwelling older adults. West J Nurs Res. 2016;38(2):231-47.
4. Cheng MH, Chang SF. Frailty as a risk factor for falls among community dwelling people: evidence from a meta-analysis. J Nurs Scholarsh. 2017;49(5):529-36.
5. Canada B, Stephan Y, Sutin A, Terracciano A. Personality and falls among older adults: evidence from a longitudinal cohort. J Gerontol B Psychol Sci Soc Sci. 2019;xx(xx):1-6. doi:10.1093/geronb/gbz040.
6. Li FF, Zhou DD, Ye ZF, Ren J, Xue C, Peng JJ, et al. Epidemiologic characteristics of fall in the elderly in urban and rural areas in Shanghai. Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi. 2019;40(7):779-85.
7. Deandrea S, Lucenteforte E, Bravi F, Foschi R, La Vecchia C, Negri E. Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology. 2010;21(5):658-68.
8. Kwan MMS, Close JCT, Wong AKW, Lord SR. Falls incidence, risk factors, and consequences in Chinese older people: A systematic review. J Am Geriatr Soc. 2011;59(3):536-43.
9. Do MT, Chang VC, Kuran N, Thompson W. Fall-related injuries among Canadian seniors, 2005-2013: an analysis of the Canadian Community Health Survey. Health promotion and chronic disease prevention in Canada : research, policy and practice. 2015;35(7):99-108.
10. Choi NG, Choi BY, DiNitto DM, Marti CN, Kunik ME. Fall-related emergency department visits and hospitalizations among community-dwelling older adults: examination of health problems and injury characteristics. BMC Geriatr. 2019;19(1):303.
11. Peeters GM, Jones M, Byles J, Dobson AJ. Long-term consequences of noninjurious and injurious falls on well-being in older women. J Gerontol A Biol Sci Med Sci. 2015;70(12):1519-25.
12. Chang NT, Yang NP, Chou P. Incidence, risk factors and consequences of falling injuries among the community-dwelling elderly in Shihpai, Taiwan. Aging Clin Exp Res. 2010;22(1):70-7.
13. Lavedan A, Viladrosa M. Fear of falling in community-dwelling older adults: a cause of falls, a consequence, or both? 2018;13(3):e0194967. doi: 10.1371/journal.pone.019496.
14. Rivasi G, Kenny RA, Ungar A, Romero-Ortuno R. Predictors of incident fear of falling in community-dwelling older adults. J Am Med Dir Assoc. 2019. doi: 10.1016/j.jamda.2019.08.020.
15. Cho H, Seol SJ, Yoon DH, Kim MJ, Choi BY, Kim T. Disparity in the fear of falling between urban and rural residents in relation with socio-economic variables, health issues, and functional independency. Annals of rehabilitation medicine. 2013;37(6):848-61.
16. Worapanwisit T, Prabpai S, Rosenberg E. Correlates of Falls among community-dwelling elderly in Thailand. Journal of aging research. 2018;2018:8546085. doi: 10.1155/2018/8546085.
17. Boonpleng W, Sriwongwan W, Sattawatcharawanij P. Rate and associated factors for falls among elderly people: chaopraya waterfront community in Nonthaburi Province. Journal of Nursing Science. 2015;33(3):74-86.
18. Sophonratanapokin B, Sawangdee Y, Soonthorndhada K. Effect of the living environment on falls among the elderly in Thailand. Southeast Asian J Trop Med Public Health. 2012;43(6):1537-47.
19. Phongphanngam S, Lach HW, Phomkaewngam S, Chantawang S. Measuring fear of falling in thai community-dwelling older adults with a new measure Boromarajonani. College of Nursing, Uttaradit Journal 2019;11(2):229-44.
20. Rongmuang D, Chantana Nakchattri C, Jeeraporn Tongdee JJS. Incidence and factors associated with fall among the community-dwelling elderly, Suratthani. Journal of Phrapokklao Nursing College. 2016;27(Suppl. 1):1-12. (in Thai).
21. Thiamwong L, Suwanno J. Fear of falling and related factors in a community-based study of people 60 years and older in Thailand. Int J Gerontol. 2017;11:80-4. doi: https://doi.org/10.1016/j.ijge.2016.06.003.
22. Kuhirunyaratn P, Prasomrak P, Jindawong B. Factors related to falls among community dwelling elderly. Southeast Asian J Trop Med Public Health. 2013;44(5):906-15.
23. Phongphanngam S. Fear of falling and disability among Thai communitt-dwelling older adults (Unpublished Dissertation): Saint Louis University School of Nursing; 2015.
24. Ngudgratoke S. Data collection and data management process. 2016. [cited 2019 Dec 27]. Available from: http://www.priv.nrct.go.th/ewt_dl.php?nid = 1434. (in Thai).
25. Tabachnick BG, Fidell LS. Using multivariate statistics. 6th eds. Boston: Perason; 2013.
26. Institute of Geriatric Medicine. Mini Mental State Examination-Thai version, MMSE-Thai 2002. Nonthaburi: Institute of Geriatric Medicine; 2002. (in Thai).
27. Dayhoff NE, Baird C, Bennett S, Backer J. Fear of falling: measuring fear and appraisals of potential harm. Rehabilitation Nursing Research. 1994;3(3):97-104.
28. Noimontree W, Lach HW, editors. Development of a Short Version of the Fear of Falling Questionnaire (Short-FFQ). 23th Annual Graduate Student Association Research Symposium; 2017;. Saint Louis University.
29. Yardley L, Beyer N, Hauer K, Kempen G, Piot-Ziegler C, Todd C. Development and initial validation of the Falls Efficacy Scale-International (FES-I). Age Ageing. 2005;34(6):614-9.
30. Phongphanngam S, Lach HW. Cross-cultural Instrument Translation and Adaptation: Challenges and Strategies. Pacific Rim International Journal of Nursing Research. 2019;23(2):170-9.
31. Radloff LS. The CES-D Scale: A self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1:385-401.
32. Vorapongsathron T, Pandii W, Traimchaisri T. A validity study of the Center for Epidemiology Studies Depression Scale. J Clin Psychol. 1990;21:26-45. (in Thai).
33. Andresen EM, Malmgren JA, Carter WB, Patrick DL. Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med. 1994;10(2):77-84.
34. Mueller AE, Segal DL, Gavett B, Marty MA, Yochim B, June A, et al. Geriatric Anxiety Scale: item response theory analysis, differential item functioning, and creation of a ten-item short form (GAS-10). Int Psychogeriatr. 2015;27(7):1099-111.
35. Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49(2):M85-94.
36. Lusardi MM, Fritz S, Middleton A, Allison L, Wingood M, Phillips E, et al. Determining Risk of Falls in Community Dwelling Older Adults: A Systematic Review and Meta-analysis Using Posttest Probability. J Geriatr Phys Ther. 2017;40(1):1-36.
37. Mortazavi H, Tabatabaeichehr M, Taherpour M, Masoumi M. Relationship Between Home Safety and Prevalence of Falls and Fear of Falling Among Elderly People: a Cross-sectional Study. Materia socio-medica. 2018;30(2):103-7.
38. Chippendale T, Boltz M. The neighborhood environment: Perceived fall risk, resources, and strategies for fall prevention. Gerontologist. 2015;55(4):575-83.
39. Choi K, Ko Y. Characteristics Associated With Fear of Falling and Activity Restriction in South Korean Older Adults. J Aging Health. 2015;27(6):1066-83.
40. Pholin T, Jitramontree N, Wirojratana V. The Relationships between Personal Factors, Health Status, Fear of Falling, and Fall Preventive Behaviors of Community Dwelling Older Persons. Journal of Nursing Science Chulalongkorn University 2017;29(1):36-50. (in Thai).
41. Souza AQ, Pegorari MS, Nascimento JS, Oliveira PB, Tavares D. Incidence and predictive factors of falls in community-dwelling elderly: a longitudinal study. Ciencia & saude coletiva. 2019;24(9):3507-16.
2. Pitchai P, Dedhia HB, Bhandari N, Krishnan D, D'Souza NRJ, Bellara JM. Prevalence, risk factors, circumstances for falls and level of functional independence among geriatric population - A descriptive study. Indian J Public Health. 2019;63(1):21-6.
3. Jung D, Kang Y, Kim MY, Ma RW, Bhandari P. Zero-inflated poisson modeling of fall risk factors in community-dwelling older adults. West J Nurs Res. 2016;38(2):231-47.
4. Cheng MH, Chang SF. Frailty as a risk factor for falls among community dwelling people: evidence from a meta-analysis. J Nurs Scholarsh. 2017;49(5):529-36.
5. Canada B, Stephan Y, Sutin A, Terracciano A. Personality and falls among older adults: evidence from a longitudinal cohort. J Gerontol B Psychol Sci Soc Sci. 2019;xx(xx):1-6. doi:10.1093/geronb/gbz040.
6. Li FF, Zhou DD, Ye ZF, Ren J, Xue C, Peng JJ, et al. Epidemiologic characteristics of fall in the elderly in urban and rural areas in Shanghai. Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi. 2019;40(7):779-85.
7. Deandrea S, Lucenteforte E, Bravi F, Foschi R, La Vecchia C, Negri E. Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology. 2010;21(5):658-68.
8. Kwan MMS, Close JCT, Wong AKW, Lord SR. Falls incidence, risk factors, and consequences in Chinese older people: A systematic review. J Am Geriatr Soc. 2011;59(3):536-43.
9. Do MT, Chang VC, Kuran N, Thompson W. Fall-related injuries among Canadian seniors, 2005-2013: an analysis of the Canadian Community Health Survey. Health promotion and chronic disease prevention in Canada : research, policy and practice. 2015;35(7):99-108.
10. Choi NG, Choi BY, DiNitto DM, Marti CN, Kunik ME. Fall-related emergency department visits and hospitalizations among community-dwelling older adults: examination of health problems and injury characteristics. BMC Geriatr. 2019;19(1):303.
11. Peeters GM, Jones M, Byles J, Dobson AJ. Long-term consequences of noninjurious and injurious falls on well-being in older women. J Gerontol A Biol Sci Med Sci. 2015;70(12):1519-25.
12. Chang NT, Yang NP, Chou P. Incidence, risk factors and consequences of falling injuries among the community-dwelling elderly in Shihpai, Taiwan. Aging Clin Exp Res. 2010;22(1):70-7.
13. Lavedan A, Viladrosa M. Fear of falling in community-dwelling older adults: a cause of falls, a consequence, or both? 2018;13(3):e0194967. doi: 10.1371/journal.pone.019496.
14. Rivasi G, Kenny RA, Ungar A, Romero-Ortuno R. Predictors of incident fear of falling in community-dwelling older adults. J Am Med Dir Assoc. 2019. doi: 10.1016/j.jamda.2019.08.020.
15. Cho H, Seol SJ, Yoon DH, Kim MJ, Choi BY, Kim T. Disparity in the fear of falling between urban and rural residents in relation with socio-economic variables, health issues, and functional independency. Annals of rehabilitation medicine. 2013;37(6):848-61.
16. Worapanwisit T, Prabpai S, Rosenberg E. Correlates of Falls among community-dwelling elderly in Thailand. Journal of aging research. 2018;2018:8546085. doi: 10.1155/2018/8546085.
17. Boonpleng W, Sriwongwan W, Sattawatcharawanij P. Rate and associated factors for falls among elderly people: chaopraya waterfront community in Nonthaburi Province. Journal of Nursing Science. 2015;33(3):74-86.
18. Sophonratanapokin B, Sawangdee Y, Soonthorndhada K. Effect of the living environment on falls among the elderly in Thailand. Southeast Asian J Trop Med Public Health. 2012;43(6):1537-47.
19. Phongphanngam S, Lach HW, Phomkaewngam S, Chantawang S. Measuring fear of falling in thai community-dwelling older adults with a new measure Boromarajonani. College of Nursing, Uttaradit Journal 2019;11(2):229-44.
20. Rongmuang D, Chantana Nakchattri C, Jeeraporn Tongdee JJS. Incidence and factors associated with fall among the community-dwelling elderly, Suratthani. Journal of Phrapokklao Nursing College. 2016;27(Suppl. 1):1-12. (in Thai).
21. Thiamwong L, Suwanno J. Fear of falling and related factors in a community-based study of people 60 years and older in Thailand. Int J Gerontol. 2017;11:80-4. doi: https://doi.org/10.1016/j.ijge.2016.06.003.
22. Kuhirunyaratn P, Prasomrak P, Jindawong B. Factors related to falls among community dwelling elderly. Southeast Asian J Trop Med Public Health. 2013;44(5):906-15.
23. Phongphanngam S. Fear of falling and disability among Thai communitt-dwelling older adults (Unpublished Dissertation): Saint Louis University School of Nursing; 2015.
24. Ngudgratoke S. Data collection and data management process. 2016. [cited 2019 Dec 27]. Available from: http://www.priv.nrct.go.th/ewt_dl.php?nid = 1434. (in Thai).
25. Tabachnick BG, Fidell LS. Using multivariate statistics. 6th eds. Boston: Perason; 2013.
26. Institute of Geriatric Medicine. Mini Mental State Examination-Thai version, MMSE-Thai 2002. Nonthaburi: Institute of Geriatric Medicine; 2002. (in Thai).
27. Dayhoff NE, Baird C, Bennett S, Backer J. Fear of falling: measuring fear and appraisals of potential harm. Rehabilitation Nursing Research. 1994;3(3):97-104.
28. Noimontree W, Lach HW, editors. Development of a Short Version of the Fear of Falling Questionnaire (Short-FFQ). 23th Annual Graduate Student Association Research Symposium; 2017;. Saint Louis University.
29. Yardley L, Beyer N, Hauer K, Kempen G, Piot-Ziegler C, Todd C. Development and initial validation of the Falls Efficacy Scale-International (FES-I). Age Ageing. 2005;34(6):614-9.
30. Phongphanngam S, Lach HW. Cross-cultural Instrument Translation and Adaptation: Challenges and Strategies. Pacific Rim International Journal of Nursing Research. 2019;23(2):170-9.
31. Radloff LS. The CES-D Scale: A self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1:385-401.
32. Vorapongsathron T, Pandii W, Traimchaisri T. A validity study of the Center for Epidemiology Studies Depression Scale. J Clin Psychol. 1990;21:26-45. (in Thai).
33. Andresen EM, Malmgren JA, Carter WB, Patrick DL. Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med. 1994;10(2):77-84.
34. Mueller AE, Segal DL, Gavett B, Marty MA, Yochim B, June A, et al. Geriatric Anxiety Scale: item response theory analysis, differential item functioning, and creation of a ten-item short form (GAS-10). Int Psychogeriatr. 2015;27(7):1099-111.
35. Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49(2):M85-94.
36. Lusardi MM, Fritz S, Middleton A, Allison L, Wingood M, Phillips E, et al. Determining Risk of Falls in Community Dwelling Older Adults: A Systematic Review and Meta-analysis Using Posttest Probability. J Geriatr Phys Ther. 2017;40(1):1-36.
37. Mortazavi H, Tabatabaeichehr M, Taherpour M, Masoumi M. Relationship Between Home Safety and Prevalence of Falls and Fear of Falling Among Elderly People: a Cross-sectional Study. Materia socio-medica. 2018;30(2):103-7.
38. Chippendale T, Boltz M. The neighborhood environment: Perceived fall risk, resources, and strategies for fall prevention. Gerontologist. 2015;55(4):575-83.
39. Choi K, Ko Y. Characteristics Associated With Fear of Falling and Activity Restriction in South Korean Older Adults. J Aging Health. 2015;27(6):1066-83.
40. Pholin T, Jitramontree N, Wirojratana V. The Relationships between Personal Factors, Health Status, Fear of Falling, and Fall Preventive Behaviors of Community Dwelling Older Persons. Journal of Nursing Science Chulalongkorn University 2017;29(1):36-50. (in Thai).
41. Souza AQ, Pegorari MS, Nascimento JS, Oliveira PB, Tavares D. Incidence and predictive factors of falls in community-dwelling elderly: a longitudinal study. Ciencia & saude coletiva. 2019;24(9):3507-16.
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2020-04-01
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