论著

帕金森病患者居家环境对居家跌倒发生的影响研究

展开
  • 上海交通大学医学院附属瑞金医院 a. 护理部;b. 神经外科;c. 手术室,上海 200025

收稿日期: 2023-04-20

  网络出版日期: 2024-03-18

基金资助

2022上海交通大学医学院附属瑞金医院护理科研基金项目(RJHK-2022-6);2022年度上海交通大学医学院护理科研面上项目(Jyh2203);上海交通大学医学院护理学科人才建设项目(SJTUHLXK2022)

Influence of home environment on incidence of home falls in patients with Parkinson’s disease

Expand
  • a. Department of Nursing; b. Neurosurgery; c. Operating Room, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received date: 2023-04-20

  Online published: 2024-03-18

摘要

目的:调查帕金森病(Parkinson disease,PD)患者的居家跌倒情况,以及居家环境因素对居家跌倒发生的影响。方法:采用便利抽样法,纳入2020年5月—2022年9月期间于我院功能神经外科就诊的260例PD患者,根据患者在调查前近3个月内有无跌倒史,将其分为跌倒组和未跌倒组。采用一般资料以及居家跌倒情况调查表、运动障碍协会(Movement Disorder Society,MDS)PD统一评定量表Ⅲ(MDS unified-PD rating scale Ⅲ, MDS UPDRS-Ⅲ)、左旋多巴日等效剂量(levodopa equivalent daily dose, LEDD)和居家跌倒风险筛查(home falls and accidents screening tool,HOME FAST)量表进行问卷调查。结果:57例(22.5%)患者调查前近3个月内发生过跌倒,其中19例(33.3%)多次跌倒,49例(86.0%)在室内跌倒,51例(89.5%)主要发生在白天,49例(86.0%)跌倒时为单独一人。居家环境因素中,地板(84.5%)和卫生间(63.2%)没有防滑垫为最常见的问题。跌倒组PD患者居家跌倒风险评估总分低于未跌倒组[(19.84±3.72)分比(21.27±2.72)分,t=3.190,P=0.002]。多因素Logistic回归分析显示,通道有杂乱物品 [优势比(odds ratio, OR)=1.214,P=0.003]以及楼梯旁没有扶手(OR=1.333,P=0.028)是PD患者居家跌倒的主要环境危险因素。结论:PD患者居家跌倒发生率高,居家环境对于PD居家跌倒的发生有影响,通道有杂物以及楼梯旁没有扶手是PD患者跌倒的主要危险因素。

本文引用格式

龚磊, 王珏, 曾志童, 李殿友, 孙伯民, 查庆华, 邱娴 . 帕金森病患者居家环境对居家跌倒发生的影响研究[J]. 内科理论与实践, 2023 , 18(06) : 404 -409 . DOI: 10.16138/j.1673-6087.2023.06.006

Abstract

Objective To investigate the influence of home environment on the incidence of home falls in patients with Parkinson disease (PD). Methods Using a convenience sampling method, 260 patients with PD treated in the functional neurosurgery department of our hospital from May in 2020 to September in 2022 were enrolled as study projects. The patients were divided into non-home fall group and home fall group based on whether they had fallen in the past three months. A questionnaire survey including general information and home falls questionnaire, Movement Disorder Society (MDS) unified PD disease rating scale Ⅲ (UPDRS-Ⅲ), levodopa equivalent daily dose (LEDD) and home falls and accidents screening tool (HOME FAST) was conducted, and the collected data was analyzed. Results There were 57 (22.5%) patients had fallen in the previous three months, 19 (33.3%) patients fell several times, 49 (86.0%) patients fell indoors, 51 (89.5%) patients fell mainly during the daytime, and 49(86.0%) patients fell without accompany. In the home environment, floor (84.5%) and toilet (63.2%) without anti-slip pads were the most common reason to lead to fall. The total score of HOME FAST in the home fall group was lower than that in the non-home fall group [(19.84±3.72) vs (21.27±2.72), t=3.190, P=0.002]. Multivariate Logistic regression analysis showed that sundry objects in the passageway[odds ratio (OR)=1.214, P=0.003] and the lack of handrails beside the stairs (OR=1.333, P=0.028) were the major risk factors of home falls. Conclusions There is high incidence of home falls in PD patient, and the home environment have an impact on the occurrence of home falls. Sundry objects in the passageway and the lack of handrails beside the stairs are the major risk factors of home falls in patients with PD.

参考文献

[1] 王艳秋, 宋文静, 陈晓侠. 帕金森病患者居家环境跌倒的影响因素分析[J]. 护理实践与研究, 2023, 20(7): 995-1000.
[2] Qi S, Yin P, Wang L, et al. Prevalence of Parkinson’s disease: a community-based study in China[J]. Mov Disord, 2021, 36(12): 2940-2944.
[3] 中华医学会, 中华医学会杂志社, 中华医学会全科医学分会, 等. 帕金森病基层诊疗指南(2019年)[J]. 中华全科医师杂志, 2020, 19(1): 5-17.
[4] 陶萍, 韩甲. 帕金森病患者跌倒评估的研究进展[J]. 中华物理医学与康复杂志, 2022, 44(1): 76-82.
[5] 凌卫仙, 周俊, 余蔚菲, 等. 帕金森患者跌倒发生情况及其相关因素分析[J]. 现代临床护理, 2013, 12(9): 20-23.
[6] Allen NE, Schwarzel AK, Canning CG. Recurrent falls in Parkinson’s disease: a systematic review[J]. Parkinsons Dis, 2013, 2013: 906274.
[7] Frank A, Bendig J, Finkbeiner S, et al. Development and validation of a fall questionnaire for patients with Parkinson’s disease[J]. Mov Disord Clin Pract, 2022, 9(7): 900-908.
[8] 宋晓萌, 孟茜, 历静, 等. 帕金森病患者跌倒相关因素的研究进展[J]. 临床神经病学杂志, 2020, 33(1): 69-72.
[9] 李靖, 原曼, 富晶, 等. 帕金森脑深部电极刺激术后患者自我效能与步态康复及生活质量的相关性研究[J]. 中华现代护理杂志, 2019, 25(11): 1401-1404.
[10] Alyamani AM, Alarifi J, Alfadhel A, et al. Public know-ledge and awareness about Parkinson’s disease in Saudi Arabia[J]. J Family Med Prim Care, 2018, 7(6): 1216-1221.
[11] Goetz CG, Fahn S, Martinez-Martin P, et al. Movement disorder society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS)[J]. Movement disorders, 2007, 22(1): 41-47.
[12] Tomlinson CL, Stowe R, Patel S, et al. Systematic review of levodopa dose equivalency reporting in Parkinson’s disease[J]. Mov Disord, 2010, 25(15): 2649-2653.
[13] Fasano A, Canning CG, Hausdorff JM, et al. Falls in Parkinson’s disease: a complex and evolving picture[J]. Mov Disord, 2017, 32(11): 1524-1536.
[14] Mackenzie LA, Byles JE, Higginbotham N. Designing the home falls and accidents screening tool(HOME FAST): selecting the items[J]. Br J Occup Ther, 2000, 63(6): 260-269.
[15] 郭启云, 郭沐洁, 张林, 等. 居家跌倒风险筛查量表在中国社区老年人中的应用[J]. 中华护理杂志, 2015, 50(9): 1128-1132.
[16] Morris R, Martini DN, Madhyastha T, et al. Overview of the cholinergic contribution to gait, balance and falls in Parkinson’s disease[J]. Parkinsonism Relat Disord, 2019, 63: 20-30.
[17] 郑醒醒. 帕金森病患者跌倒风险及其危险因素的研究[D]. 安徽: 安徽医科大学, 2022.
[18] Xu H, Hunt M, Bo Foreman K, et al. Gait alterations on irregular surface in people with Parkinson’s disease[J]. Clin Biomech (Bristol, Avon), 2018, 57: 93-98.
[19] Padovani C, Lopes MCL, Higahashi IH, et al. Being caregiver of people with Parkinson’s disease: experienced situations[J]. Rev Bras Enferm, 2018, 71 Suppl 6: 2628-2634.
[20] Keus S, Munneke M, Graziano M, et al. European physiotherapy guideline for parkinson’s Disease[EB/OL].(2014-12-15) [2021-08-31] https://www.parkinsonnet.nl/app/uploads/sites/3/2019/11/eu_guideline_parkinson_guideline_for_pt_s1.pdf.
[21] Pelicioni PHS, Menant JC, Latt MD, et al. Falls in Parkinson’s disease subtypes: risk factors, locations and circumstances[J]. Int J Environ Res Public Health, 2019, 16(12): 2216.
[22] Ehgoetz Martens KA, Silveira CRA, Intzandt BN, et al. Overload from anxiety: a non-motor cause for gait impairments in Parkinson’s disease[J]. J Neuropsychiatry Clin Neurosci, 2018, 30(1): 77-80.
[23] 赵鸣, 王浩, 罗央努, 等. 社区老年人跌倒发生情况及家庭环境危险因素分析[J]. 预防医学, 2017, 29(9): 888-891.
[24] 李林忆, 闫维维, 马建军, 等. 清晨关期对早期帕金森病患者生活质量的影响[J]. 中华实用诊断与治疗杂志, 2020, 34(2): 148-151.
[25] 黄馨睿, 端烨, 叶梦华, 等. 帕金森病患者跌倒预防的最佳证据总结[J]. 中华护理杂志, 2022, 57(19): 2414-2421.
文章导航

/