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篇名 血液透析老人之平衡能力、檢驗數值與害怕跌倒之相關性探討
卷期 17:2
並列篇名 Relationships Between Balance Ability, Laboratory Test Results, and Falling of Elderly Hemodialysis Patients
作者 廖雅玲吳明珠曾致豪洪英禕詹立楨
頁次 007-019
關鍵字 透析老人平衡能力害怕跌倒Elderly hemodialysis patientsBalance abilityFear of falling
出刊日期 202104

中文摘要

目的 台灣地區末期腎臟疾病發生率及洗腎率居世界之冠,血液透析人口數增加且呈老化趨勢。老人因長期接受透析治療,易出現肌肉無力、步態不穩的症狀,身體功能比一般老人差,跌倒的風險增加。故本研究目的旨在探討血液透析老人身體平衡能力、檢驗數值與害怕跌倒程度之相關性。
方法 為橫斷式前瞻性研究,以中部兩家區域醫院血液透析三個月以上的65歲以上老人為收案對象,共計111名受試者。害怕跌倒程度之評估使用老人害怕跌倒量表(Geriatric Fear of Falling Measure, GFFM)。身體平衡能力之評估則使用伯格氏身體平衡評估量表(Berg Balance Scale, BBS)。統計方法使用獨立t檢定、單因子變異數與多變量線性迴歸分析找出與GFFM相關之因子。
結果 GFFM與BBS呈顯著負相關(p<0.001),而GFFM與年齡、過去一年發生跌倒的次數則呈現顯著正相關(p<0.001)。在過去一年發生過跌倒相較於沒發生過跌倒者,有顯著較高的GFFM。年齡較長或過去一年較多的跌倒次數均影響GFFM的增加幅度。結果約有50.2%的GFFM的變異可以被年齡、過去一年發生跌倒次數、BBS等因素解釋。
結論 血液透析老人的害怕跌倒程度與身體平衡能力、過去一年跌倒次數以及年齡三個因素有關,解釋了約50%於老人害怕跌倒程度之變異,表明改善血液透析老人的平衡功能與跌倒次數能減少害怕跌倒並降低未來跌倒的風險。

英文摘要

Purposes Taiwan has the highest incidence of end-stage renal disease (ESRD) and dialysis rate in the world. The number of hemodialysis patients is increasing, and their ages tend to be older. Due to long-term dialysis treatment, the elderly patients are prone to symptoms of myasthenia and gait instability. Their body functions are worse than those of healthy elderly, and the risk of falling is high. Therefore, this study aims to investigate the relationships between balance ability, laboratory test results, and fear of falling.
Methods This is a cross-sectional and prospective study. A total of 111 participants were recruited. The participants were elders above 65 years old who had received hemodialysis for more than three months in two regional hospitals of central Taiwan. Fear of falling was assessed using the Geriatric fear of falling measure (GFFM). Balance ability was assessed using the Berg Balance Scale (BBS). Independent t-test, one-way ANOVA, and multivariate linear regression analyses were used to find the factors that significantly correlated with the GFFM.
Results GFFM was significantly negatively correlated with BBS (p<0.001) and significantly positively correlated with age and the number of falls in the previous year (p<0.001). Compared to those who did not fall, GFFM was significantly higher for those who experienced falls in the previous year. Both older age and high frequency of falls in the previous year affected the GFFM score. The results indicated that about 50.2% of GFFM variation could be explained by factors such as age, number of falls in the previous year, and BBS.
Conclusions The fear of falling among elderly hemodialysis patients was correlated with balance ability, the number of falls in the previous year, and age. All these three factors explained approximately 50% of the GFFM variation, suggesting that improving the balance function and the number of falls of elderly hemodialysis patients could decrease the fear of falling and reduce the risk of falling in the future.