目標：透過篩檢方式找出機構跌倒高風險群老人，並探討跌倒因素及防跌課程介入之成效。方法：本研究分為兩階段，第一階段執行期間為 2009年7月至10月，針對機構具跌倒高風險個案進行相關因素之調查(包括基本特質、健康狀況與行為、過去一年跌倒經驗、老年憂鬱量表、預防跌倒知識與行為及簡易心智量表評估)；第二階段於2009年11月至2010年2月進行12週預防跌倒課程介入進行前後測成效分析。將資料利用SPSS 17.0版套裝軟體進行相關性分析、邏吉斯迴歸及配對前後測檢定分析。結果：第一階段共計286位跌倒高風險老人，在過去一年曾跌倒的發生率為33.9%；與過去一年曾經跌倒之相關因素為：服用止痛劑(OR=3.75, 95%C.I=1.40-10.01)、使用安眠鎮定劑(OR=2.71, 95%C.I=1.32-5.57)、無運動習慣(OR=2.17, 95%C.I=1.00-4.68)及因害怕跌倒減少活動(OR=2.61, 95%C.I=1.39-4.91)；第二階段為預防跌倒課程介入之成效分析，共計69位完整參與者，結果顯示：參與預防跌倒課程者能有效降低跌倒自我效能量表分數(透過增加信心以減緩老人害怕跌倒的程度)、提升生活品質並能增加部分平衡能力及下肢肌力(p<0.05)。結論：實施預防跌倒課程可作為機構在推行預防老人跌倒主題之參考。因該項介入措施的應用可提供相關人員預防跌倒知識與運動訓練(靜態平衡、動態平衡及下肢肌力)，進而增加從事相關行為的信心(降低跌倒自我效能信心與害怕跌倒程度)、提升生活品質及改善身體功能。

Objectives:The prevention of falls in elderly adults is an important issue. The aims of this study were to investigate the risk factors for falling and the effects of fall prevention programs for the high risk elderly in long-term care. Methods: There were two stages in this study from 2009/09 to 2010/2. In the first, we collected data on demographics, health status, history of falling, the geriatric depression scale, knowledge and behavior about preventing falls, and the mini-mental status examination (MMSE) with a structured questionnaire. The second stage was a pre-post study design with a 12 week fall prevention program that included health education and exercise.
Results: The first stage was a cross-sectional study design and involved a sample of 286 aged 65 and older, high risk elderly. Of these, 33.9% had fallen at least one or more times in the past year. The main risk factors were use of analgesics (OR=3.75, 95%C.I=1.40-10.01), use of hypnotics (OR=2.71, 95%C.I=1.32-5.57), no regular exercise (OR=2.19, 95%C.I=1.00-4.68) and avoidance of activity due to a fear of falling (OR=2.61, 95%C.I=1.39-4.91). In the second stage, 69 subjects completed the 12-week fall prevention program which focused on reduction of the incidence and fear of falling, improvement in health-related quality of life, ability to balance, and strengthening the lower-extremities. Conclusions: The fall prevention program improved fear of falling, quality of life, and partial body function among the elderly in long-term care institutions. This study offers our suggestions and clinical interventions as the basis for future studies with more subjects in other long-term care institutions.