Earticle

Objectives: The purpose of this study is to understand the relevance of chronic disease conditions and fall experience among people aged 65 and older. and use them as basic data to reduce the risk of falling. Methods: The study selected 26,122 men and 37,777 women aged 65 and over as final subjects of the study, using raw data from the Community Health Survey in 2015. The statistical analysis used SAS 9.4 USA. Results: About 20% of those aged 65 and older experienced a fall, with one in five elderly people experiencing a fall, and the ratio of men to women was 3:7, women higher than men. As the age grew, the lower the level of education, the more senior citizens who lived alone occurred falls. In addition, the incidence of falls was higher when the number of chronic diseases was more than three. The incidence of falls was 1.1-1.5 times higher depending on chronic diseases. Conclusion: The development of education and exercise programs for preventing fall of senior citizens aged 65 and older is required and further study is needed.

Purpose: The objective of this study was a virtual reality-based balance training program effective for improvement in physical function, examined the balance ability and fall efficacy of elderly women with experienced falls, intending to examine the program's usefulness as an exercise program to prevent the recurrence of a fall. Methods: The participants were 30 elderly women aged 65 or older who met the conditions. The participants were randomly assigned to either a balance training group (BT) or a virtual reality-based balance training group (VT) and received the training three times per week, 30 minutes per day, for six weeks. To measure static balance, the Tetrax Portable Multiple System (Tetrax Ltd, Israel) were used. To measure dynamic balance, the Berg Balance Scale (BBS) and functional reach test (FRT) was used, and regarding fall efficacy, the Korean Fall Efficacy Scale (K-FES) was used. Results: Tetrax significantly improved after the intervention in both the BT group and the VT group (p<0.05). The comparison between the two groups was not significantly. BBS and FRT result significantly improved after the intervention in both the BT and VT groups (p<0.001), while K-FES was significantly ameliorated in the VT group only (p<.05). Comparing the groups, there were more significant changes in the BBS (p<0.05) and FRT (p<0.01) result of the VT group than the BT group. Conclusion: A virtual reality-based balance training program is considered to be usable as an exercise program to prevent recurrence of falls in elderly women.

Objective: The purpose of this study was to investigate the effects of fall experience and task complexity on gait performance in community-dwelling persons with chronic hemiparetic stroke. Design: Cross-sectional study. Methods: Thirty-three persons who had a history of stroke participated in this study. The participants included 18 persons (aged mean 54.0, mean score of 24.6 points on the Montreal Cognitive Assessment, MoCA) with fall experience (faller group) and 15 persons (aged mean 53.7, mean score of 24.7 points on the MoCA) without fall experience (non-faller group) in the previous six months. This study measured balance and gait performance at two different conditions (with/without 70% of water filled in a 200 cc cup). The participants were clinically assessed using the 10-meter walk test (10MWT), 6-minute walk test (6MWT), Berg Balance scale (BBS), Dynamic Gait Index (DGI), and Timed Up-and-Go (TUG) test. Results: After analyzation, persons in the faller group performed significantly better on the 10MWT, 6MWT, BBS, DGI, and the TUG test in the no-cup-carrying condition than those in the cup-carrying condition (p<0.05). The persons in the non-faller group also performed significantly better in all outcome measures with the no-cup-carrying condition than those in the cup-carrying condition (p<0.05). However, there was no interaction between fall experience and task complexity in the two groups. Conclusions: Our results showed that balance and gait performance depended on fall experience and task complexity but fall experience did not interact with task complexity. Clinicians should consider fall prevention and task complexity during therapeutic approaches in persons with hemiparetic stroke.

Objective: This study conducted in order to investigate the correlations between fall experience, balance, mobility, and confidence. We examined the difference between fall experience, and Berg Balance Scale (BBS), Timed-Up-and-Go test (TUG), Tinetti balance assessment (Tinetti balance [TiB], Tinetti gait [TiG]), and Activities-specific Balance Confidence (ABC) scale scores to see how fall experience, balance, mobility, and confidence of the persons with stroke affects their balance. Design: Cross-sectional study. Methods: Forty-one subjects participated in this study. The BBS includes 14 items, consisting of a 5-point scale from 0 to 4, totaling up to 56 points. The Timed Up and Go-Alone (TUGA) was used to measure the average time to take a 3 m round-trip by getting up and down from a 46-cm high chair with an armrest on a flat floor. The Timed-Up-and-Go-Cognitive (TUGC) was performed by counting backwards and the Timed Up and Go-Manual (TUGM) is performed by holding a cup full of water. The total score for the TiB is 16 points, and the TiG is 12 points, making a total of 28 points. There are 16 items total for the ABC scale. Results: According to the fall experience, BBS, the TUGA and TUGC values were significantly higher in the inexperienced group compared to the experienced group (p<0.05). The number of falls was significantly correlated with BBS, TUGA, TUGC, TUGM, TiB, TiG, TiB+TiG (p<0.05). Conclusions: This study supports that falls experience is strongly related to balance, mobility, and confidence. Optimal balance training programs for fall prevention is still insufficient and must be developed.

PURPOSE: The purpose of this study was to investigate the quality of life related to fall experiences in chronic stroke patients. METHODS: This cross-sectional study included 117 patients with stroke from 3 hospitals in D metropolitan city. General characteristics, including fall experiences and quality of life, were assessed through a face-to-face interviews conducted in a quiet place using a questionnaire. Measurement of quality of life in stroke patients was conducted using the Korean Stroke Specific Quality of Life Scale (SS-QOL). To identify the SS-QOL items related to fall experiences, the items of the SS-QOL were considered as independent variables, and the variables that were significantly different according to fall experiences were identified using a univariate analysis. A binary logistic regression was then performed using fall experiences as the independent variable. RESULTS: According to the univariate analysis, self help activities, social role, and upper extremity function were significantly lower in the fall group than that in the non-fall group (p<.05). The findings of the binary logistic regression confirmed that social roles and upper extremity function were the SS-QOL items that were related to fall experience in chronic stroke patients. CONCLUSION: These findings suggest that social roles and upper extremity function may be risk factors for fall experience in patients with chronic stroke.

Purpose: This study aimed to construct a model to predict whether the elderly population over 65 years of age will experience falls according to multi-drug therapy and related factors. Methods: Decision tree analysis was used to analyze data from the 2020 national survey of the living condition and welfare needs of older Koreans. Results: The fall experience rate was 23.7%, which was the highest in the case of diet management due to disease while taking multi-drug therapy. In contrast, those who did not receive multi-drug therapy had good subjective health rates, and those who did not have arthritis showed the lowest fall experience rate (5.5%). Conclusion: The elderly population has a high prevalence of chronic diseases, and the number of people using multi-drug therapy is increasing accordingly. For this reason, healthcare providers should carefully prescribe medication for older adults. In addition, it is necessary to develop and apply a customized fall management program that reflects the demographic and health-related factors, which include diet, disease types, and health levels, with multi-drug therapy.

Purpose: This study aimed to identify factors associated with fear of falling (FOF) by fall experience in the community-dwelling elderly. Methods: Multivariate logistic regression with complex samples was used to analyze the data of 74,475 elders aged 65 and over from the Community Health Survey in 2019. Results: Factors associated with FOF included gender, age, education level, smoking, high-risk drinking, physical activity, stress, depression, cognitive impairment, subjective health status, hypertension, and diabetes mellitus in the non-fall group. In the single fall group, the associated factors were gender, age, physical activity, stress, depression, cognitive impairment, and subjective health status. Related factors in the recurrent fall group included gender, age, physical activity, cognitive impairment, and subjective health status. Conclusion: The study’s findings suggest that it is necessary to develop different strategies to prevent FOF by understanding the contributing factors of FOF in each group of fall experience.

본 연구는 S구에서 시행하는 '어르신 낙상방지 주거복지 서비스'를 이용한 노인의 경험을 심층적으로 탐색하는 것을 목적으로 하였다. 질적 사례연구 설계를 적용하여 서비스를 이용한 노인 10명을 대상으로 반구조화된 심층면접을 실시하였으며, 3건의 면접에서는 가족이 보완적으로 참여하였다. Braun과 Clarke(2006)가 제안한 주제분석 절차에 따라 자료를 분석한 결과, 4개의 대주제와 12개의 하위주제가 도출되었다. 연구 결과, 첫째, 노인들의 강한 정주의식은 자발적이든 비자발적이든 현재 거주지에서의 삶을 전제로 하며, 반복적 낙상과 노후주택의 구조적 위험이 서비스의 필요성을 뒷받침하였다. 둘째, 안전손잡이 등 소규모 개입이 심리적 안전감, 독립성 회복, 보호자 돌봄 부담 경감이라는 다층적 효과를 가져왔으며, 리모컨 조명은 수면 질 향상과 야간 낙상 위험 저감에 기여하였다. 셋째, 물리적 서비스의 방문이 사회적 고립 완화의 통로가 되고 있었으며, 특히 사별 노인에게 유의미한 정서적 지지 기능을 수행하였다. 넷째, 초기 사업의 다층적 협력 구조 속에서 예산 정보의 전달이 충분하지 않아 이용자 기대와의 간극이 발생하였으며, 서비스를 권리가 아닌 베풂으로 인식하는 소극적 욕구 표현도 확인되었다. 이러한 결과를 바탕으로 사전 예산 안내 표준화, 주거-정서 통합돌봄 모델 구축, 소극적 이용자의 욕구 파악을 위한 전문적 소통 역량 강화 등의 실천적·정책적 함의를 제시하였다.

This study explored the experiences of older adults who used the "Fall Prevention Housing Welfare Service for the Elderly" in District S. Semi-structured in-depth interviews were conducted with 10 older adult service users, with family members participating in three interviews as supplementary informants. Data were analyzed using Braun and Clarke's (2006) thematic analysis, yielding four main themes and 12 subthemes. First, participants' sense of place attachment?whether voluntary or involuntary?underscored the necessity of making their current homes safer, given recurrent falls and structural hazards in aging housing. Second, small-scale interventions such as safety handrails produced multifaceted effects, including psychological security, restored independence, and reduced caregiver burden. Third, home visits for physical services simultaneously functioned as a channel for social contact and emotional support, particularly for bereaved and isolated older adults. Fourth, insufficient budget communication within the project's multi-layered structure created gaps between expectations and actual services, and some participants expressed needs passively, perceiving services as charity rather than a right. Based on these findings, implications were proposed, including standardized pre-service budget guidance, an integrated housing and emotional care model, and enhanced professional communication to identify passive users' latent needs.

Background: This study was conducted in order to see if muscle strength is different according to fall experience in female elders by comparing their muscle strength of waist and knee, which is one of factors inducing fall. Method: For this study, 22 female elders aged over 65 sampled from senior centers in D City were surveyed on their fall experiences using a questionnaire asking clinical history. Then, 8 elders with fall experience (FE) and another 8 without (NFE) were selected and participated in the research. Isokinetic muscle strength was measured with isokinetic equipment BIODEX SYSTEM 3 PRO, and the peak torque was obtained from the highest of 9 measurements at angular velocity 60°/sec according to the method recommended in the manual. Measured items were waist flexion and extension, and knee flexion and extension. Results: The FE group showed higher extensor and flexor muscle strength of the waist, but the difference was not significant (p<.05). In addition, no difference was observed in extensor muscle strength of the knee (p<.05). In flexor muscle strength, however, the FE group was significantly higher than the NFE group (p<.05). Conclusion: The application of regular exercise programs for improving muscle strength, endurance, etc. to those with fall experience will be effective in preventing falls among them.

Purpose: This study aimed to investigate the factors that increase fall risk in the residential environment and the perceived fall risk among community-dwelling elderly through comparisons between fallers and non-fallers. Methods: The subjects were 95 community-dwelling elderly aged 65 years and over residing in the metropolitan city of Ulsan. A structured questionnaire consisting of items on sociodemographics and health- and fall-related characteristics was used and data were collected from July to August 2015. The data were analyzed with the SPSS/WIN program. Results: Among recent fallers, 38.9% had diagnosed diseases when the fall occurred, 56.87% were fearful of a recurrent fall, and 86.5% stated that they were increasing their carefulness but that had led to a decrease in activity. There were significant differences between elders who had fallen at least once and elders who had no falls in age, health status, depression, the experience of falling, fear of falling, diseases, and medications. Conclusion: The results indicate a need to assess risk factors to identify older adults with a high risk for falling and the need to develop multifactorial intervention programs that consider both environmental and perceived risk factors as well as physical risk factors to reduce and prevent falls among the elderly.

본 연구는 여성노인의 낙상 유무에 따른 기능체력 및 하지근력과 대칭성을 비교 분석하여 낙상 예방을 위한 노인운동프로그램 개발의 기초자료를 얻고자 하는데 그 목적이 있다. 65-75세의 62명의 여성 노인이 본 연구에 자발적으로 참여하였으며 이들을 낙상경험자(n=27), 낙상비경험자(n=35)로 구분하였다. 평형성, 유연성, 민첩성, 보행능력등 기능체력을 측정하기 위하여 외발서기, 좌전굴, 반응시간, 6분 걷기를 실시하였으며, cybex770을 이용하여 등속성 하지근력 및 대칭성을 측정하였다. 결과적으로 기능체력에서는 평형성, 민첩성, 보행능력이 그룹간 유의한 차이가 있는 것으로 나타났으며, 양측 굴근과 신근의 근력과 근지구력, 양측대칭성(좌우비), 좌측의 동측대칭성(굴신비)에서 그룹간 유의한 차이가 나타났다. 결론적으로, 기능체력, 하지근력 및 하지근력 비대칭은 낙상에 영향을 미치므로 낙상예방을 위해서는 하지근력의 발달뿐 아니라 하지의 균형적인 발달이 매우 중요하다. 따라서 기능체력 뿐 아니라 양측 및 동측 대칭성을 파악하여 약한 측면의 근력 및 근지구력을 개선할 수 있는 적절한 운동프로그램이 낙상예방을 위해 필요할 것으로 생각된다.

The purpose of this study was to investigate functional fitness and asymmetry on lower body muscle strength of elderly women with fall experience. 62 women aged 65-75 years old participated in this study. They were divided into two groups (faller, n=27; non-faller, n=35) according to the fall experience. Closed one leg stand, sit & reach, reaction time, 6min walking were conducted to measure balance, flexibility, agility, and walking ability, respectively. Isokinetic knee strength and asymmetry were measured by cybex 770. As a result, significant differences were shown in balance, agility, walking ability between groups. Muscular strength and endurance of both side flexors and extensors, bilateral asymmetry, and muscular strength of left side ipsilateral asymmetry showed significant differences between groups. In conclusion, weakness of functional fitness and lower body muscle strength, endurance, and asymmetry affect to the fall experience. Therefore, proper exercise training focused not only on functional fitness but on improving asymmetry is needed to prevent fall down.

The purpose of this study was to investigate the effect of fall injuries on the balancing abilities and ankle flexibility. Fifteen of the voluntary participants had no experience of falling in the last two years (none falling group, NFG) and 15 others experienced at least one (falling group, FG). Static balance (sway length, sway area), dynamic balance (timed up and go (TUG), and functional to reach test (FRT) were measured in each group. In comparison of static balance, sway length was not significantly different between NFG and FG in both eyes open and eyes close, however the sway area of the FG was significantly wider than that of the NFG (p<.05). In dynamic balance comparisons, TUG of FG was significantly longer than that of NFG (p <.05), however FRT and STS were no significant difference between groups. Ankle flexibility was significantly higher in NFG than in FG. This study suggests that the fall prevention program should include methods for improving ankle stability and lower extremity function.

The purpose of this study is to conduct a qualitative case study of visiting nurses caring for the elderly at home. In this study, various experiences are identified among case managers in emergency situations with regards to falls. It was conducted to explore experience as a case manager in emergency situations. Data were collected through in-depth interviews with five visiting nurses living in both the Seoul and Gyeonggi regions. The collected data were analyzed qualitatively to identify experiences, strategies, and issues between research cases. In addition, by categorizing them according to emergency management with regards to falls, this study derives six final categories. Furthermore, in verifying the validity of the study, participant review and peer review of the study results and interpretation were conducted. As a result of this study, a total of six categories were derived: requests for visiting nurses of the home-based elderly to understand the characteristics of these home-based seniors, requests for assessment of high-risk groups in emergency management for visiting nurses of the home-based elderly, request to identify abnormal symptoms in emergency situations for visiting nurses of the home-based elderly, responsibility for emergency management of for visiting nurses of the home-based elderly, interaction requests for information sharing in emergency situations for visiting nurses of the home-based elderly, request to build confidence through repeated training of visiting nurses for the at-home elderly. Based on the results of this study, it was found that there is a need to lay the foundation for the development of a fall prevention program for visiting nurses who take care of the elderly at home, and to find ways to reduce falls during emergency treatment.

본 연구는 낙상 경험, 낙상 두려움, 낙상 두려움으로 인한 활동제약이 65세 이상 노인의 노쇠에 미치는 영향을 확인하기 위한 서술적 조사연구이다. 본 연구는 제8차 고령화연구패널조사 자료를 이용하였으며, 노쇠는 자가 건강 평가, 신체 상태, 정신 상태, 인지능력, 일상생활 활동, 도구적 일상생활 활동, 만성질환의 7개 요인과 41개의 항목으로 구성된 노쇠지수를 이용하여 도출하였다. 대상자의 노쇠에 미치는 영향요인을 파악하기 위해서 단계적 회귀분석을 사용하여 분석하였다. 본 연구의 대상자의 연령은 평균 76.0±7.4세였다. 최종모델에서 다른 요인을 조정하였을 때, 나이(β= 0.52, p<.001), 교육 수준(β= -2.29, p<.001), 배우자 유무(β= -0.75, p<.001), 사회적 만남 횟수(β= -1.04, p<.001)가 노쇠의 영향요인이었다. 낙상관련 요인에 있어서는 다른 요인을 조정하였을 때, 낙상 무경험자에 비하여 유경험자일수록(β= 1.47, p<.001), 낙상에 대한 두려움이 없는 대상자에 비하여 두려움이 약간 있거나(β= 2.87, p<.001), 두려움이 많을수록(β= 8.85, p<.001), 낙상 두려움으로 인한 활동제약이 없는 대상자에 비하여 활동 제약이 있는 대상자일수록(β= 5.14, p<.001) 노쇠지수가 증가하였다. 본 연구 결과를 바탕으로 낙상 사고를 예방하고, 낙상에 대한 두려움을 감소시키며, 낙상 두려움으로 인한 활동 제약을 극복할 수 있는 중재를 제공하면 노쇠를 예방하고 개선하여 노인이 보다 건강한 노화를 이룰 수 있을 것으로 기대된다.

The purpose of this study was to determine the effects of fall experience, fear of fall, and activity limitations due to fear of fall on frailty in older people. This study used national data from the 8th Korean Longitudinal Study of Aging, and frailty index was assessed by 7 divisions and 41 items: self-health assessment, physical condition, mental condition, cognitive ability, activities of daily living, instrumental activities of daily living, and chronic diseases. Stepwise regression analysis was used to identify factors influencing the participants' frailty. The average age of the participants was 76.0 ± 7.4 years. When other factors were adjusted in the final model, age(β= 0.52, p<.001), education level(β= -2.29, p<.001), presence of spouse(β= -0.75, p<.001), social network(β= -1.04, p<.001) was an influential factor in frailty. Compared to individuals without a history of falls, those with a history of falls had a higher frailty(β= 1.47, p< .001). Additionally, individuals with a little fear of fall(β= 2.87, p< .001) or a high level of fear of fall(β= 8.85, p< .001) had higher frailty compared to those with no fear of fall. Furthermore, older people with activity limitation due to fear of fall had higher frailty index scores compared to those without activity limitation(β= 5.14, p< .001). Based on the results of this study, it will be possible to prevent and improve frailty through interventions to prevent falling accidents, reduce fear of fall, and relieve activity limitation due to fear of fall.

This study aimed to understand the experiences of older adults participating in community exercise programs who return to the program after experiencing a fall, and to explore how their experiences changed after falling. Methods: The subjects were 15 older adults who have experienced accidental falls and have continued to participate in the programs even after falling. Data were collected from February to March 2011 through unstructured face-to-face interviews. Data analysis was using Colaizzi’s phenomenological method. Results: The experiences of older adults were divided into the following six categories:"practicing exercise in order to recover from physical impairment," "having gone through trial and error to find the exercise that is right for me," "noticing physical changes as a result of exercise," "having developed confidence through exercise," "having stronger physical functions thanks to consistent exercise," and "lingering fears about recurrent falling." The subjects stated that the best strategy for overcoming their fear of recurrent falling is "to actively participate in exercise programs." Conclusion: By gradually proceeding the exercise that was right for their physical condition and refraining from being over-hasty, they experienced positive physical and emotional changes, gained confidence about their lives in old age, and developed improved physical functionality.

Purpose: This study was designed to investigate fall experiences of the elderly who live alone at their home and to improve the quality of their lives by preventing falls. Methods: The participants in the interview were 9 old people comprised of 1 man and 8 women who were aged over 65. Data were collected through in-depth interviews with the participants and observation of their behaviors. In-depth interview materials were analyzed by the phenomenological method proposed by Giorgi. Results: Fall experience of the elderly living alone consists of absence of a helper, fall due to minor carelessness, poverty, severe pain, negligence of their children, loneliness, cautious behaviour after injuries, desire of death and so on. The whole meaning shows that "they need help desperately." Conclusion: As can be seen from this research, most elderly who live alone are poor, lonely, and disable. As they get injuries from a fall, they suffer from more severe poverty, loneliness, and physical disability. Hence, they might think of death. Therefore, well-being of the elderly should be maintained through the development of fall prevention program to prevent fall.

A Study on the Variables Forecasting Elderly Inpatients' Fall Experience Kwon, In Gak1)·Kim, Kyung Hee2) 1) Associate Professor, Department of Clinical Nursing Science, Samsung Medical Center, Sungkyunkwan University School of Medicine 2) Professor, Department of Nursing, College of Medicine, Chungang University Purpose: This study was designed to identify the variables forecasting elderly inpatients' fall experience through a comprehensive analysis of individual, disease, environment and fall risk related factors. Method: The medical records of 144 elderly inpatients were reviewed. The data collected from January to July 2003. Frequencies, t-test, χ2-test and logistic regression were done using the SPSS program. Result: Individual-related factors for elderly inpatients' fall experience were age. Fall risk related factors for elderly inpatients' fall experience were fall history and depression. Conclusion: The experience of fall among Korean elderly inpatients was associated not only with individual factors, but also with fall risk factors. The findings of this study suggest that broad intervention program should be provided to prevent related to elderly inpatients' fall.

Purpose: The purpose of this study is to identify the characteristics and factors affecting falls among elderly inpatients with chronic diseases based on the data from the discharge damage depth survey of the Korea Disease Control and Prevention Agency(KDCA) from 2014 to 2018. Method: The study selected elderly inpatients aged over 65 who were hospitalized(n=1,173). Their data were analyzed after being assigned to either a fall group(KSCD, W00-W19) or a non-fall group. Frequency analysis, cross-tabulation analysis, and binary logistic regression analysis were conducted, using SPSS 28. Results: According to the analysis on category of fall and non-fall group were statistically significant difference in age and having chronic diseases. Based on the binary logistic regression analysis of factors affecting falls, The risk of falls was 1.058 times higher with age, and E11-E14 and I63 as main diagnostic codes, the risk of falls was 2.049 times and 2.437 times higher. Conclusion: It is necessary to develop customized educational manuals and muscle exercise programs considering the characteristics of chronic diseases and to create a safe hospital room environment, and this result is expected to be used as basic data for fall prevention education and manual development for elderly inpatients with chronic diseases.

목적 본 연구에서는 지난 1년 동안 낙상을 경험한 노인을 대상으로 반복 낙상의 위험요인을 분석하였다. 연구를 통해 지역사회 거주 노인의 반복 낙상 위험 요인 예방을 위한 중재 개발의 기초자료를 제시하고자 하였다. 방법 본 연구에서는 2020년 노인실태조사 자료를 이용하여 이차자료분석을 시행하였다. 지난 1년 동안 낙상 경험이 있는 지역사회 거주 노인 650명을 분석에 포함하였다. 반복 낙상의 위험요인을 파악하기 위해 일반적 특성, 건강관련 특성, 낙상의 원인을 포함하 여 다항 로지스틱 회귀분석을 실시하였다. 결과 지난 1년간 대상자의 낙상 경험 횟수는 1회가 435명(66.9%), 2회가 156명(24.0%), 3회 이상이 59명(9.1%)이었다. 다항 로지스틱 회귀분석을 위해 지난 1년간 낙상을 경험한 횟수가 1회인 군을 참조군으로 선정하였으며, 분석 결과 우울이 있는 경우, 5회 sit-to-stand 검사를 수행하지 못하는 경우, 낙상의 원인이 신체적 문제인 경우가 반복 낙상의 위험요인으로 나타났다. 결론 지역사회 거주 노인의 반복 낙상의 예방을 위해 보건의료인은 참가자의 균형 장애, 신체적 문제와 함께 우울과 같은 정신적 문제를 고려할 필요가 있다.

Objectives This study aimed to identify risk factors for recurrent falls among community-dwelling older adults who had experienced a fall in the past year. Methods This study performed secondary analysis using data from the 2020 National Survey of Older Koreans. Data from 650 community-dwelling older adults with one or more fall experiences in the past year were utilized. To identify risk factors for recurrent falls, a multinomial logistic regression analysis was conducted including general characteristics, health-related characteristics, and reasons for falls. Results The distribution of participants according to the number of falls in the past year was 435 (66.9%) people who had fallen once, 156 (24.0%) people who had fallen twice, and 59 (9.1%) people who had fallen three or more times. In the multinomial logistic regression analysis, the categorical number of falls (1, 2, and 3 or more) were considered as dependent variables, and the category of “1” was determined as the reference group. The findings of the analysis revealed that failure to perform a five-time-sit-to-stand test and depression were risk factors for the group that experienced falls twice. In addition, depression and physical reasons for falling were found to be risk factors in the group that experienced falls three or more times. Conclusions This study suggested that risk factors for recurrent falls among community-dwelling older adults comprehensively. Health care providers who provide screening and intervention to prevent recurrent falls need to consider mental problems such as depression along with the participants' balance disorder and physical problems.

본 연구는 상관성 조사연구 설계를 이용하여 낙상경험 유무에 따른 낙상두려움 영향 요인을 파악하기 위해서 수행하였다. 연구대상자는 전라남도 1개시에 거주하는 낙상군 148명, 비낙상군 256명 총 404명을 대상으로 구조화된 설문지를 이용 하여 편의표집 하였으며 조사 기간은 2013년 4월 22일부터 6월 9일까지이었다. 연구결과 낙상률은 36.6%였으며 낙상군과 비낙상군은 연령, 만성질환 수, 영양위험도, 보조기구 사용, 시력장애, 청력장애에서 두 집단 간 유의한 빈도 차이를 보였다. 일반적 특성에 따른 낙상두려움 정도는 낙상군은 영양불량위험도, 보조기구 사용, 시력장애, 거주형태, 주거환경문제수에서 통계적으로 유의한 차이를 나타냈으며, 비낙상군은 연령, 종교, 영양위험도, 보조기구 사용, 시력장애, 청력장애, 거주형태, 주거환경문제수에서 통계적으로 유의한 차이를 나타냈다. 낙상군은 비낙상군에 비해 낙상두려움, 일상활동장애, 우울은 유의하게 더 높았고 낙상효능감과 주거환경 문제수는 낮았으며 정적균형, 복합이동능력, 생활만족도는 두 집단간 유의한 차이가 없었다. 상관관계를 측정한 결과 낙상군은 낙상두려움과 생활만족도, 낙상효능감 간에 유의한 음의 상관성을 보였으며, 일상활동장애, 우울, 주거환경문제수와는 유의한 양의 상관성을 보였다. 비낙상군은 낙상두려움과 생활만족도, 낙상효능감은 유의한 음의 상관성을 보였고 일상활동장애, 복합이동능력, 우울, 주거환경문제수와는 유의한 양의 상관성을 보였다. 낙상군의 낙상두려움 영향요인은 일상생활장애, 우울, 낙상효능감, 정적균형, 보조기구사용으로 46.1%의 설명력을 보였으며, 비낙상군은 낙상효능감, 주거환경문제수, 일상활동장애. 영양위험도, 주거형태, 현기증, 보조기구사용 등으로 55.2%의 설명력을 보였다. 이상의 결과를 바탕으로 독거여성노인 낙상두려움은 신체적 특성과 심리적 특성 및 주거 환경적 특성과 관련이 있는 것으로 나타났지만 낙상경험에 따라 차이가 있으므로 독거노인 의 낙상두려움을 감소시키기 위해서는 낙상경험을 고려한 중재가 필요함이 확인되었다. 그러나 낙상두려움이 재낙상의 중요한 관련 변수이기는 하지만 교정가능성이 높은 점을 고려하여 낙상두려움 정도 및 위험요인에 대한 주기적 평가를 통해 고위험군을 발견하도록 하고, 이들을 대상으로 낙상경험에 따른 통합적 중재 프로그램이 맞춤형으로 개발 제공되어 져야 할 것이다.

Objectives: This study was to investigate fear of falling and related factors in elderly living alone based on fall experience. Methods: Participants were 404 elderly women(faller=148, non-faller=256) over 65 years who were homebound living alone in Jeollanam-do Province. Face-to-face interviews were conducted using questionnaires from April $23^{th}$ to June $9^{th}$ 2013. The questionnaires consisted of demographic variables, fall experience, Fear of falling questionnaire(FOFQ), Falls Efficacy Scale(FES) and Center for Epidemiologic Studies Depression(CES-D). The collected data were analyzed using the SPSS version 14.0. Results: The fear of falling and the influential factors were different according to fall experience. Regression model for fear of falling in fallers significantly accounted for 46.1%(F=6.71, p<0.001); difficulty of performing activity, depression, fall-efficacy, static balance and assistive devices. Regression model for fear of falling in non-fallers significantly accounted for 55.2%(F=15.16, p<0.001); fall-efficacy, environmental hazards, difficulty of performing activity, risk of nutrition, housing type, dizziness and assistive devices. Conclusion: Results demonstrate that fall is an important health problem for elderly women living alone, and show fall experience for factors influencing fear of falling. These results could be used in the developing fall prevention programs.