Earticle

Introduction: Age-related co-morbidities are common among persons living with chronic Human Immunodeficiency Virus (HIV). However, data are largely absent on the relationship between frailty and incontinence as related to falls—common age-related co-morbidities—among people living with chronic HIV (PLWH). Methods: To inform hospital-based Occupational Therapy (OT) services for PLWH, we performed a case-control study using extracted data from the electronic medical records of PLWH who had received OT at a large academic hospital. Two-hundred-and-four subjects were included in the final dataset; sixty-eight were cases that reported a fall within the last 12 months, while 136 were controls which were PLWH who had not sustained a fall. Results: The association between falls and frailty indicated that persons categorized as ‘pre-frail’ with balance deficits were more likely to fall (OR=2.77 [1.18-6.52]). Women who lacked insurance were less likely to fall (OR=0.38 [0.18-0.82]) and (OR=0.29 [0.09-0.88]) respectively. The association between incontinence and falls among PLWH were not statistically significant in a multivariate adjusted regression model (OR=1.38 [.59-3.22]). Conclusion: Our findings suggest further examination of the person factors of PLWH who are categorized clinically as ‘pre-frail’ or ‘frail’ may improve health outcomes and reduce falls when paired with occupation-based interventions.

목적: 본 연구에서는 우리나라 노인의 인지장애 경험과 낙상과의 관련성을 분석하여, 인지 기능 저하를 관리하고, 낙상 예방에 필요한 보건학적 중재 프로그램 개발에 기초자료로 활용 하고자 한다. 방법: 인지장애와 관련된 변수의 활용하기 위하여, 2019년 지역사회건강조사 원시자료를 이용하였다. 연구대상자는 총 13,879명이었다. 분석은 SAS 9.4(SAS Institute Inc. Cary. NC, USA)를 사용하였다. 결과: 성별에 따른 인지장애와 낙상 경험 간의 요인은 인지장애 경험이 있는 남성과 여성이 낙상 위험이 1.47배 높았고, 인지장애로 일상생활의 어려움이 있는 남성의 낙상 위험은 1.34 배, 여성은 1.33배 높았다. 인지장애로 인한 도움이 필요한 남성과 여성의 낙상 위험은 1.35 배, 인지장애로 인한 상담 경험은 남성의 낙상 위험이 1.45배, 여성은 1.47배 높았다. 결론: 인지기능 저하 노인을 위한 낙상 예방 정책은 단순한 신체적 중재를 넘어 인지기능 유지 프로그램, 사회적 고립 해소, 안전한 주거환경 조성, 일상생활 지원 등의 다차원적 접근 이 병행되어야 한다. 특히 여성 노인에 대한 포괄적이고 통합적인 건강 지원 체계 마련이 요구된다.

Objectives: This study analyzed the relationship between cognitive impairment (CI) and falls among the elderly in Korea. The findings aim to serve as foundational data for developing health intervention programs to manage cognitive decline and prevent falls. Method: To examine variables related to CI, raw data from the 2019 Community Health Survey were analyzed. The total number of study participants was 13,879. Statistical analyses were conducted using SAS 9.4 (SAS Institute Inc., Cary, NC, USA). Results: The risk of falling was 1.47 times higher among both men and women with CI. Among those with CI and difficulty in daily life, men had a 1.34 times higher risk of falling, and women had a 1.33 times higher risk. Men and women who required assistance due to CI had a 1.35 times higher risk. Those who had received counseling related to CI showed a 1.45 times higher fall risk in men and a 1.47 times higher risk in women. Conclusion: Fall prevention policies for elderly individuals with CI should go beyond simple physical interventions. A multidimensional approach including cognitive, emotional, and social support should be considered to effectively reduce fall risk.

목적 : 본 연구는 낙상과 관련된 노인의 일반적 특성 및 건강 관련 특성과 주거환경 사이의 관련성을 확인 하고자 하였다. 연구방법 : 2020년 노인실태조사 자료를 활용하여 지역사회에 거주하는 만 65세 노인을 대상으로 낙상과 일반적 및 건강 관련 특성, 주거환경 간의 관계를 분석하였다. 변수의 결측치를 제외한 9,411명의 자료 를 활용하였다. 노인의 낙상 여부에 따른 일반적 및 주거환경, 건강 관련 변수들의 관련성을 파악하기 위해 다중 로지스틱 회귀분석을 실시하였다. 결과 : 지난 1년간 낙상을 경험한 노인은 585명(6.2%), 낙상을 경험하지 않은 노인 8,826명(93.8%)으로 나타났다. 전체 대상자의 연령은 65~74세가 6,069명(64.49%)으로 여성이 59.78%에 해당하였다. 낙 상과 가장 큰 관련이 있는 요인으로 주택 종류 중 기타 3.91배(95% CI: 1.85, 8.27)로 나타났으며 배 우자가 없을 때 2.30배(95% CI: 1.37, 3.85), 일한 경험은 있으나 현재 일을 하지 않는 노인의 경우 2.13배(95% CI: 1.49, 3.04) 등의 순서로 나타났다. 결론 : 본 연구를 통해 노인의 낙상 위험과 관련된 요인을 확인하고 주거환경 개선을 위한 대상자 분류 및 선정을 위한 자료로 사용될 수 있기를 기대한다.

Objective: The purpose of this study was to examine the association between falls and the demographic and health-related characteristics of older adults as well as their home environments. Methods: A total of 9,411 community-dwelling older adults were retrieved from the 2020 National Survey of Older Koreans. The relationships among falls, demographic and health-related characteristics, and home environment were analyzed using step-wise hierarchical logistic regression models. The dependent variable was fall events during the past 12 months, and the independent variables were demographics, health-related characteristics, and home environments. Results: The majority of the sample individuals were 65-74 years in age (n = 6,069, 64.49%) and female (n = 5,626, 59.78%). A total of 585 (6.2%) older adults experienced a fall during the past year. Among the older adults, those living in another house type (odds ratio [OR] = 3.91, 95% confidence interval [CI] 1.85-8.27), having no spouse ([OR] = 2.30, 95% [CI] 1.37-3.85), and having no jobs ([OR] = 2.13, 95% [CI] 1.49-3.04) were likely to have a fall during the past 12 months. Conclusion: The findings of this study can inform clinicians regarding the fall-related characteristics in community-dwelling older adults and help practitioners prioritize treatment plans for home modifications.

Objectives: The purpose of this study is to identify the relationship between metabolic syndrome factor diseases and falls in the elderly aged 65 years or older and use them as basic data to reduce the risk of falls. Methods: The method of this study was to compare the injury-related characteristics of the fall and non-fall groups with a factor disease of metabolic syndrome in Korea over 65 years of age. Data from the 14th National Hospital Discharge In-depth Injury Survey in 2018 were used to conduct the study. A total of 7,991 data were analyzed using SPSS 23.0. Results: Among the total injuries, the fall group with metabolic syndrome factor disease accounted for 69.0% and the non-fall group 31.0%. Falls occurred in 86.3% of households. In the fall group with metabolic syndrome factor disease, the number of females was 1.9~2.1 times higher than that of males. Compared to 65~69 years of age, the incidence of falls was 1.4~1.5 times higher in 70~79 years, 1.7~2.2 times higher in 80~89 years, and 2.5~3.6 times higher in 90-year-olds and older. In NISS, the incidence of falls was 1.7 times higher in moderate compared to mild. In principle diagnosis, the incidence of falls was 2.2 times higher in S40-S99 compared to S00-S19. Conclusion: The elderly with metabolic syndrome factor disease should continue to promote health through light exercise that can strengthen muscle strength to prevent falls.

The large-sized, complex, and multi-storied construction industry caused the increasing construction amount together with insufficient skilled workers to increase the probability of occurring accident , resulting in the most construction accidents next to manufacturing industry. Death accidents have risen to serious level, compared construction industry with manufacturing industry along the numbers of workers. Due to the main feature of one-time industry receiving orders, open-air dispersed production activity and the long-complex production process, the continuous efforts to prevent and manage safety accidents were made but the results were of no effect. They didn't deeply analyze the falling accidents that consist of half death accidents in construction industry. This study has classified in detail Missteps, Slip, Trip, Unstability and the others on the basis of gait characteristics, occurrence types, frequency and intensity of death accidents. This study suggested the effective methods on the construction safety management according to the causes of falling accidents. This study will be expect to be used as the basic data in the procedure and the program of safety management.

Purpose: Dizziness and balance impairment are major risk factors for falls in older adults. While grip strength decline and depressive symptoms are independently associated with balance problems, few studies have examined their combined effects in community-dwelling adults aged 65 years and older. Methods: This cross-sectional study analyzed data from the 2019, 2022, and 2023 Korean National Health and Nutrition Examination Survey (KNHANES), comprising 3,407 participants aged 65 years or older. Grip strength was measured using a digital dynamometer, and low grip strength was defined according to the 2019 Asian Working Group for Sarcopenia (AWGS) criteria (men <28 kg, women <18 kg). Depressive symptoms were assessed by asking whether participants had experienced persistent feelings of sadness or hopelessness for two consecutive weeks. Participants were classified into four groups: (1) normal grip strength with no depressive symptoms (reference group), (2) low grip strength only, (3) depressive symptoms only, and (4) both conditions combined. Complex sample logistic regression analyses were conducted using SPSS 29.0, adjusting for sex, age, education, income, smoking, alcohol use, hypertension, diabetes, and survey year. Results: The weighted prevalence of dizziness or balance impairment was 38.2%. In the fully adjusted model, adjusted odds ratios (AOR) relative to the reference group were as follows: low grip strength only, 1.23 (95% CI: 0.94–1.61, p = 0.132); depressive symptoms only, 2.18 (95% CI: 1.59–3.01, p < 0.001); and combined, 2.21 (95% CI: 1.16–4.20, p = 0.016). No significant interaction effect was observed (p = 0.462). Conclusion: Depressive symptoms showed a stronger association with dizziness and balance impairment than grip strength decline, with no synergistic effect between the two factors. These findings suggest that screening for depressive symptoms should be prioritized alongside physical assessments in fall prevention programs for older adults.

본 연구는 비만 노인 여성들을 대상으로 12주간의 복합운동프로그램이 낙상 관련 체력, 낙상 효능감, 및 인지기능 에 미치는 영향을 검증하는 것을 목적으로 수행되었다. 연구 대상은 A시 경로당에 등록된 65세 이상의 비만 여성 노인 48명으로, 규칙적인 운동을 하지 않는 참여자를 대상으로 하였다. 연구 참여자들은 12주간 주 3회씩 60분으로 복합운동 프로그램(저항성 밴드운동과 시니어로빅)을 수행하였다. 연구 결과, 수축기 혈압과 이완기 혈압에서 통계적 상호작용 효과가 나타났으며(p <0.05), 낙상 관련 체력 요소 중 악력, 유연성, 협응성에서 통계적 상호작용 효과가 나타났다 (p<0.05). 또한, 낙상 효능감 점수가 향상되어 복합운동이 낙상에 대한 심리적 두려움을 완화하는 데 긍정적인 영향을 미쳤음을 확인하였다(p<0.05). 반면, 인지기능(MMSE-DS)에서는 유의미한 변화가 나타나지 않았으나, 운동군에서 점 진적인 향상 경향이 관찰되었다. 본 연구는 비만 노인 여성의 신체 건강 개선뿐만 아니라 낙상 예방 및 심리적 안정성 향상 을 위한 복합운동프로그램의 효과를 입증하는 데 기여한다. 향후 연구에서는 장기적인 운동 개입과 다양한 인지기능 평가 도구를 활용하여 복합운동의 인지기능 개선 효과를 더욱 심층적으로 분석할 필요가 있을 것이다.

This study was conducted to examine the effects of a 12-week combined exercise program on fall-related physical fitness, fall efficacy, and cognitive function in obese older women. The study was conducted on 48 obese elderly women aged 65 and older registered at the senior center in City A, and the participants did not engage in regular exercise. The study participants performed a combined exercise program (resistance band exercise and senior aerobics) for 60 minutes, three times a week, for 12 weeks. The results of the study showed that systolic and diastolic blood pressure significantly decreased after participating in the combined exercise program (p<0.05), and grip strength, flexibility, and coordination, which are physical fitness factors related to falls, significantly improved (p<0.05). In addition, the improved score for the sense of falling efficacy confirmed that the combined exercise had a positive effect on alleviating the psychological fear of falling (p<0.05). On the other hand, no significant changes were observed in cognitive function (MMSE-DS), but a gradual improvement trend was observed in the exercise group. This study contributes to the demonstration of the effects of a combined exercise program for improving the physical health of obese older women, as well as preventing falls and improving psychological stability. Future studies should analyze the effects of combined exercise on cognitive function in more depth by using long-term exercise interventions and various cognitive function assessment tools.

오타고 운동은 노인의 낙상을 예방하고 개선하기 위해 특별히 고안된 운동 프로그램이며 이를 통해 노인의 낙상 위험을 생리적으로 감소시킬 수 있다. 그러나 여러 기존 연구에서는 오타고 운동이 노인의 낙상 위험, 균형, 근지구력, 보행 능력에 미치는 효과가 서로 다르게 나타나고 있다. 따라서 본 연구는 메타 분석을 통해 오타고 운동이 노인 낙상 예방 에 효과적인지 체계적으로 분석하고자 한다. 연구 방법으로는 Web of Science, PubMed, CNKI 등 데이터베이스에서 엄격한 포함 및 제외 기준에 따라 문헌을 선별하고, 데이터 추출 및 편향 위험 평가를 실시하였으며, 전통적인 메타 분석을 위해 Stata 20.0 소프트웨어를 사용하였다. 연구 결과, 오타고 운동은 노인의 낙상 효능감[WMD=0.62, 95% CI(0.28, 0.97)], 균형 능력[WMD=0.93, 95% CI(0.70, 1.16)], 하지 근지구력[WMD=0.75, 95% CI(0.54, 0.96)], 보행 능력 [WMD=-0.56, 95% CI(-0.84, -0.28)] 향상에 통계적으로 유의미한 효과를 보였다. 또한 오타고 운동은 6개월에서 12개 월 동안 지속될 때 가장 효과적이며, 주 3회, 회당 30분 실시가 가장 효과적인 것으로 나타났다. 연구 결과를 종합해 보면, 오타고 운동은 노인의 낙상 효능감, 균형 능력, 하지 근지구력 및 보행 능력을 현저히 개선하여 노인의 낙상을 예방하고 기능적 활동 수준을 크게 향상시키는 데 도움이 될 것이라 사료된다. 본 연구는 오타고 운동 프로그램의 강도 및 시간별 중재 효과에 대한 최적화 방안을 명확히 제시하므로 혁신적이고 실용적인 가치가 돋보인다.

The Otago Exercise Program (OEP) is specifically designed exercise regimen aimed at preventing and improveing falls in older adults, with the potential to physiologically reduce the risk of falls in this population. However, existing studies have shown varying effects of the Otago Exercise on fall risk, balance, muscular endurance, and gait ability in older adults. Therefore, this study systematically analyze the effectiveness of the Otago Exercise Program in preventing falls in older adults through a meta-analysis. The study utilized a rigorous selection process based on inclusion and exclusion criteria to screen literature from databases such as Web of Science, PubMed, and CNKI. Data extraction and risk of bias assessments were conducted, and Stata 20.0 software was used for traditional meta-analysis. The results indicate that the Otago Exercise Program significantly improves fall efficacy [WMD=0.62, 95% CI(0.28, 0.97)], balance ability [WMD=0.93, 95% CI(0.70, 1.16)], lower limb muscular endurance [WMD=0.75, 95% CI(0.54, 0.96)], and gait ability [WMD=-0.56, 95% CI(-0.84, -0.28)] in older adults, with statistically significant effects. Furthermore, the program was found to be most effective when sustained for 6 to 12 months, with a frequency of three sessions per week, each lasting 30 minutes. In conclusion, the Otago Exercise Program significantly enhances fall efficacy, balance ability, lower limb muscular endurance, and gait ability in older adults, thereby aiding in fall prevention and substantially improving functional activity levels. This study clearly outlines optimal intervention strategies regarding the intensity and duration of the Otago Exercise Program, demonstrating innovative and practical value.

이 연구는 필라테스 운동과 소도구 운동이 균형능력에 미치는 영향을 비교 분석하여 운동 형태에 따라 낙상예방 운동 처방에 있어 활용할 수 있는 지식을 확장하고자 40대 여성 20명을 선발하여 필라테스 운동 과 소도구 운동을 각 10명씩 나누어 8주간 각 그룹별 운동을 실시하였다. 8주 운동프로그램 전 과 후에 눈감고 외발서기와 Y-balance Test 를 통해 정적균형능력과 동적균형능력을 평가하였으며, mixed design two-way ANOVA 방법으로 비교 분석하여 다음 과 같은 결과를 얻었다. 첫째, 소도구 운동집단이 필라테스 운동집단 보다 정적균형능력의 향상도가 높게 나타났다. 둘째, 소도구 운동집단이 필라테스 운동집단 보다 동적균형능력의 향상도가 높게 나타났다. 결과적으로 소도구 운동집단이 필라테스 운동집단보다 상대적으로 균형능력의 향상도가 높게 나타난 것으로 보인다. 이는 고유수용성 향상을 위해서는 불안정한 지지면에서의 운동이 필요하며, 이 연구의 운동 프로그램 중 소도구 운동집단에 불안정한 지지면에서의 운동이 많기 때문에 나타난 결과인 것으로 생각되며, 필라테스 운동집단은 대부분 복위 자세로 실시한 운동이 많아 고유수용성 향상에는 부족했을 것이라 생각된다.

This study compared and analyzed the effects of Pilates exercise and prop exercise on balance ability, and selected 20 women in their 40s and performed Pilates exercise and prop exercise separately in order to expand the knowledge that can be used in prescribing fall prevention exercise according to the type of exercise. Each group was divided into 10 participants and exercised for 8 weeks. Before and after the 8-week exercise program, static balance ability and dynamic balance ability were evaluated through standing on one leg with eyes closed and the Y-balance test, and the following results were obtained by comparative analysis using the mixed design two-way ANOVA method. First, the small tool exercise group showed higher improvement in static balance ability than the Pilates exercise group. Second, the small tools exercise group showed a higher degree of improvement in dynamic balance ability than the Pilates exercise group. This is thought to be a result of the fact that exercise on an unstable support surface is required to improve proprioception, and exercise on an unstable support surface is common in the small-tool exercise group among the exercise programs in this study. Most of the Pilates exercise group performed exercises in the prone position, so it is thought that the improvement in proprioception was insufficient.

본 연구는 노인들이 일상생활을 수행하면서 겪는 낙상과 관련된 이동운동과제를 객관적으로 평가하여 자세조절 능력을 알아볼 수 있는 평가도구 초안을 개발하는데 목적이 있다. 이러한 목적을 달성하기 위해 노인들의 낙상관련 자세조 절능력을 검사하는 이동운동과제 항목을 선정하여 평가도구의 초안을 개발하였다. 첫째, 체계적 문헌고찰을 위한 지침 7단계 중 ‘1단계 연구 선정기준 작성, 2단계 문헌 검색, 3단계 문헌 선택과 분류, 4단계 자료 추출’ 단계를 거쳐 문헌고찰을 하였으며, 고찰된 평가도구를 바탕으로 1차 델파이 조사를 실시한 후 자세조절능력을 평가하기 위한 이동운동과제 항목 으로 ‘누운자세에서 일어서기’, ‘장애물 걷기’ 가 최종 과제 항목으로 선정되었다. 둘째, 최종 선정된 이동운동과제의 평가 항목별 점수를 7점 척도로 구성하고 각 항목의 점수 척도내용은 움직임의 수준을 고려하기 위해 VanSant (1988a, 1988b)의 신체특성과 신체분절 분류 기준, 대칭적 움직임을 기준으로 적용하여 자세조절능력 평가도구 초안을 개발하였 다. 셋째, 2차 델파이 조사를 실시한 후, 개발된 초안 평가도구의 내용타당도를 검증하고 전문가들의 의견을 수렴하여 개발한 평가도구 초안을 수정하였다. 이 과정에서 용어의 통일과 일관성 있는 문항 내용으로 문장을 간결하게 수정하여 재구성하였다. 넷째, 수정된 자세조절 평가도구에 대한 평가의 객관성을 알아보고자 재검사 신뢰도, 평가자내 신뢰도, 평가자간 동의도 분석을 실시하였으며 수정된 자세조절 능력 평가도구 초안을 개발하였다. 본 연구에서 개발된 수정 개발 된 평가도구는 추후 유용성 및 다양한 변인과의 연계 가능성 등의 검증 과정이 필요할 것이다.

The purpose of this study was to develop a posture control ability draft assessment tool to evaluate the locomotor skill related to falls that the elderly experience while performing their daily lives. This study was development of postural control ability assessment tool. Specific details on development of postural control ability assessment tool from study were: (1) Four stages (Preparation of research selection criteria, literature search, literature selection & classification, and data extraction) of the seven stages of systematic literature review were applied to examine posture control evaluation tools related to falls of the elderly. After conducting the 1st round Delphi survey, 'supine position to erect stance' and 'walking obstacle' were selected as the final task items as locomotor skill tasks to evaluate posture control ability, (2) It was composed of a seven-point scale for each assessment item of the finally selected locomotor skill task. The contents of the scale were constructed by applying VanSant's criteria (body characteristics, body segment classification criteria and symmetrical movement), (3) 2nd round Delphi survey was conducted to verify the validity of the content and the assessment tool was revised by reflecting the opinions of experts, and (4) The final assessment tool was developed by verifying the reliability and agreement of the assessment tool.

This study determined the effectiveness of a 3-month group-based mul-ticomponent exercise program in the mobility, balance confidence, and muscle performance of older adults. A total of 40 participants (mean age=70.60±6.25 years completed pre- and posttest clinical intervention measures of mobility using the Timed Up and Go (TUG) test, balance confidence using the Activities-specific Balance Confidence scale, up-per limb strength (handgrip dynamometer), and lower limb function (30-sec chair rise test). Data were analyzed using paired t-test and based on TUG criteria for risk of fall (low- and high-risk groups). Signifi-cant improvements were found in all measures (All P<0.05) following the 3-month program. Measures according to the risk of fall categories were also significantly improved (P<0.01), except the left handgrip strength (P>0.05). The low-risk group showed a higher improvement in mobility (14.87% vs. 11.74%), balance confidence (34.21% vs. 26.08%), and lower limb function (96.87% vs. 21.20%) but was not significantly different from the high-risk group (P>0.05). A group-based multicompo-nent exercise program benefited the physical functions of older adults at low- or high risk of falls.

Risks of falls among older adults are multifactorial in nature. A com-bined training program might be beneficial on fall-related outcomes. This study aimed to explore the effects of group-based physical-cogni-tive trainings on physical and psychological outcomes among older adults with type 2 diabetes mellitus (T2DM) and balance impairment. Fall incidence were also determined. Thirty-seven older adults with T2DM and balance impairment were randomly assigned to control and intervention groups. The intervention program comprised of 24 training sessions of 45–60 min exercise for 8 weeks. The exercise consisted of warm-up, aerobic exercise by nine square stepping, resistance exer-cise combined with cognitive training and cool down. All participants were assessed at baseline, 4 and 8 weeks after intervention, and 1-year follow-up. Both groups reported similar rates of falls. Global cognition, depressive symptoms, and fear of falling did not differ between groups at any time. The Timed Up & Go (TUG) test, alternate stepping test (AST), knee extensors, ankle plantarflexors, and dorsiflexors strength differed at 4 weeks. TUG, AST, hip abductors, knee flexors, ankle plantarflexors, and dorsiflexors strength differed at 8 weeks. The activity of daily living (ADL), TUG test (P=0.002) and AST, hip extensors and abductors, knee extensors and flexors, ankle plantarflexors and dorsiflexors were differ-ent at 1-year follow-up. The group-based physical-cognitive training could benefit older adults with T2DM in terms of maintaining ADL. The intervention could reduce fall risk factors by improving balance and lower limb muscle strength among older adults with T2DM and balance impairment.

연구목적: 본 연구의 목적은 안전보건공단과 고용노동부의 자료를 분석해본 결과 2019년 산업재해로 인하 여 전체 사망자(질병+사고) 수도 2,020명에 달하며 경제적 손실추정액은 27.6조 원으로 나타났다. 이는 Table 1에서와같이 경제적 손실추정액은 꾸준히 증가하고 있으며 정부 차원의 손실액을 획기적으로 감소 시킬 수 있도록 개선방안을 제시해야 할 때라고 판단된다. 연구방법: 본 연구에서는 선행연구를 통한 요인 을 선정하였으며, 서울, 경기지역을 우선으로 지방에 산재되어 있는 현장 관리 감독 업무를 담당하는 기술 자들을 대상으로 설문조사를 실시하고 결과분석을 위해 Jamovi 프로그램으로 신뢰도 분석, 기술통계 및 상 관관계 분석, 다중회기 분석을 시행하였다. 연구결과: 본 연구에서 지시한 연구가설을 검증하기 위하여 다중회기 분석을 시행하였으며분석결과개구부에 대한 떨어짐사망사고 방지를위하여 기계적 요인과 관리적 요인은 영향을 미치지 않는 것으로 나타났으며 인적 요인과 물질·환경적 요인은 정적인 영향을 미치는 것으로 나타났다. 또한 외벽의 떨어짐 사망사고 방지를 위하여 마찬가지로 기계적 요인과 관리적 요인은 영향을 미치지 않으 며 인적 요인과 물질·환경적 요인은 정적인 영향을 미치는 것으로 나타났다. 결론: 본 연구는 안전보건공단 에 게시된 자료 중 최근 13년간 450건의 떨어짐 사망사고를 분석한 결과 떨어짐 사망사고가 가장 많이 발 생하고 있는 개구부와 외벽부에 대하여 떨어짐 사망사고를 감소시킬 수 있는 요인을 분석하였다.

Purpose: The purpose of this study was to analyze data from the Ministry of Health, Safety and Health and the Ministry of Employment and Labor, and the total number of deaths (disease + accidents) reached 2,020 in 2019 and the estimated economic loss was 27.6 trillion won. This is believed to be the time to present improvements to ensure that economic loss estimates are steadily increasing as in Table 1, and that government-level losses can be drastically reduced. Method: In this study, factors were selected through prior research, and reliability analysis, technical statistics and correlation analysis, and multi-term analysis were conducted through the Jamovi program for the analysis of results. Result: Multiple session analysis was conducted to verify the research theory indicated in this study, and the analysis showed that mechanical and management factors did not affect the fall death accident of the opening, and human factors, material and environmental factors had a static effect. In addition, mechanical and administrative factors do not affect the fall of the outer wall, and human and material and environmental factors have a static effect. Conclusion:: As a result of analyzing 450 falling deaths over the past 13 years among the data posted to the Korea Health and Safety Corporation, the most common causes of falling deaths were the openings and outer walls.

The present study aimed to investigate the fear of falling and its associ-ated factors among patients with vestibular hypofunction. We conduct-ed a cross-sectional survey using structured questionnaires to evaluate fear of falling and activities of daily living among participants. Vestibular function was assessed via a rotary chair test. This study was conduct-ed from January through March 2018. The subjects were 167 individuals older than 20 years who agreed to participate in this study. Data were analyzed using SPSS ver. 22.0. The significant variables associated with fear of falling were gender (P=0.012), age (P<0.001), marital status (P=0.006), living alone (P=0.020), having a job (P<0.001), frequency of dizziness (P=0.007), use of antivertigo medication (P<0.001), and histo-ry of falling (P<0.001). Fear of falling showed statistically significant positive correlations with activities of daily living (r=0.82, P<0.001) and dizziness (r=0.61, P<0.001). In the multiple regression analysis, age, gender, history of falling, and severity of dizziness explained 53.4% of the variance in fear of falling. The results of this study demonstrate that thoroughly assessing predictors making an impact on fear of falling in the initial assessment and the level of fear of falling needs to be ad-dressed early to prevent sedentary behavior.

Life expectancy due to development of medical technology The problem of aging attracted attention. As the population of the elderly living alone increases, To make a request for a solution. The fall of the elderly is the most important. This is a common problem. In particular, Approximately one-third of the elderly by experiencing more than one fall are reported. If physical injury results from falls, The elderly are not easy to recover. Fear of re-falls increases even if actual physical damage does not occur. As a result, Body function is reduced to dependency and may lead to a decrease in quality of life. Preventing falls is a daily life. It is also very important for maintenance of operation. Fear of falls is associated with decreased movement Because it reduces confidence in balance. It is a major factor in the health of the elderly. When an accident occurs, it collapses or falls. Around the wrist or heart rate sensor When an accident occurs to a person or a hospital. It is aimed at quick response. The purpose of this study is to develop a device and environment for the elderly living alone who have little or no income in case of safety accidents that are common to their subjects in everyday life. In order to provide a healthy and better quality of life, many users will be able to provide new experience and value to users through this research.

Purpose: The purpose of this study was to explore the factors influencing evidence-based fall prevention nursing performance of hospital nurses. Methods: A self-reported questionnaire was completed by 344 nurses from three general hospitals from January 20 to March 10, 2013. The study instruments included general characteristics of the subjects, and awareness and performance of fall prevention. Data were analyzed by t test, ANOVA, Pearson’s correlation, and multiple regression using SPSS v. 20.0. Results: There were statistically significant differences in awareness and performance according to age, marital status, clinical experiences, workplace, experience of fall prevention education, knowledge of fall prevention, compliance with fall prevention, attention level toward prevention, recognition level of potential falls, nurse responsibility for falls, importance of fall prevention, efforts level for fall prevention, and awareness score of falls prevention. There was a positive correlation among awareness and performance of fall prevention. Based on the multiple regression analysis, compliance with fall prevention, efforts level for fall prevention, and awareness score of falls prevention were significant predictors for performance of fall prevention. The explanation power of the model was 64.1%. Conclusion: The findings revealed the need to develop an effective nursing intervention to improve hospital nurses’ performance for fall prevention.

Purpose : A Study on the falls and prevent falls through the study of literature from the necessity and the prevention of procedure is designed to find a way. Method : Analyze the related papers. Result : (1)Percentage falls is ① Somewhere in 30 to 50 % of older adults, experienced the falls. ② Community appeared higher than in the fall rate is 40 to 80 percent of hospitals or nursing agencies. ③ Women there is a high occurrence of falls than men. ④ The occurrence of the more difficult economic situation, fall is high. ⑤ There is a higher occurrence of cases that have experienced in falls. ⑥ If there is a disease, have a higher occurrence of falls. ⑦ The environmental problem is happening to increase the occurrence (2)Fall cause classification ; Should be categorized into groups to control of the causes of falls. Therefore, physical, psychological, environmental, classified by environmental factors. (3)The problems caused by falls : 65 percent of the fall an old man's suffered a cerebral hemorrhage, fractures, sprains, contusions, lacerations, abrasions, damaged. (5)Prevention methods : It was exercise and music, rhythm, education programs, a combination of effective. Conclusion : Evaluation of the possible fall on a regular basis. And the development of any program that combines rhythmic movements and interesting education enhances its effectiveness.

According to the statistics of occupational injuries in 2013, the work platforms were main objects causing fall injuries in construction sites. But many scaffold and platform workers use and install the work platforms and the fixed and mobile scaffolding without considering about safety and health standards. We had done a nationwide survey about how the platform workers obey safety and health standards. As the result of this survey, in order to ensure the safety of the work platforms, we founded that the platform workers must obey the safety and health standards when using and installing the work platforms. To improve the safety and health conscious of the workers, it needs to educate a worker on safety and health standards for work platforms. Also, to effectively prevent constructin injuries for the work platforms, it is rextricted for workers to use only safety certified work platforms. And, before installing and using work platforms, it needs to make a work plan for work platforms and obey it.

연구 목적: 이 연구의 목적은 소아 낙상위험 측정 도구 중 하나 인 Humpty Dumpty Falls Scale의 효율성과, 낙상 예측 인자로서 위험 요소를 평가하는 것이다. 연구 방법: 전자 의무 기록을 이용한 후향적, 환자-대조군 연구 설계이며, 전체 연구 대상은 낙상을 경험한 13명과 낙상 경험이 없는 1941명의 소아 환자이다. 성별, 연령, 진단명, 재원 기간을 기준으로 낙상군에 매칭했을 때 비 낙상군은 429명이었다. 연구 결과: 매칭 후 낙상과 비낙상군 간의 모든 변수는 유의 한 차이가 없었다. Cutoff score 13점에서 민감도, 특이도, 음성 및 양성 예측도는 각각 92.3 %, 37.1 %, 99.9 % 및 0.01 %이었다. ROC 곡선 하 면적은 0.597이었다. 로지스틱 회귀 분석 결과 낙상 위험 점수가 높은 소아 환자 집단이 낙상과 유의한 관련이 있음을 보여주었다(OR 2.49, 90% CI 1.31-4.71). 결론: 진단 점수를 측정하는 매개 변수 중 하나인 ‘산소화 장애’는 낙상 감소 경향과 관련된 것으로 나타났으나, 다른 매개 변수에 비해 배점이 상대적으로 높다. 따라서 대규모 반복 연구를 통한 평가가 필요할 것으로 사료된다.

Purpose: The aim of this study was to evaluate the efficiency of the Humpty Dumpty Falls Scale as one of the falls risk assessment tools, and also to evaluate risk factors as predictors of falls in pediatric patient populations. Methods: In a retrospective, case-control design with data from the electronic medical records of 13 pediatric patients who fell and 1,941 who did not fall before matching and 429 who did not fall after matching by gender, age, diagnosis, and length of stay. Results: All the variables showed no significant differences after matching. At the cutoff score of 13, sensitivity, specificity, negative and positive predictive values were 92.3%, 37.1%, 99.9%, and 0.01%, respectively. The area under the Receiver Operating Characteristics was 0.597. The results from the logistic regression showed that the pediatric inpatient population who had higher risk scores was significantly associated with falls. The odds ratios ranged from 1.31 to 4.71 with 90% confidence interval. Conclusion: The saturation impairments criterion as one of the diagnostic parameter was negatively associated with falls, but the relative risk score was higher than the other criteria. Therefore, it seems that the diagnostic parameter seems to be required to verify results through large sample studies.

목적 : 본 연구의 목적은 낙상 위험 주거환경 평가인 HOME FAST의 국내사용을 위해 체계적인 절차를통해 한국어로 번안하여 내용이해도 및 신뢰도를 검증하고자 하였다. 연구 방법 : 한글로 번역된 HOME FAST의 내용이해도를 알아보기 위해 작업치료사 총 21명에게 한글번역본의 이해도 평가하게 하였다. 이후 한글번역본을 역번역 하여 원문과 비교하고 문장구조 및 의미 유사성을평가하였다. 아울러 신뢰도 검증을 위해 지역사회에 거주하고 있는 낙상 고위험군 노인 75명을 대상으로평가를 진행하고 내적 일치도를 검증하였다. 그중 9명의 대상자의 경우 2명의 작업치료사가 방문하여각각 평가한 뒤 검사자 간 신뢰도를 검증하였다. 결과 : 작업치료사를 대상으로 한 내용이해도 검증 결과에서 11개 문장이 이해도가 떨어지는 것으로 나타났다. 이해도 검증 결과의 의견을 바탕으로 검증위원회를 통해 구문을 수정하고 한글번역본을 완성하였다. 한글판을 역번역하여 유사성 검증을 한 결과 문장구조에서는 3문항이 유사하지 않음으로 평가되었고, 의미적 측면에서는 총 6문항이 유사하지 않음으로 평가되었다. 최종적으로 반복적 역번역 과정을 통해한글판 HOME FAST의 내용 타당도를 확보하였다. 한글번역본의 내적일치도는 .62(p<.01)로 나타났고, 검사자 간의 신뢰도는 .97 (p<.01)로 매우 높은 것으로 나타났다. 결론 : 본 연구는 체계적 번역-역번역 과정을 통해 HOME FAST를 한국어로 번역하였다. 아울러 한글판의내용이해도를 검증하였고, 내적일치도 및 검사자간 신뢰도 검증을 통해 신뢰도를 입증하였다.

Objective : This study aims to obtain the validation of Korean version of HOME FAST using the translation-back translation process and to evaluate the reliability. Methods : Total three stages were conducted which includes forward translation to Korean, test for degree of understanding of translated version, back translation to English, and then review and proof reading process. 21 occupational therapists were participated in the evaluation of understanding of Korean-translated HOME FAST, then some of expressions were modified for better understanding. Korean version was went through back-translation to English. Similarity between the original version and re-translated version were evaluated. Total 75 data from community dwelling elderly group were collected to assess internal consistency. Two occupational therapists simultaneously evaluated for the inter-rater reliability. Results : 11 items of Korean-translated scale were responded as having confused meaning by occupational therapists. There was some modification on expression. In the evaluation of similarity between original version and re-translated version, 3 items were selected as dissimilar items in terms of syntax and 6 items were selected in terms of semantic similarity. After the repetitive modification process, items were obtained conceptual equivalence between two different languages. Internal consistency was .62(KR20) (p<.01) and inter-rater reliability was .97(ICC) (p<.01). Conclusion : Korean version of HOME FAST was finalized through translation-retranslation process. The conceptual equivalence was established and Korean version showed highly reliable. In further study, The modification of items reflecting Korean house and life style should be conducted.