• Journal of Korean Critical Care Nursing
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• v.12 no.1
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• pp.57-70
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• 2019

Purpose : The purpose of this study was to identify the risk factors for falls in tertiary hospital inpatients and to suggest data for developing a nursing intervention program for preventing falls. Methods: Data were collected between January 1, 2017, to December 31, 2017. Kaplan-Meier estimation was used to measure the survival rate, and the log-rank test was used for the differences between the fall group and the non-fall group. The Cox proportional hazards model was used to identify the risk factors for falls. Results: The incidence rate of falls for the inpatients was 1.2 cases per 1,000 days of hospitalization. The risk factors for falls were more likely to be found among those who were aged ${\geq}81$, had not undergone surgery, had poor joint motion, had unsteady gait, needed help or supervision, used assistive devices, had comorbidity, and took at least two drugs. Conclusion: For the inpatients, the risk factors for falls included age, surgery, comorbidity, medication that could change mobility, joint motion, and use of patient care equipment. It is necessary to give special attention to inpatients who have any of these risk factors and to develop a falls risk assessment tool.

• Physical Therapy Rehabilitation Science
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• v.11 no.1
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• pp.66-77
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• 2022

Objective: This study is a systematic review conducted to analyze the environmental factors that cause falls in the older adult. Design: Systematic review Methods: The study was conducted by searching the Research Information Sharing Service (RISS), Korean studies Information Service System (KISS), and Data Base Periodical Information Academic (DBpia) databases for literature published in South Korea up to July 2020. A total of 12 studies were selected for analysis based on the inclusion and exclusion criteria. Results: The results of the analysis revealed that all the selected literature were surveys and the study subjects were 65 years of age and above. The sample size ranged from a minimum of 95 subjects to a maximum of 3,278. A total of eight tools were used to measure the environmental factors associated with falls. The prevalence and recurrence of falls increase with age and deterioration of health. Older adult individuals who experience falls encounter difficulties in recovering from impaired physical function and disability; moreover, in severe cases, falls may lead to death. Falls are largely associated with a combination of intrinsic and extrinsic (i.e., environmental) factors. The purpose of this study was to assess potential extrinsic risk factors for falls. Falls occur in indoor environments, such as washrooms, bathrooms and living rooms, and outdoor environments, including roads and stairways, depending on the season, time of day, and use of ambulatory aids. In such environments, falls are mainly caused by slipping and stuttering. Conclusions: Therefore, as the rate of fall is influenced by several factors, extrinsic factors should be improved by developing comprehensive accident prevention programs that address the improvement of environmental risk factors around places of residence to reduce risk factors among the older adult, who, especially, are at a high risk for falls.

• Journal of Korean Academy of Nursing
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• v.43 no.5
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• pp.595-604
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• 2013

Purpose: The purpose of this study was to identify risk factors for pediatric inpatients falls. Methods: The study was a matched case-control design. The participants were 279 patients under the age of 6 who were admitted between January 1, 2004 and December 31, 2009. Through chart reviews, 93 pediatric patients who fell and 186 ones who did not fall were paired by gender, age, diagnosis, and length of stay. Five experts evaluated the 38 fall risk factors selected by the researchers. Results: In a general hospital, pediatric patients with secondary diagnosis, tests that need the patient to be moved, intravenous lines, hyperactivity, anxiolytics, sedatives and hypnotics, and general anesthetics showed significance for falls on adjusted-odds ratios. Conditional logistic regression analysis was performed to elucidate the factors that influence pediatric inpatient falls. The probability of falls increased with hyperactivity and general weakness. Patients who didn't have tests that required them to be moved and intravenous line had a higher risk of falls. Conclusion: These findings provide information that is relevant in developing fall risk assessment tools and prevention programs for pediatric inpatient falls.

• Journal of Korean Academy of Nursing
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• v.47 no.3
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• pp.420-430
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• 2017

Purpose: The aim of this study was to explore characteristics of and risk factors for accidental inpatient falls. Methods: Participants were classified as fallers or non-fallers based on the fall history of inpatients in a tertiary hospital in Seoul between June 2014 and May 2015. Data on falls were obtained from the fall report forms and data on risk factors were obtained from the electronic nursing records. Characteristics of fallers and non-fallers were analyzed using descriptive statistics. Risk factors for falls were identified using univariate analyses and logistic regression analysis. Results: Average length of stay prior to the fall was 21.52 days and average age of fallers was 61.37 years. Most falls occurred during the night shifts and in the bedroom and were due to sudden leg weakness during ambulation. It was found that gender, BMI, physical problems such elimination, gait, vision and hearing and medications such as sleeping pills, antiarrhythmics, vasodilators, and muscle relaxant were statistically significant factors affecting falls. Conclusion: The findings show that there are significant risk factors such as BMI and history of surgery which are not part of fall assessment tools. There are also items on fall assessment tools which are not found to be significant such as mental status, emotional unstability, dizziness, and impairment of urination. Therefore, these various risk factors should be examined in the fall risk assessments and these risk factors should be considered in the development of fall assessment tools.

• Research in Community and Public Health Nursing
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• v.30 no.2
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• pp.141-149
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• 2019

Purpose: The purpose of this study is to identify risk factors of accidental falls by age in the Korean elderly. Methods: The study subjects included 10,242 community-dwelling elders aged 65 or over. The data were analyzed by logistic regression analysis. Results: The risk factors of accidental falls in the younger old group (aged 65~74) include fear of falling (OR=16.28, 95% CI: 12.03~22.03), depression (OR=1.24, 95% CI: 1.06~1.44), and hearing impairment (OR=1.20, 95% CI: 1.01~1.43). The risk factors of accidental falls in the older old group (aged 75~84) include fear of falling (OR=11.54, 95% CI: 7.04~18.93), muscle strength (OR=1.36, 95% CI: 1.15~1.60), number of chronic disease (OR=1.65, 95% CI: 1.09~2.50), and presence of spouse (OR=1.27, 95% CI: 1.06~1.51). The risk factors of accidental falls in the oldest old group (aged 85 years old or older) include fear of falling (OR=8.05, 95% CI: 1.85~34.98) and exercise (OR=2.91, 95% CI: 1.36~6.24). Fear of falling is defined as a common factor in the all age groups. Conclusion: Different strategies should be developed for age groups to prevent elderly falls with understanding of contributing factors of falls in each group.

• Journal of Korean Academy of Nursing
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• v.40 no.4
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• pp.589-598
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• 2010

Purpose: The purpose of this study was to investigate the factors that increase of the risk for falls in low-income elders in urban areas. Methods: The participants were elderly people registered in one of public health centers in one city. Data were collected by interviewing the elders, assessing their environmental risk factors, and surveying relevant secondary data from the public health center records. For data analysis, descriptive statistics and multiple logistic regression were performed using SPSS version 14. Results: Stroke, diabetes, visual deficits, frequency of dizziness, use of assistive devices and moderate depression were statistically significant risk factors. The comorbidity of chronic diseases with other factors including depression, visual deficit, dizziness, and use of assistive devices significantly increased the risk of falls. From multiple logistic regression analysis, statistically significant predictors of falls were found to be stroke, total environmental risk scores, comorbiditiy of diabetes with visual deficits, and with depression. Conclusion: Fall prevention interventions should be multifactorial, especially for the elders with stroke or diabetes, who were identified in this study as the high risk group for falls. A fall risk assessment tool for low-income elders should include both the intrinsic factors like depression, dizziness, and use of assistive devices, and the extrinsic factors.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.13 no.2
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• pp.200-207
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• 2006

Purpose: This study was done to identify factors influencing falls in inpatients. A comprehensive analysis of individual, disease, and environment related factors and an assessment of being in a risk factor group were included in the data. Method: The medical records of 325 inpatients were reviewed. Data were collected from January to July 2003. Frequencies, 1-test and $X^2-test$ were used to analyze the data and the SPSS program was used. Results: Individual-related factors for inpatients falls were age, drinking and weakness. Disease-related factors for inpatients falls were diagnostic department, admission from ER or OPD, admission by wheelchair or orther method and activity status. Environment-related factors for inpatient falls were re-education and side-rails. Assessment of the risk factor group related factors were age, history of falls, body balance, depression, communication, medication, chronic disease, urinary condition and total score for risk factors. Conclusion: Experienceing a fall among Korean inpatients was associated not only with individual factors, but also with disease and environmental factors. The findings of this study suggest that broad intervention programs should be provided to prevent inpatient falls.

• Physical Therapy Korea
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• v.30 no.1
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• pp.1-7
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• 2023

Background: Like many other countries, falls and related injuries in older adults are great concerns in South Korea. In particular, falls are common in medical institutions, often causing the increase of the length of hospitalization. Objects: The purpose of this review was to help understand and address falls in hospitalized individuals in South Korea. Methods: The review was conducted on literature published in Korean from 2010 to 2022, searched in the Korea Citation Index and PubMed. Keywords used for the search were as follows: falls, fall risk, fall risk assessment, hospital, inpatient, intervention, Korea, and prevention. Results: A total of 54 articles were found and reviewed. The most common place of fall accidents was the inpatient room, where there were many cases of falls while walking. Loss of balance was the most common cause of falls, and many falls occurred in patients admitted to the internal medicine. Furthermore, a risk of falling increased with the type of medications taken. In terms of tools to assess patients' fall risk, the Morse Fall Scale (MFS) was commonly used. Patient-specific fall prevention activities were common to address falls, and they decreased the frequency of falls and the fear of falling. Factors influencing the effectiveness of the fall prevention activities included attitudes toward falls, education, environmental factors, patient safety culture, and self-efficacy in preventing falls. Conclusion: Our results should help understand and address falls and injuries in medical institutions.

• Korean Journal of Health Education and Promotion
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• v.25 no.2
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• pp.1-18
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• 2008

Objectives: The objective of this study is to identify the gender differences of risk factors for falls among the elderly in community dwellings. Methods: We analyzed the data on 3,278(male 1,255, female 2,023) persons, including 497 persons who have experienced falls, drawn from the 2004 National Elderly Survey. We conducted a cross-tabulation analysis, $X^2$-test and hierarchical regression analysis of the impact of the socio-economical characteristics, environmental characteristics, the number of chronic diseases, usage of supplementary devices, activities of daily living, dementia, and the severity of problem behavior. Results: For the entire sample of the elderly, gender, age, the size of the cities of residence, the number of chronic diseases, and the severity of problem behavior were identified as risk factors for falls. The number of chronic diseases and the severity of problem behavior were found to be significant for the male subsample, while age, the size of cities of residence, dwelling types, and the number of chronic diseases were found to be significant for the female subsample. Conclusion: The number of chronic diseases was identified as a common risk factor for falls in the male and female elderly. Chronic diseases were also found to aggravate the risk for falls when they concur with other diseases.

• Korean Journal of Health Education and Promotion
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• v.27 no.1
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• pp.21-34
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• 2010

Objectives: The objective of this study was to investigate risk factors for falls in the elderly by life-cycle. Methods: This study used the data on 435 male and female elderly generated from a survey taken at 21 Welfare Centers for the Elderly in Seoul. The incidence of demographic characteristics, physical changes brought about with ageing, health-related behavior, chronic diseases, and environmental characteristics on falls in the elderly was analyzed. Hierarchical Logistic Regression analysis was also conducted to investigate the incidence by life-cycle (early-mid-late stage) and the results were used for predicting falls. Results: The incidence of risk factors on falls varied across life-cycle. Among the elderly in the early (ages from 65 through 74), marital status, the existence of a companion, the quality of sleep, the chronic diseases, and the condition of the bathroom floor were found to be related to falls. Among those in the mid-stage (ages from 75 through 84), sex, marital status, the existence of a companion, hearing capacity, sense of balancing, chronic diseases, the exclusive use of rooms, and the side bar with bath tub were found to affect falls. Finally, for the elderly in their late stage (85 years of age and older), drinking and vision were found to be related to falls. Conclusion: The incidence of risk factors on falls was found to vary according the stage in the elderly. A key implication of this finding is that falls prevention programs and interventions must be catered to specific age sub-groups.