OBJECTIVE: This study aimed at developing a fall prevention program in an inpatient rehabilitation Spinal cord injury unit.
METHODS: A participatory action research approach utilizing a before-and-after, mixed-method design was employed for this study. The study was performed at Rofaydeh Rehabilitation Hospital in Tehran, Iran, from 2021 to 2022. the study implemented Cohen\'s four-stage model, encompassing the design of a change program, action, observation and evaluation, and feedback stages. A purposeful sampling method was utilized to select 19 nurses and members of the rehabilitation team from the hospital, ensuring maximum diversity. Data collection involved semi-structured interviews, focus groups, and a checklist for fall prevention measures. Qualitative content analysis, alongside descriptive (frequency, mean, and standard deviation) and inferential statistics (paired t-tests and Chi-square tests), were employed for data analysis. The study adhered to COREQ guidelines.
RESULTS: Falls were most common among patients aged fifty years or older (P = 0.026). Throughout the study period, men were more likely to experience falls than women (P = 0.01). Preventive interventions have led to significant improvements in indicators of patient monitoring and care, patient education, and environmental safety, as demonstrated by a paired-sample t-test (P<0.001). Moreover, factors contributing to patients\' falls included \"shortcomings in fall prevention policies\" and \"lack of knowledge and participation among patients and caregivers.\" Changes implemented in the Spinal Cord Injury unit involved enhancing interprofessional interactions, conducting educational workshops for patients and their companions, and identifying high-risk patients. These findings indicate a significant decrease in the incidence of falls following the intervention (P = 0.02).
CONCLUSIONS: The study found that a multifaceted intervention can increase knowledge about fall risks and substantially reduce both falls and associated minor injuries.
目的:本研究旨在制定一项预防跌倒的住院康复脊髓损伤单元计划。
方法:一种参与式行动研究方法,利用前后,本研究采用混合方法设计。这项研究是在德黑兰的Rofaydeh康复医院进行的,伊朗,从2021年到2022年。这项研究采用了科恩的四阶段模型,包括变革计划的设计,行动,观察和评估,和反馈阶段。采用有目的的抽样方法,从医院抽取19名护士及康复小组成员,确保最大的多样性。数据收集涉及半结构化访谈,焦点小组,和防坠落措施检查表。定性内容分析,除了描述性的(频率,意思是,和标准偏差)和推理统计(配对t检验和卡方检验),用于数据分析。这项研究遵循了COREQ准则。
结果:跌倒在50岁以上的患者中最为常见(P=0.026)。在整个研究期间,男性比女性更容易跌倒(P=0.01).预防性干预导致患者监测和护理指标的显著改善,患者教育,和环境安全,如配对样本t检验所示(P<0.001)。此外,导致患者跌倒的因素包括“跌倒预防政策的缺陷”和“患者和护理人员缺乏知识和参与”。“脊髓损伤单元中实施的变化涉及加强职业间的互动,为患者及其同伴举办教育研讨会,识别高危患者。这些发现表明干预后跌倒的发生率显着降低(P=0.02)。
结论:该研究发现,多方面的干预措施可以增加对跌倒风险的了解,并大大减少跌倒和相关的轻伤。