| Summary: | 碩士 === 國防醫學院 === 公共衛生學研究所 === 107 === Background: The ageing society has created many health problems. At the same time, it has been heavy burden in the world. In this world where the average life expectancy increases and the overall birth rate decreases, the ageing rate of the population is rising rapidly. This is a problem that human beings must face now. According to the information of the Ministry of Health and Welfare in Taiwan, the population of elderly people living alone in Taiwan and the current unmarried people is increasing. With the progress of time, the proportion of old people may increase year by year, and the fall is also a common cause for death in many accidents. Therefore, effective intervention should be adopted. Reducing the risk of falling in elderly living alone is one of the important issues of public health today.
Objectives: This study used case management to track the risk factors of falling elderly living alone to improve fear of falling and understand their satisfaction after intervention.
Methods: This study is a randomized trial design study. Our target population are 212 people in the Nangang District of Taipei City, who were over 65 years old in May 2018. They were randomly assigned to distinguish between the intervention group and the control group. The Taiwanese version of the Fukang questionnaire (Tw-FROP-Com), short version of the Fall Efficacy Scale International (SFES-I), and fall prevention case management satisfaction questionnaire are used to implement data collection, the risk of falling points is between 0-60, the fear of falling points is between 7-28, and satisfaction points is between 15-75. This study is to compare the risk of falling, fear of falling, and satisfaction between intervention group and control group before and after the case management after 6-month follow-up.
Results: The tracking for a total number of 175 elders was completed, the same basic traits shared by the intervention and control group didn’t show any significant difference. The study showed that the total risk of falling in the intervention group was reduced by 2.060 points (p=0.025) and the overall satisfaction rate was increased by 6.205 points compared with the control group. Females’ total risk of falling was lower than males’ by 2.140 points (p= 0.021); if the marital status was widowed, the total risk of falling was reduced by 2.997 points (p=0.018) compared with the unmarried; in the case of divorce or separation, the total risk of falling compared with the unmarried was diminished by 3.561 points (p=0.033); in terms of education degree, the higher degree of education, the higher satisfaction. In the case of falls, compared with those who didn’t have any falls, for those who underwent a fall in the past year, the risk of falling increased by 4.518 points (p<0.001); the score of fear of falling was enhanced by 1.703 points (p=0.007); however, the score of overall satisfaction decreased by 2.416 points. Something noteworthy in this study was that for those elders who lived with others (living alone by definition from Taipei City Government Social Affairs Bureau, 2018), compared with those who literally “lived alone” (without any company), the total risk of falling rose by 3.486 points (p<0.001). In terms of being taken care, for those who had a caregiver, compared with those who didn’t have any, the total score increased by 4.557 points (p <0.001).
Conclusions: After the intervention of the case management for the elders living alone, the total falling risk score in the post-test for the intervention group was significantly lower than that in the pre-test. As for the comparison between the intervention and control group, the score of the intervention group was far lower than that of the control group. In respect of the overall satisfaction, the score in the intervention group was significantly higher than that in the control group. Last, with regard to the fear of falling, the scores of the two groups were both higher in the post-test than those in the pre-test. However, the comparison of the scores between the two groups in the post-test didn’t indicate significant difference.
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