老年衰弱患者跌倒恐惧现状及影响因素的混合研究

A Mixed-methods Study on the Current Status and Influencing Factors of Fear of Falling in Elderly Patients with Frailty

摘要

目的 探讨老年衰弱患者跌倒恐惧现状并分析其影响因素。方法 采用解释性混合研究设计，采取便利抽样法，选取2025年1月至2025年10月在云南省某三甲医院老年医学科住院的335例老年衰弱患者为调查对象。使用一般资料调查表、Morse平衡量表、焦虑自评量表、抑郁自评量表和修订版跌倒恐惧调查问卷进行调查，多元线性回归分析老年衰弱患者跌倒恐惧的影响因素。采用目的抽样对16位老年衰弱患者进行半结构型访谈并对访谈资料进行分析。结果 老年衰弱患者跌倒恐惧得分为（42.88 ± 3.65）分，焦虑自评得分为（41.17 ± 10.83）分，抑郁自评得分为（44.21 ± 8.92）分。多元线性回归显示，性别、月收入、年龄、情感状况、每周运动次数、疾病种类、Morse评分和每日睡眠时间是老年衰弱患者跌倒恐惧的主要影响因素（P < 0.05）。质性研究提炼了4个主题：躯体衰弱和疾病发作的双重挑战、跌倒经历引起自我暗示、缺乏安全舒适的外部环境和信息理解不全面。整合结果显示量性与质性研究结果相互验证与补充。结论 老年衰弱患者的跌倒恐惧处于中等偏高水平，跌倒恐惧水平受到个人和环境的共同作用，医护人员应为此类患者实施针对性的护理干预措施。

Abstract

Objective To explore the current status of fear of falling in elderly patients with debilitating diseases and analyze its influencing factors. Methods An explanatory mixed-methods design was adopted. Through convenience sampling, a total of 335 elderly debilitated patients hospitalized in the department of geriatrics a tertiary hospital in Yunnan Province from January 2025 to October 2025 were enrolled as participants. Data were collected using a general Information Questionnaire, the Morse Balance Scale, the Self-Rating Anxiety Scale, the Self-Rating Depression Scale and the Modified Fear of Falling Questionnaire. Multiple linear regression analysis was used to identify the influencing factors of Fear of Falling in elderly debilitated patients. Semi-structured interviews were conducted with 16 elderly debilitated patients by purposive sampling and the interview data were analyzed qualitatively. Results The mean score of fear of falling in frail elderly patients was 42.88 ± 3.65. The mean scores of anxiety and depression were 41.17 ± 10.83 and 44.21 ± 8.92 respectively. Multiple linear regression showed that gender, monthly income, age, emotional status, weekly exercise frequency, number of disease types, Morse score and daily sleep duration were the main influencing factors of fear of falling in elderly debilitated patients (P < 0.05). The qualitative study refined four themes: the dual challenges of physical frailty and disease onset, self-suggestion caused by the fall experience; lack of a safe and comfortable external environment; and incomplete understanding of information. The integrated results show that the quantitative and qualitative findings mutually validated and supplemented each other. Conclusion The level of fear of falling in elderly debilitated patients is moderately high, influenced by both individual and environmental factors. Healthcare providers should implement targeted nursing interventions for this population.

关键词

跌倒恐惧 / 老年衰弱 / 影响因素 / 混合研究

Key words

Fear of falling / Frail elderly / Influencing factors / Mixed-methods study

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基金资助

昆明医科大学护理学专项基金(2025KYHLZXZK23)