跌倒對老人健康相關生活品質變化的影響
The Effect of Falls on the Changes of Health-related Quality of Life
among the Elderly People
中文摘要 研究目的：調查跌倒對社區老人的世界衛生組織生活品質問卷台灣簡明版的四個 範疇所造成的變化。 研究設計：前瞻性的社區調查。 研究地區：台中縣新社鄉。 研究群體：一千二百位居住在自宅的六十五歲(含)以上之老年人。 研究結果：在生理、心理和社會關係範疇方面，跌倒二次(含)以上的老人要比沒 有跌倒的老人分別多下降 1.2、0.9 和 0.5 分。跌倒一次的老人僅在生理範疇方面 比沒有跌倒的老人多下降 0.9 分。在環境範疇生活品質分數變化方面，沒有跌倒 的老人、跌倒一次和跌倒二次(含)以上的老人並沒有顯著的差別。生理範疇的分 數下降約 2.0 分(1.9 至 2.5 分)、心理範疇的分數下降約 1.5 分(1.3 至 2.0 分)反應 出吃飯、穿衣、整理容貌這三項日常生活活動能力的狀態從“不需要幫助＂變成 “需要一些幫助＂，或是從“需要一些幫助＂變成“完全需要別人幫助＂。 生 理範疇的分數下降約 6.0 分(5.5 至 7.3 分)、心理範疇的分數下降約 4.0 分(2.9 至 5.1 分)反應出走路、上下床舖、沐浴、上廁所、大小便控制這五項日常生活活動 能力的狀態從“不需要幫助＂變成 “完全需要別人幫助＂。 研究結論：跌倒對生活品質變化的影響會隨著範疇的不同和跌倒的次數而有所差 異，生理範疇和心理範疇分數的下降反應出日常生活活動能力的功能變壞。 關鍵字：老人、生活品質、世界衛生組織生活品質問卷台灣簡明版、跌倒 英文摘要
Objective: To examine the effects of falls on the changes in 4 domains (physical capacity, psychological well-being, social relationships, and environment) of the Brief Version of World Health Organization’s Quality of Life (WHOQOL-BREF) among community-dwelling elderly people.
Design: A prospective community survey.
Setting: Shin-Sher Township in Taichung County, Taiwan.
Participants: A total of 1,200 subjects aged 65 years and older and living at home. Results: In comparison with non-fallers, subjects who had 2 or more falls had a larger decline in physical capacity, psychological well-being and social relationships (1.2, 0.9 and 0.5 points respectively); however, subjects who had a fall had a larger decline in physical capacity only (0.9 points). Compared with non-fallers, score change in the environment had no significant difference among either those who had a fall or those
who had 2 or more falls. The decline of approximate 2 points (1.9 to 2.5 points) in physical capacity and approximate 1.5 points (1.3 to 2.0 points) in psychological well-being were responsive to the level changes of the self-feeding, self-dressing, or grooming from “independent” to “some help needed” or from “some help needed” to “completely dependent.” The decline of approximate 6 points (5.5 to 7.3 points) in physical capacity and approximate 4 points (2.9 to 5.1 points) in psychological well-being were responsive to the level changes of the walking, transferring, bathing, toileting, or controlling bladder and bowel movements from “independent” to
“completely dependent.”
Conclusions: The impacts of falls on the changes of quality of life among elderly people differ over domains and also depend on the number of falls. The decline in physical capacity and psychological well-being was responsive to the functional impairment of activities of daily living.
