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Author: 張毓芬
Chang, Yu-Fen
Thesis Title: 跌倒風險篩檢簡表應用於社區中老年人之研究
A short-form fall-risk screening tool for community- dwelling
Advisor: 郭鐘隆
Guo, Jong-Long
Degree: 碩士
Master
Department: 健康促進與衛生教育學系
Department of Health Promotion and Health Education
Thesis Publication Year: 2011
Academic Year: 99
Language: 中文
Number of pages: 60
Keywords (in Chinese): 跌倒風險篩檢簡表信度效度
Keywords (in English): fall-risk, screening tool, Reliability, Validity
Thesis Type: Academic thesis/ dissertation
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本研究目的是透過跌倒風險篩檢簡表應用於社區中老年人之研究,用於篩檢『中老人年跌倒的風險』,並探討其信度與效度,而決定最佳切點分數,並區辨具有跌倒風險的社區中老年人。
研究對象為臺灣29個社區的保命防跌班學員,總計為669位50歲以上中老年人,本研究的跌倒風險篩檢簡表共有14題,總分範圍為0-14分,若得分越高,表示跌倒的可能性越高。
研究結果發現,跌倒風險篩檢簡表之信度檢定,內部一致性良好。可以有效預測跌倒組與未跌倒組,4分為最佳切點分數,兼具敏感性及特異性。應用重複跌倒個案的篩選,4到6分敏感性與特異性均達70%以上,若用4分或5分當作切點分數,其敏感性均達9成以上,但5分特異性較高,達84.68%。若欲進一步減少人力評估或檢查,則切點分數可提高至6分,雖然敏感性70%,但特異性達88.5%。
本研究工具簡單易操作,可供衛生專業人員利用短時間篩檢出跌倒高危險族群,利於公共衛生上推廣。

Through application of a short-form fall-risk screening tool for community-dwelling elderly people, this study aims to carry out fall-risk screening for community-dwelling elderly people and discuss its reliability and validity so that the best cut-off point can be determined and the community-dwelling elderly people with fall risk can be identified.
The research subjects are 669 elderly people who are over 50 years of age from 29 communities’ life-saving and anti-fall classes in Taiwan. The short-form fall-risk screening tool in this study has 14 questions with score between 0 and 14; the higher score represents higher probability of falling.
The research results show that the short-form fall-risk screening tool’s reliability test has good internal consistency. It is able to effectively predict the falling group and non-falling group. The score of 4 is the best cut-off point with sensitivity and specificity. With the application of repeat falling case, both sensitivity and specificity are over 70% for score between 4 and 6. If we use the score of 4 or 5 as cut-off point, the sensitivity is over 90%; however, the score of 5 has higher specificity with 84.68%. For the purpose of reducing assessment or inspection manpower, the cut-off point can be increased to score of 6, with sensitivity of 70% and high specificity of 88.5%.
The tool used in this study is easy to operate and it can help the health and care professionals to identify the high fall-risk group in a timely manner so that it is also conductive to the promotion of public health.

摘要…………………………………………………………………………i Abstract………………………………………………………………… ii 目次 ………………………………………………………………………iii 表次……………………………………………………………………v 圖次 ………………………………………………………………………vi 第一章 緒論………………………………………………… 1 第一節 研究動機與重要性…………………………………… 1 第二節 研究目的……………………………………………… 3 第三節 研究問題與研究假設……………………………… 4 第四節 名詞解釋……………………………………………… 5 第五節 研究限制……………………………………………… 6 第二章 文獻探討………………………………………………… 7 第一節 老人跌倒的危險因子……………………………… 7 第二節 各跌倒相關介入研究中所應用的篩檢工具………… 9 第三節 跌倒篩檢工具於研究中之發現……………………… 16 第四節 篩檢工具的評價……………………………………… 25 第三章 研究設計………………………………………………… 28 第一節 研究對象……………………………………………… 28 第二節 研究工具……………………………………………… 30 第三節 研究步驟 ……………………………………………… 31 第四節 資料處理與統計分析………………………………… 32 第四章 研究結果與討論………………………………………… 34 第一節 研究對象之社會人口學變項在跌倒發生的差異…… 34 第二節 跌倒風險篩檢簡表之效度分析………………… 39 第三節 跌倒風險篩檢簡表之信度分析…………………… 47 第五章 結論與建議……………………………………………… 49 第一節 結論………………………………………………… 49 第二節 建議……………………………………………… 51 參考文獻 ……………………………………………………… 53 附錄 ……………………………………………………………… 60 附錄一:跌倒風險篩檢簡表……………………………………… 60

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