本研究主要目的在於探討「老年住院病人預防跌倒衛生教育」之成效。本研究採「準實驗設計」，實驗組為臺北縣立醫院三重院區65歲以上內科病人50位；對照組為板橋院區65歲以上內科病人50位。
實驗組之介入教材包括：以健康信念模式為理論基礎之預防跌倒衛生教育DVD及手冊，教材內容包括1.生活起居注意（鞋具衣著注意、睡前注意、上下床注意）2.住院環境安排（日常物品擺設、地面、燈光）3.行動注意（行走及使用輔具注意，如輪椅、手杖、助行器等）等三大部分，進行衛教之人員則為受過訓練之研究員及醫院護理人員；對照組則採取原來衛教方式。實驗組與對照組皆接受前測、後測的「老年住院病人預防跌倒衛生教育介入成效問卷」調查。
本研究之重要結果如下：
一、老年住院病人預防跌倒衛生教育介入後，經共變數分析發現實驗組在「預
防跌倒知識」、「預防跌倒健康信念」、「預防跌倒行動線索」、「預防跌倒自我效能」與「預防跌倒行為」的分數皆顯著優於對照組，顯示老年住院病人預防跌倒衛生教育介入在「預防跌倒知識」、「預防跌倒健康信念」、「預防跌倒行動線索」、「預防跌倒自我效能」與「預防跌倒行為」等效標變項上皆產生效果。
二、老年住院病人預防跌倒衛生教育介入後，經共變數分析發現實驗組與對照組在「跌倒次數」上尚未顯著差異。
本研究中「跌倒次數」雖未產生效果，但依據次數調整後平均數發現實驗組之後測跌倒次數低於對照組，可能由於觀察時間較短尚未產生效果，其效果有待較長時間之觀察。建議未來研究可延長觀察時間以及增加肌力訓練等衛生教育內容以增加其效果。

The purpose of this study is to explore the effect of “health education of falling prevention for aged hospitalized patients”. In this study, we adopted “quasi-experiment design”--- the experimental group is the 50 patients of internal medicine who are over 65 in Sanchung Branch of Taipei County, while the control group is the 50 patients of internal medicine who are over 65 in Banqiao Branch of Taipei County.
The involving teaching materials for the experimental group include health education of falling prevention DVD and manual based theoretically on the model of health belief with the contents of 3 parts such as1.attentions for living（attention for footwear, attention before sleeping, attention for getting on and off bed）2.arrangement for hospitalizing environment（settings of daily utensils, ground, lights）3. attentions for actions（attentions for walking and using assistives like wheelchairs, canes and walking-assisting device）, and the health educational personnel are the trained researchers and nurses in hospital; as for the control group, it adopted the previous health education. Both experimental group and control group accepted pre-test and post-test of the survey of “questionnaires for the involving effect of health education of falling prevention for aged hospitalized patients”.
The important results of this study are as follows:
I. After the involvement of health education of falling prevention for aged hospitalized patients, through the analysis of covariance, we find experimental group’ scores in “knowledge of falling prevention”, “health belief of falling prevention”, “action clue of falling prevention”, “self-efficacy of falling prevention” and “behavior of falling prevention” are all better than those of control group showing that the involvement of health education of falling prevention for aged hospitalized patients created effects the validity variables of “knowledge of falling prevention”, “health belief of falling prevention”, “action clue of falling prevention”, “self-efficacy of falling prevention” and “behavior of falling prevention”.
II. After the involvement of health education of falling prevention for aged hospitalized patients, through the analysis of covariance, we find there is no salient deviation in “frequency of falling” between experimental group and control group.
In this study, though “frequency of falling” doesn’t have effect, but according to the average after frequency adjustment, we find the post-test frequency of falling is fewer than that of control group; this is possibly because the short time of observation didn’t create effect, so its effect needs longer time of observation. We suggest, in the future researches, they can prolong time of observation and increase such health education content as muscle force training to enhance its effect.

一、中文部分
王巧諄、翁靖雅、吳盈燕（2004）。提昇住院病人跌倒衛教完成率，北市醫學
雜誌，4（2），36-44。
王琬詳（2006）。預防跌倒。慈濟護理雜誌，5（1），44-45。
王曼溪（2000）。如何製作好讀易懂的書面衛教資料。臺灣醫學，4（3），
334-337。
台灣醫療事務管理學會（2007）。台灣醫療照護品質指標系列品質系列手冊
（第六版）。
尹祚芊、蔡欣玲、林麗華、黃令宜、簡淑芬、紀美滿等（2004）。建構安全的
醫療環境-預防跌倒自學媒體教材的製作與評值。行政院衛生署九十三年
度病人安全訓練計畫研究報告。臺北：行政院衛生署。
行政院衛生署（2006）。公共衛生年報。台北：行政院衛生署。
行政院衛生署（2008）。病人安全年度目標。2008年12月11日，取自行政院
衛生署，病人安全資訊網址
http://www.patientsafety.tw/big5/default.asp
吳淑芳（2007）。臺北縣松年大學學員參與動機及學習困難之研究。（碩士論
文，國立臺灣師範大學，2007）。國立臺灣師範大學碩博士論文系統。
邱寶萱（2003）。預防社區老人跌倒介入研究之前驅研究：城鄉之比較。（碩
士論文，國立臺灣師範大學，2003）。國立臺灣師範大學碩博士論文系
統。
周淑慧、吳麗蘭、程淑珍與林如錚（2004）。預防病人跌倒安全作業指引。北
市醫學雜誌，1（4），110-112。
官蔚菁（2003）。台灣健康信念模式研究之統合分析（碩士論文，國立成功大
學，2003）。全國碩博士論文資訊網，092NCKU5563009。
林勤敏（2002）。高齡學習者的障礙與困難。成人教育，65，44-50。
林碧珠、林麗嬋、林金真（1997）。成人教育理論與老人衛生教育。護理雜
誌，44（2），81-86。
柯彩風、張麗銀（2005）。根本原因分析病人跌倒事件。榮總護理，22
（2），125-131。
洪聖惠、秦文靜、黃清水、陳小蓮、鄭嘉惠、陳韋君等（2008）。病人安全通
報系統跌倒事件分析，醫院，41（1），42-53。
洪如慧、李佩樺、張育菘、張偉洲（2005）。住院病人跌倒事件探討分析。福
爾摩沙醫務管理雜誌，1（1），87-96。
洪惠鈴（2005）。高齡者非參與學習因素之研究。（碩士論文，國立中正大
學，2005）。全國碩博士論文資訊網，093CCU00782002。
柴惠敏、胡名霞、吳英黛、鄭百副、曹昭懿（2008）。社區中老年人「預防跌
倒」衛教課程之成效。物理治療，33（3），175-181。
許淑芬（2005）。機構老人預防跌倒課程介入之過程及衝擊評價研究。（碩士
論文，國立臺灣師範大學，2005）。國立臺灣師範大學碩博士論文系統。
郭憲華、李慶女、江怜妴、曾淑惠（2001）。某教學醫院住院病人跌倒事件之
調查報告，醫院，34（3），29-40。
張淑娟、賴仲亮、郭淑珍、邱慧菁、陳宜蓁、曾盈溶等（2008）。某區域教學
醫院住院病人跌倒事件分析，醫院，41（3），25-36。
張鳳琴、蔡益堅、吳聖良（2003）。台灣地區非致命事故傷害狀況。臺灣公共
衛生雜誌，22（6），492-500。
陳清美（2001）。高齡者對學習環境偏好之研究。（碩士論文，國立中正大
學，2001）。全國碩博士論文資訊網，089CCU00142018。
陳玉枝、范毓佩、林麗華（2001）。病人住院特性之探討與防範措施之研究—
台灣醫療品質指標計畫（TQIP）系列研究之一，醫院，34（2），16-
26。
陳玉枝、林麗華、簡淑芬（2002）。住院病人傷害跌倒的影響因素與其醫療資
源耗用之相關性。慈濟護理雜誌，1（3），66-77。
陳玉枝、林麗華、簡淑芬（2003）。跌倒危險因子，醫院，36（5），42-
53。
黃英祚（2007）。高危險群病人跌倒傷害事件之探討（碩士論文，東海大學，
2007）。全國碩博士論文資訊網，095THU00030038。
曾淑梅、李小菁、李淑桂、林惠暖、林隆堯（2005）。醫學中心住院病人之跌
倒意外事件，中山醫學雜誌，16（2），225-233。
曾揚容（2003）。老人社會大學高齡學習者學習型態及其相關因素之研究。
（碩士論文，國立臺灣師範大學，2003）。國立臺灣師範大學碩博士論文
系統。
楊美紅、徐姍姍（2003）。住院病人跌倒之新觀念。護理雜誌，50（1），
86-92。
葉兆斌、周明智、林怡芬、林錦源（2006）。跌倒患者至急診部就醫之臨床分
析。中山醫學雜誌，17（2），169-178。
黃富順（2002）。成人學習。台北市：五南出版社。
黃富順（1996）。學習與記憶的發展與適應。台北：國立空中大學。
萬彛芬（2007）。安養機構老人預防跌倒課程介入之成效研究。（碩士論文，
國立台北護理學院，2007）。全國碩博士論文資訊網，
096NTCN0710008。
廖純真（2002）。應用戴明理論於病人跌倒改善方案，醫院，35（5），1-
11。
劉俐蓉、沈希哲（2008）。都會社區獨居及慢性病老人跌倒之預測因子。北市
醫學雜誌，5（1），86-101。
蔡益堅、葉純志、藍祚運、張文瓊、曾德運（2007）。1999年與2005年台灣
地區老人跌倒現況之比較-2005年國民健康訪問暨藥物濫用調查結果。
2008年11月25日，取自行政院衛生署，國民健康局網址
http://www.bhp.doh.gov.tw/BHPnet/Portal/Them_Show.aspx?
Subject=200712270001&Class=2&No=200712270007.
蔡德甫（2004）。跌倒對老人健康相關生活品質變化的影響。（碩士論文，臺
北醫學大學，2004）。全國碩博士論文資訊網，093TMC00679010。
蔡素蘭、林茂榮（2002）。跌倒對臺灣鄉村社區老人日常生活活動能力衰退與
害怕跌倒心理的影響。物理治療，27（4），155-164。
謝昌成、蔡坤維、劉鎮嘉（2007）。老年人的跌倒問題。基層醫學，22
（10），352-357。
戴靜文（2002）。老人學習動機、學習行為與學習的有效策略之探討。諮商與
輔導，195，33-39。
二、英文部分
Alywahby, N. F. (1989). Principles of teaching for individual learning of older adults. Rehabilitation Nursing, 14(6), 330-333.
Boechler, P. M., Foth, D., & Watchorn, R. (2007).
Educational technology research with older adults:
Adjustments in protocol, materials, and procedures.
Educational Geronotology, 33, 221-235.
Barnett, L. M., Beurden, E. V., Eakin. E. G., Beard, J.,
Dietrich & Newman, B.(2004). Program sustainability of
a community-based intervenetion to prevent falls among
older Australians. Health Promotion International, 19
(3), 281-288.
Backer, C., Kron, M., Lindemann, U., Sturm, E., Eichner,
B., & Nikolaus, B., et al.(2003). Efectiveness of a
multifaceted intervention on falls in nursing home
residents. Journal of the American Geriatrics Society,
51, 306-313.
Bell, A. J., Talbot-Stern, J. K., & Hennessy, A.(2000). Characteristics and outcomes of older patients presenting to the presenting to theemergency department after a fall: a retrospective analysis. Medical Journal of Australia, 173(4), 176-177.
Blaser, B. W.(1999). Patient teaching for older adults and families in long-term care setting. Journal for Nurses in Staff Development, 15(2), 75-77.
Bandura, A. (1977). Self-efficacy: toward a unifying theory of behavioral change. Psychological Review, 84, 191-215.
Center for Disease control and Prevention.(2008a). Self-reported falls and fall-related injuries among persons aged >65 years --- United States, 2006. Retrieved November 22, 2008, from Center for Disease control and Prevention Web site: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5709a1.htm.
Center for Disease control and Prevention.(2008b). Falls Among Older Adults: An Overview. Retrieved November 22, 2008, from Center for Disease control and Prevention Web site: http://www.cdc.gov/ncipc/factsheets/adultfalls.htm
Cameron, I. D. & Kurrle, S.(2007). Preventing falls in elderly people living in hospitals and care homes. British Medical Journal, 334(7584), 53-54.
Cameron, I. D., Stafford, B., Cumming, R. G., Birks, C., Kurrle, S. E., Lockwood, K., et al.(2000). Hip protectors improve falls self-efficacy. Age and Ageing, 29, 57-62.
Close, J., Ellis, M., Hooper, R., Glucksman, E., Jackson, S., & Swift, C.(1999). Prevention of falls in the elderly trial(PROFET): a randomized controlled trial. The Lancet, 353, 93-97.
Cunningham, M. A., & Baker, D.(1986). How to teach patients better and faster. Rehabilitation Nursing, 49(9), 51-52.
Davison, J., Bond, J., Dawson ,P., Steen, I., N., & Kenny, R.,(2005). Patients with recurrent falls attending accident & emergency benefit from multifactorial intervenetion—a randomized controlled trial. Age and Ageing, 34(2), 162-168.
Deery, H. A., Day, L. M., Fildes, B. N.(2000). An impact evaluation of a falls prevention program namong older people. Accident Analysis and Prevention, 32, 427-433.
Donald, I. P. & Bulpitt, C. J.(1999). The Prognosis of falls in elderly people living at home. Age and Ageing, 28, 121-125.
Gardner, M. M., Robertson, M. C., McGee,R., & Campbell, A. J.(2002). Application of a falls prevention program for older people to primary health care practice. Preventive Medicine, 34, 546-553.
Gaskey, N. J.(1987). Evaluation of the effect of a pre-operative anesthesia videotape. Journal of the American Association of Nurse Anesthetists, 55(4), 341-345.
Hosseini, H., & Hosseini, N.(2008). Epidemology and prevention of fall injuries among the elderly. Heldref Publications, 86(3), 15-20.
Haines, T. P., Hill, K. D., Bennell, K. L., & Osborne. R. H.(2007). Additional exercise for older subacute hospital inpatients to prevent falls: benefits and barriers to implementation and evaluation. Clinical Rehabilitation, 21, 742-753.
Halil, M., Ulger, Z., Cankurtaran, M., Shorbagi, A., Yavuz, B. B., Dede, D., et al.(2006). Falls and the elderly: Is there any difference in the developing world? A cross-sectional study from Turkey. Archives of Gerontology and Geriatrics, 43, 351-359.
Joint Commission on Accreditation of healthcare Organization(2008). 2008 National Patient Safety Goals. Retrieved December 11, 2008, from Joint Commission on Accreditation of healthcare Organization Web site: http://www.jointcommission.org/GeneralPublic/NPSG/08_npsgs.htm
Janz, N. K., Champion, V. L., & Strecher, V. J.(2002). The health belief model. In K. Glanz, B. K. Rimer, F. M. Lewis(Eds.), Health behavior and health education: Theory, research, and practice(3nd ed., pp. 45- 66). San Francisco: Jossey-Bass.
Kemption, A., Beurden, E. V., Sladden, T., Garner, E., & Beard, J.(2000). Older people can stay on their feet: final results of a community-based falls prevention programme. Health Promotion International, 15(1), 27-33.
Lightbody, E., Watkins, C., Leathley, M., Sharma, A., & Lye, M.(2002). Evaluation of a nurse-led falls prevention programe versus usual care: a randomized controlled trial. Age and Ageing, 31, 203-210.
Mott, V. W.(2008). Rural education for older adults. New directions for adult and continuing education, 117, 47-57.
Mclnnes, E. & Askie, L.(2004). Considering older people’s view is important in gaining and maintaining participateon in falls prevention. World Views on Evidence-Based Nursing, 1, 20-37.
Miller, A.(1985). When is the time ripe for teaching? American Journal of Nursing, 85(7), 801-804.
Ness, K. K., Gurney, J. G., & Ice, G. H.(2003). Screening, education , and associated behaveioral responses to reduce risk for falls among people over age 65 years attending a community health fair. Physical Therapy, 83 (7), 631-637.
Oliver, D., Britton, M., Seed, P., Martin, F. C., & Hopper, A. H.(1997). Development and evaluation of evidence based risk assessment tool (STRATIFY) to predict which elderly inpatients will fall: case-control and cohort studies. British Medical Journal,315(7115), 1049-1053.
Price, C., Suddes, M., Maguire, L., Harrison, S., & O’Shea, D.(1998). Single assessment of risk predicted which elderly patients would fall. British Medical Journal, 316(7146), 1750.
Renteln-Kruse, W., Krause, T., & Geogr, D.(2007). Incidence of in-hospital falls in geriatric patients before and after the introduction of an interdisciplinary team-based fall-prevention intervenetion. The American Geriatrics Society, 55(12), 2068-2074.
Robertson, M. C., Campbell, J., Gardner, M. M., & Devlin, N.(2002). Preventing injuries in older people by preventing falls: a mata-analysis of individual-level data. The American Geriatrics Society,50(5), 905-911.
Rosenstock, I. M., Strecher, V. J., & Becker, M. H.(1988). Social learning theory and health belief model. Health Education Quarterly, 15(2), 467-475.
Sleet, D. A., Moffett, D. B., Stevens, J.(2008). CDC’s research portfolio in older adult fallprevention: A review of progress, 1985-2005, and future research directions. Journal of Safety Research, 39, 259-267.
Stevens, J. A., Corso, P. S., Finkelstein, E. A., Miller, T. R.(2006). The costs of fatal and non-fatal falls among older adults. Injury Prevetion, 12, 290-295.
Stel, V. S., Smit, J. H., Pluijm, S. M. F., & Lips, P.(2004). Consequences of falling in older men and women and risk factor for health service use and functional decline. Age and Ageing, 33(1), 58-65.
Sterling, D. A., O’Connor, J. A., & Bonadies, J.(2001). Geriatric falls: injury severity is high and disproportionate to mechanism. Journal of Trauma-Injury, Infection and Critical Care, 50(1), 116-119.
Sullivan, R. P. & Badors, K. K.(1999). Recognize risk factors to prevent patients falls. Nursing Management, 30 (5), 37-40.
Tzeng, H., & Yin, C.(2008). Nurses’ solutions to prevent inpatient rooms. Nursing Economic, 26(3), 179-187.
Tsai, Y.-J., & Wilkinson, P.(2005). Health care burden of fall-inducing hip fracture projected in the elderly in Taiwan, 2000-2020. 2005 Annual Conference of Taiwan Population Association. Taipei, Taiwan: International Convention Center, National Chen Chi University.
Vassallo, M., Vignaraja, R., Sharma, J., Hallam, H., Binns, K., Briggs, R. et al.(2004). The effect of changing practice on fall prevention in a rehabilitative hospital: The hospital injury prevention study. Clinical Interventions, 52, 335-339.
Veldhuizen, K., Voorham, T., & Hertog, P.(2001). Preventing falls in the elderly living in a deprived area: Evaluation of a community intervention. Injury Contral and Safety Promotion, 8(3), 195-197.
Vellas, B. J., Wayne, S. J., Romero, L. J., Baumgartner,R. N., & Garry, P. J.(1997). Fear of falling and restriction of mobility in elderly fallers. Age and Ageing. 26, 189-193.
Williams, T., King, G., Hill, A., Rajagopal, M., Barnes, T., Anita, B. et
al.(2007). Evaluation of a falls prevention program in an acute tertiary care hospital. Journal of Clinical Nursing, 16, 316-324.
Wagner, E., LaCroix, A., Grothaus, L., Leveille, S., Hecht, J., Artz, K. et al.(1994). Preventing disability and falls in older abults: Apopulation-based randomized trial. American Journal of Public Health, 84(11), 1800-1806.