| Objectives The aim of this study is examine the reliability,effectiveness and the best divided value of the self-awareness of falls in elderly scale(SAFE).Analysis the staus of the self-awareness of falls among older adults in pension insititution,explore the influencing factors of the self-awareness of falls in elderly among nursing homes,and analyze the path of action among the various factors.Provide a theoretical basis for the nursing staff in nursing homes use effective intervention measures to improve the self-awareness of falls in elderly.Methods Firstly,communicated with the author of the scale to get the complete scale and the permission to test the scale’s reliability and validity and apply it in the elderly.Then,converted the traditional Chinese into simplified Chinese.Part 1:from July 2020 to October2020,324 elderly in 7 nursing homes in Hebei province were selected by convenient sampling method.The reliability and validity of the SAFE in pesion institutions are evaluate by the General information questionnaire and the self-awareness of falls in elderly scale.Part2:from December 2020 to April 2021,440 senior citizens come from 6pesion institusions in Hebei province and 2 pesion institutions in Tianjin city were selected by convenient sampling method.The basis information scale,characteristic questionnaire of nursing institutions,the self-management abilities for fall prevention in elderly questionnaire,SAFE and other scales were applied to explore the level and relevant infulence factors of the SAFE in olderly adults in nursing institutions.After the questionnaire collection,applied Excel2013 software to establish the database,then SPSS 23.0 and AMOS 23.0 were applied to data analysis.The mean±standard deviation used to describe the measurement data;the count data was described in the form of frequency and composition ratio(%).The scale validity was assessed by structure validity,aggregation validity and discriminant validity.Cronbach’sαcoefficient and retest reliability were used to estimate the reliability.Univariate analysis used t test or F test,multivariate linear stepwise regression analysis was used for multivariate analysis,and Pearson correlation analysis was applied to analysis the correlation between factors.Path analysis model was built to test the direct or indirect effects of each factor on the self-awareness of falls.Results 1 Reliability and effectiveness test of SFAE In the exploratory factor analysis,the KMO was 0.869,the result of bartlett’s test was 3015.579(P<0.001),and there were 4factors with characteristic root>1 extracted after orthogonal rotation of the maximum variance method,which explained 59.296%of the total variation.The confirmatory factor analysis results showed thatχ~2/df=1.919,RMSEA=0.068<0.080,IFI=0.949,TLI=0.941,CFI=0.948,PNFI=0.783,PGFI=0.681.Based on the calculation of the path coefficient,the AVE of all factors in the scale were higher than 0.5,the CR were greater than 0.7,and the correlation coefficients between the factors were lower than the square root of the Average Variance Extract value of the homologous factor.The Cronbach’sαcoefficient of the self-awareness of falls in elderly scale was 0.892,the test-retest reliability was 0.862.The optimal cut-off point was 58.00.2 the current state of the self-awareness of falls and its influencing factors in elderly among nursing homes 1)Status of the self-awareness of falls in elderly in nursing institutions The average score of the self-awareness of falls in elderly in nursing homes was(62.10±9.63),the lowest score was 38,the highest score was 92 points,the item average score for the awareness of activity safety and environment was the highest(3.66±0.55),the average item score of the awareness of physical functions was lowest(2.46±0.58)points.2)Single-factor analysis The results have shown that age,gait,body fatigue,anxiety,care and support,household register,marital status,educational backdrop,job,individual monthly income,living conditions,the frequency of participate in collective activity,whether the room is equipped with calling device,the frequency of family visits,amount of children,use of walking aids,the kinds of chronic diseases,and activities ability in daily life,physical examination,integrated medical care and elderly care institutions falls situations,fall risks,the fear of falls and the self-management behavior had statistical significance in the score of the self-awareness of falls in elderly in nursing institutions(P<0.05).3)Multi-factor analysis Multiple linear regression results have shown that fall situation,self-management behavior,fear of falling,physical fatigue,teaching profession,feeling care and support,physical examination,use of walking aids,fall risk,personal monthly income and family visit had significant effects on the SAFE in nursing institutions,with statistical significance(P<0.05).4)Path analysis of influencing factors The results have shown that physical fatigue and family visits only have impact on the self-awareness of falls in elderly in nursing homes through the direct route.Walking aid use and profession only bring effect on the self-awareness of falls in elderly through indirect paths.Personal monthly income,physical examination,care and support,fall situation and fall risk can influence the self-awareness of falls in elderly through both direct and indirect paths.Fear of falling and self-management behavior were not only mediating variables,but also have a direct effect on the self-awareness of falls in elderly in nursing institutions.Conclusions 1 The self-awareness of falls in elderly scale has good reliability and validity among the elderly in nursing institutions,and can be used to measure the degree of cognition of the elderly in nursing institutions about the risk of falling.2 The self-awareness of falls in elderly in nursing institutions were at the higher level.3 Older adults with falling history,better self-management behavior,fear of falling,physical fatigue,have falling risk,teacher,feeling more care and support,frenquent physical examinations,higher personal monthly income,using walking aids and frequent family visits often have higher self-awareness of falls.4 Self-management behavior and fear of falling can not only directly affect the self-awareness of falls of the elderly,but also act as mediating variables to influence the self-awareness of falls of the elderly.According to the inividual situation of the old population,the nursing staff need to apply targeted intervention,change the aim and methods based on abid by the fall prevention strategy,to improve the elderly’s self-awareness of falls and reduce the incidence of fall,given a decline to the medical burden of personnal and social.Figure 5;Table 23;Reference 155... |
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