看護研究における転倒予防研究の意義と今後の課題

The Importance of Fall Prevention Research in the Nursing Field and Future Issues That Need to be Addressed

　近年，転倒による事故死亡者数は男女ともに増加の傾向にあり，高齢者の転倒は自律機能や健康寿命を低下させるなど生活を脅かす大きな要因として着目されている。医療・福祉・保健の現場において看護師は，転倒予防の実践的な側面での具体的な予防対策における重要な役割を担ってきた。また看護研究では，転倒ハイリスク者を明らかにして，予測可能な効果的戦略の開発と実施を促すことを主に，転倒リスクアセスメントツールに関する研究が中心に行なわれてきた。現在，地域の介護予防事業では，運動器の機能向上において転倒予防を目的とした運動介入が主流になっているが，看護学的なアプローチにおける実証が必要とされている。看護師には，地域で生活する比較的健康で活動的な高齢者の転倒，施設入所中あるいは在宅療養中の加齢や要介護に関連した高齢者，成人・小児も含めたすべての入院患者の安全対策としての転倒すべてにおいて，転倒予防介入実践とそのエビデンスを実証することが期待されている。そして転倒は，高齢者医療の大きな課題であるばかりでなく，医療現場においては看護の質評価指標としても重要な課題である。以上のことからも，看護師の取り組む転倒予防研究は予防的，実践的側面のニーズが大変高いのが現状であり，より具体的で効果的な予防介入方法を確立する必要がある。

　In recent years, the number of fatalities from accidents involving falls has increased among both men and women. Falls among the elderly have received a great deal of attention given their significant role in threatening patients’ lifestyles by reducing their ability to function autonomously and lowering their healthy life expectancy. Nurses in the fields of medicine, welfare, and health have played an important role in the development of specific prevention policies related to the practical aspects of fall prevention. Since nursing research has focused on identifying high-fall-risk patients and promoting the development and implementation of predictable and effective strategies to prevent falls, it has primarily focused on fall risk assessment tools. Exercise intervention aimed at preventing falls has become a common means of improving the functions of exercise equipment in community long-term care prevention programs, but empirical evidence is needed on the approaches espoused by nursing science. Falls not only pose a major health problem for seniors, but also play an important role in actual medical practice as an evaluative index of nursing quality. Nurses are expecting fall prevention intervention practices and anticipate that evidence of those practices will serve as safety policies for all admitted patients, including adults, children and the elderly who are relatively healthy and active in their communities, in addition to the elderly who are institutionalized in geriatric hospitals and care facilities. This suggests that the fall prevention research being conducted by nurses needs to explain that the preventive and practical aspects of the patients’ needs are extremely high, as well as to establish more specific and effective methods of prevention and intervention. Research being conducted by nurses needs to explain that the preventive and practical aspects of the patients’ needs are extremely high, as well as to establish more specific and effective methods of prevention and intervention.