単科精神病院の転倒・転落に関する事故報告書の分析

Analysis of reports concerning falling accidents in a psychiatric hospital

要旨：当精神病院における転倒・転落の要因を検討する目的で，1年間の事故報告書を基に転倒群と非転倒群を比較検討した．転倒の有無を従属変数とし，在院期間，Body Mass Index（BMI），CP換算値，Barthel Index（BI）スコアを独立変数として多重ロジスティック回帰分析を行った．さらに報告書より，事故発生状況を環境の観点からまとめた．その結果，転倒群は非転倒群に比べ，年齢，在院期間，CP換算値が有意に高く，BMI，BIは有意に低かった．多重ロジスティック回帰分析では有意な変数に，在院期間，BMI，BIの下位項目（階段昇降）があげられた．環境の観点からは，初動動作が転倒・転落につながっていることなどが明らかとなった．

　The purpose of this study was to pursue compound factors for the prevention of falling based on accident reports. In this study, falling rates were determined in 464 in-patients during one year. A total of 113 falls occurred among 58 patients. Attributes were compared between a falling accident group and a non-falling accident group. Using a logistic regression model, five variables were analyzed: age, body mass index, dose of antipsychotic medicine, length of hospital stay, and going up and down stairs. Next, the contents of the 113 reports were analyzed by the Model of Human Occupation theory (MOHO). From multiple logistic regression analysis, the length of hospital stays, low BMI, and difficulty of going up and down stairs were extracted. Other causes of the falling accidents became clear by the MOHO analysis such as “Operation of the initial motion acquired by the custom”, and “falling accidents caused by objects when walking”. These results can be useful to prevent falling accidents in hospitals in the future.