地域高齢者における転倒に関する経験が転倒脅威に与える影響

The Effects of Fall-Related Experience on Fall Threat among the Community-Dwelling Elderly

要旨

　目的：地域高齢者における転倒に関する経験が転倒恐怖感の媒介変数である転倒脅威に及ぼす影響を明らかにすることを目的とした．

　方法：地域在住高齢者289名を対象に転倒に関する経験および筆者らが作成した転倒脅威項目24項目に関して質問紙調査を実施した．t検定および一元配置分散分析，重回帰分析にて経験が転倒脅威5因子に及ぼす関係性と影響力，本研究の概念モデルの予測力を検討した．

　結果：転倒自体よりも外傷経験が「身体的苦痛」因子に影響を及ぼし，つまずき経験は「自己の自立性の喪失」「重篤な末期へのきっかけ」の2因子に有意な影響が認められた．知人・家族からの情報は「身体的苦痛」「他者依存に対する心理的負担」に正の影響を及ぼし，地域の健康教室などの教育的な機会は「重篤な末期へのきっかけ」に負の影響を及ぼしていた．しかし，重回帰分析の結果，R²はいずれの因子とも0.1以下であり，転倒に関する経験だけでは転倒脅威全体を予測・説明できていなかった．

　結論：地域高齢者の転倒に関する経験は転倒脅威に特徴的な影響を及ぼすものではあるが，経験という条件のみでは転倒脅威を説明するには限界があり他の要因も含めた検討が必要であることがわかった．

Abstract

　Objectives: The present study aimed to clarify the effects of fall-related experiences in community-dwelling elderly on fall threat, which is a parameter of fear of falling.

　Methods: A questionnaire survey was conducted on 289 community-dwelling elderly regarding their fall-related experiences and 24 fall threat items developed by the authors. Relationships, effects of experiences on the five fall threat factors and the predictive capability of the conceptual model of this research were investigated using t-test, one-way analysis of variance and multiple regression analysis.

　Results: Injury experience had a greater effect than the act of falling itself on the factor of “physical pain” and stumbling experience significantly affected the two factors of “loss of independence” and “trigger for a serious terminal phase.” Information from family and acquaintances had a positive effect on “physical pain” and “psychological burden of dependence on others,” while educational opportunities such as community health classes had a negative effect on “trigger for a serious terminal phase.” However, multiple regression analysis revealed an R² of ≦0.1 for all factors and fall-related experiences alone were unable to predict and explain overall fall threat.

　Conclusion: Although fall-related experiences have a characteristic effect on fall threat, the condition of “experience” alone has a limited capacity to explain fall threat. Further investigation involving other factors is required.