İnmeli hastalarda düşme riskinin değerlendirilmesi: üç düşme risk değerlendirme aracının karşılaştırılması
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Dosyalar
Tarih
2019
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Namık Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu araştırma yaygın olarak kullanılan İtaki, Morse ve Hendrich II Düşme Riski Değerlendirme Ölçeklerinden hangisinin hastanede yatan, inme hastalarında düşme riskinin belirlenmesinde en iyi tahmin gücüne sahip olduğunun belirlenmesi amacıyla tanımlayıcı olarak gerçekleştirildi. Araştırma verileri Temmuz 2018-Aralık 2018 tarihleri arasında elde edildi. Çalışma bir devlet hastanesinin nöroloji servisinde tedavi gören 125 inme hastası ile gerçekleştirildi. Araştırmada literatür taraması ile araştırmacı tarafından oluşturulan Hasta Tanılama Formu ile Glaskow Koma Skalası, İtaki Düşme Riski Ölçeği, Hendrich II Düşme Riski Ölçeği, Morse Düşme Ölçeği kullanıldı. Hastaların fonksiyonel durumu Fonksiyonel Bağımsızlık Ölçeği ile değerlendirildi. Hastalarda meydana gelen düşme olayları Düşme Bildirim Formu ile kayıt altına alındı. Düşme riski değerlendirmesi ve düşme olayları için hastalar yatış süresince günlük olarak izlendi. Düşme riski ölçeklerinin değerlendirilmesinde duyarlılık-özgüllük analizleri ve ROC eğrisi kullanıldı. Çalışmaya katılan 125 inme hastasının yaş ortalaması 71,47±11,16 olarak saptandı. Hastanede yatış süreleri ortalama 8,66±1,80 gün olan hastaların %9,6’sında (n=12) hastanede düşme tespit edildi. Düşen 12 hastanın 11’inde 1 defa, 1 hastada ise tekrarlı düşme kaydedildi. Hastanede meydana gelen düşmeler en fazla hasta odasında (%61,5) gerçekleşti. Düşen hastaların çoğu kadındı (%58,3). Çalışmada kullanılan düşme risk değerlendirme araçlarından İtaki Düşme Riski Değerlendirme Ölçeği için duyarlılık 75,0, özgüllük 63,7, Hendrich II Düşme Riski Değerlendirme Ölçeği için duyarlılık 83,3, özgüllük 50,4, Morse Düşme Ölçeği için duyarlılık 91,7, özgüllük 73,5 olarak hesaplandı. ROC analizi değerlendirme sonuçlarına göre ölçeklerin cut off değerleri; İtaki Düşme Riski Değerlendirme Ölçeği için 14, Hendrich II Düşme Riski Değerlendirme Ölçeği için 4,5, Morse Düşme Ölçeği için 66,2 olarak saptandı. Sonuç olarak; Morse Düşme Ölçeğinin duyarlılık ve sözgüllüğünün diğer ölçeklere göre daha yüksek olması nedeni ile hastanede yatan inme hastalarında kullanımı önerilmektedir.
This descriptive study was conducted with the aim of determining which one among the İtaki, Morse, and Hendrich II Risk of Falling Evaluation Scales had the best power of prediction in the determination of the risk of falling for stroke inpatients. Study data was obtained between July and December 2018. The study was conducted with 125 stroke patients being treated in the neurology service of a public hospital. For data collection, a Patient Identification Form prepared by the researcher through a literature scan, the Glasgow Coma Scale, the İtaki Risk of Falling Scale, the Hendrich II Risk of Falling Scale, and the Morse Falling Scale were used. The functionality statuses of the patients were evaluated using the Functional Independence Scale. The events of falling occurring in the patients were recorded using a Falling Report Form. For risk of falling evaluation and events of falling, the patients were monitored daily throughout their hospital stays. In the evaluation of the risk of falling scales, sensitivity – selectivity analyses and the ROC curve were used. The mean age of the 125 stroke patients included in the study was calculated to be 71.47±11.16. The mean duration of hospital stay was 8.66±1.80 among the patients, and falling in the hospital was detected in 9.6% (n=12). While 11 of the 12 patients who experienced events of falling fell once, repeated falling was recorded for 1 patient. Most of the events of falling in the hospital occurred in the patient rooms (61.5%). Most of the patients who fell were female (58.3%). The İtaki Risk of Falling Evaluation Scale had a calculated sensitivity of 75.0 and a specificity of 63.7 while the Hendrich II Risk of Falling Evaluation Scale had a sensitivity of 83.3 and a specificity of 50.4 and the Morse Falling Evaluation Scale had a sensitivity of 91.7 and a specificity of 73.5. According to the evaluation results of the ROC analysis, the cut off values of the scales were 14 for the İtaki Risk of Falling Evaluation Scale, 4.5 for the Hendrich II Risk of Falling Evaluation Scale, and 66.2 for the Morse Falling Evaluation Scale. As a result, the Morse Falling Scale was suggested for use in stroke in patients because of its higher sensitivity and selectivity compared to the other scales.
This descriptive study was conducted with the aim of determining which one among the İtaki, Morse, and Hendrich II Risk of Falling Evaluation Scales had the best power of prediction in the determination of the risk of falling for stroke inpatients. Study data was obtained between July and December 2018. The study was conducted with 125 stroke patients being treated in the neurology service of a public hospital. For data collection, a Patient Identification Form prepared by the researcher through a literature scan, the Glasgow Coma Scale, the İtaki Risk of Falling Scale, the Hendrich II Risk of Falling Scale, and the Morse Falling Scale were used. The functionality statuses of the patients were evaluated using the Functional Independence Scale. The events of falling occurring in the patients were recorded using a Falling Report Form. For risk of falling evaluation and events of falling, the patients were monitored daily throughout their hospital stays. In the evaluation of the risk of falling scales, sensitivity – selectivity analyses and the ROC curve were used. The mean age of the 125 stroke patients included in the study was calculated to be 71.47±11.16. The mean duration of hospital stay was 8.66±1.80 among the patients, and falling in the hospital was detected in 9.6% (n=12). While 11 of the 12 patients who experienced events of falling fell once, repeated falling was recorded for 1 patient. Most of the events of falling in the hospital occurred in the patient rooms (61.5%). Most of the patients who fell were female (58.3%). The İtaki Risk of Falling Evaluation Scale had a calculated sensitivity of 75.0 and a specificity of 63.7 while the Hendrich II Risk of Falling Evaluation Scale had a sensitivity of 83.3 and a specificity of 50.4 and the Morse Falling Evaluation Scale had a sensitivity of 91.7 and a specificity of 73.5. According to the evaluation results of the ROC analysis, the cut off values of the scales were 14 for the İtaki Risk of Falling Evaluation Scale, 4.5 for the Hendrich II Risk of Falling Evaluation Scale, and 66.2 for the Morse Falling Evaluation Scale. As a result, the Morse Falling Scale was suggested for use in stroke in patients because of its higher sensitivity and selectivity compared to the other scales.
Açıklama
Anahtar Kelimeler
İnme, düşme riski, hemşirelik, duyarlılık, özgüllük, Stroke, risk of falling, nursing, sensitivity, specificity
