Associated factors of falls in nursing home residents in Hong Kong and the role of restraints: a cross-sectional survey using the Resident Assessment Instrument (RAI) 2.0.

摘要

BACKGROUND AND AIMS: To identify factors associated with falls in non-bedridden nursing home residents in Hong Kong, and to examine whether restraints are protective against falls. METHODS: Cross-sectional survey of 1710 nursing home residents, examining factors associated with falls and use of restraints, as documented in the RAI questionnaire. RESULTS: Vision impairment is highly associated with falls (OR 1.75, 95% CI 1.29-2.34), whereas older age (OR 1.03, 95% CI 1.01-1.05), dementia (OR 1.46, 95% CI 1.05-2.04), and intake of psychotropics (OR 1.52, 95% CI 1.06-2.17) were moderately associated. Women were less likely to fall (OR 0.65, 95% CI 0.48-0.90). Walking with aids and taking more medications were not associated with falls in this population. Restraints were used in 68%. The use of any type of restraint was marginally associated with fewer falls (OR 0.73, 95% CI 0.53-1.00). CONCLUSIONS: Men, those with impaired vision, dementia or taking psychotropic drugs were more likely to fall. Restraints are very commonly used in Hong Kong nursing homes. Although their use was associated with fewer falls, their effect on preventing falls could not be established in this cross-sectional study.