[[alternative]]Explore the relationships among scenarios, mechanism, experience, home environment hazards of falls, and severity of falls in elderly fallers admitted to emergency department.

[[abstract]]本研究旨在探討急診就醫老人跌倒情境、跌倒機轉、跌倒經驗、居住環境危害及跌倒受傷程度相關性，為橫斷式相關性研究設計，以中部某區域教學醫院老人跌倒到急診就醫為對象，本研究資料來自臺北醫學大學傷害防治所之研究【老人髖部骨折之危險因子與健康剖面】，研究資料採方便取樣，以結構式問卷、電話訪問收集，第一階段先在急診室登錄收案，實際完成353位樣本，第二階段接受電話訪談之樣本數為187位。研究工具包含「人口學變項」、「老人跌倒情境」、「老人跌倒機轉」、「老人跌倒經驗」、「居住環境危害評估」。以SPSS for Windows 18.0套裝軟體，分析方法分為描述性統計、卡方檢定、獨立樣本T檢定、多元(複)線性迴歸分析。研究結果顯示：影響老人受傷程度之風險因子包括有無協助者、 鞋子種類、居家環境危害、年齡、步行輔具、跌倒方向、有無手持物品、跌倒前4小時服藥，以上因子會造成老人跌倒後嚴重的傷害。因此，透過本研究發現可提供改善居家環境危害，多宣導老人活動時使用步行輔具，平衡身體重心，降低老人內在因素如軟倒、昏/暈倒、落倒/踩空、傾倒等的意外發生，在溝通時用老人最熟悉的語言，給予病人及家屬預防跌倒之觀念，與周全的評估及防治計劃，強化病人認知自己具跌倒傾向，詳細解釋防範措施及跌倒之相關因子提出適當的防範方法。關鍵字：老人跌倒情境、老人跌倒機轉、老人跌倒經驗、老人居住環境危害、老人跌倒受傷程度[[abstract]]The purpose of this study was to investigate the relationships between fall facts, including scenarios, mechanism, experiences, environmental hazards, and injury levels, among the elderly who received emergency-room treatment for their falls. This cross-sectional study was conducted among the elderly subjects visiting a teaching hospital located in central Taiwan for emergency treatment. Data collection using convenience sampling, structured questionnaire and telephone interviews were based on “Risk Factors, Psychological Trauma, and Health Utility in Elderly People with Hip Fractures”, a project from Taipei Medical University. At the first stage, 353 subjects were enrolled at emergency room. A total of 187 subjects accepted telephone interviews at the 2nd stage. Data including demographic variables, fall circumstance, mechanism, experience and living environment hazards were analyzed. SPSS for Windows (Ver.18) was used for descriptive statistics, Chi-square test, independent student t- test, and multiple linear regression.Results showed that the risk factors affecting injury levels in the elderly included the presence or absence of a facilitator, types of shoes, living environmental hazards, age, walking aids, fall direction, with or without hand-held items, and taking medications four hours before the falls. Aforementioned factors could lead to serious injury following falls among the elderly. Thus, this study demonstrated that improvement of living environment, use of walking aids in daily activities to maintain body balance, reduce internal factors related accidents such as soft falls, faint/dizzy, fall straight down, miss of footing, and tipping fall down. Use the most familiar language to effectively communicate and to provide the ideas for preventing falls to patients and their families. Comprehensive assessments and prevention programs are necessary to enhance patients’ understanding about their tendency to fall. Detailed explanation is needed to promote awareness of appropriate strategies and approaches for preventing falls in the elderly.Keywords: Elderly fall scenarios, elderly fall mechanism, elderly fall experience, home environmental hazards, injury levels of falls in the elderl