社区老年糖尿病患者跌倒警觉度的潜在类别及其影响因素和干预策略 [中文引用][英文引用]

目的  分析社区老年糖尿病患者跌倒警觉度的潜在类别及影响因素，为制定预防跌倒的干预策略提供依据。方法  采用便利抽样法，于 2024 年 5 月—9 月选取湖南省、海南省糖尿病的 600 例社区老年人为研究对象，应用一般资料调查表、跌倒警觉度量表（self-awareness of falls scale，SAFE）、阿森斯失眠量表（Athens insomnia scale，AIS）、简版老年抑郁量表（geriatricdepression scale-15，GDS-15）和微型营养评定简表（short-form mini-nutritional assessment，MNA-SF）进行调查。对社区老年糖尿病患者的跌倒警觉度进行潜在剖面分析，应用 Logistic 回归分析不同类别特征的影响因素。结果  586 例老年人完成研究。社区老年糖尿病患者可分为 3 个类别：低警觉型（10.1%）、中警觉型（58.8%）和高警觉型（31.1%）。Logistic 回归分析结果显示，性别、年龄、文化程度、营养状况是社区老年糖尿病患者跌倒警觉度类别的影响因素（均 P<0.05）。结论  社区老年糖尿病患者跌倒警觉度整体处于中等偏上水平，可分为 3 个类型。社区护理人员应早期识别各类别特征的患者，并给予针对性干预，同时加强基础设施适老化建设，以提升社区糖尿病老年人跌倒警觉度水平。

Objective To identify the latent profiles and detect factors influencing on fall alertness among elderly diabetic patients in communities,thereby offering guidance for targeted intervention strategies. Methods Convenience sampling was conducted to recruit 600 older adults diagnosed with diabetes from Hunan and Hainan provinces between May and September 2024. A general information questionnaire,the self-awareness of falls scale（SAFE）,Athens insomnia scale（AIS）,15-item geriatric depression scale （GDS-15）,and short-form mini-nutritional assessment（MNA-SF）were employed for the questionnaire-based survey. Latent profile analysis was performed to classify fall awareness and multinomial Logistic regression was used to analyse the influencing factors. Results Toally 586 patients finished the study. Three latent classes were identified：low fall-alertness（10.1%）,moderate fall-alertness awareness（58.8%）and high fall-alertness（31.1%）. Multinomial logistic regression analysis indicated that gender,age,education and nutritional status were the factors that affect the three profiles（P<0.05）. Conclusion Overall,community-dwelling elderly with diabetes exhibit moderate-to-high fall alertness and can be segmented into three distinct types. Community nurses should identify these subgroups of the elderly early and deliver tailored interventions. Meanwhile,age-friendly environmental should be established and be in place to further improve fall-alertness among the elderly.