BackgroundThe Japanese Orthopaedic Association Hip Score is widely used in Japan, but this tool is designed to reflect the viewpoint of health-care providers rather than that of patients. In gauging the effect of medical therapies in addition to clinical results, it is necessary to assess quality of life (QOL) from the viewpoint of patients. However, there is no tool evaluating QOL for Japanese patients with hip-joint disease.MethodsWith the aim of more accurately classifying QOL for Japanese patients with hip-joint disease, we prepared a questionnaire with 58 items for the survey derived from 464 opinions obtained from approximately 100 Japanese patients with hip-joint disease and previously devised evaluation criteria. In the survey, we collected information on 501 cases, and 402 were subjected to factor analysis. From this, we formulated three categories—movement, mental, and pain—each comprising 7 items, for a total of 21 items to be used as evaluation criteria for hip-joint function.ResultsThe Cronbach’s α coefficients for the three categories were 0.93, 0.93, and 0.95, respectively, indicating the high reliability of the evaluation criteria. The 21 items included some related to the Asian lifestyle, such as use of a Japanese-style toilet and rising from the floor, which are not included in other evaluation tools.ConclusionsThis self-administered questionnaire may become a useful tool in the evaluation of not only Japanese patients, but also of members of other ethnic groups who engage in deep flexion of the hip joint during daily activities.

The purpose of the present study was to identify risk factors for falls among institutionalized elderly, using the standardized risk assessment tool developed by Izumi. We examined 746 patients from three types of facilities: rehabilitation wards in four general hospitals, three long-term care facilities, and three nursing homes, for up to three months. The incidence of falls within all facilities was 12.5%. Patterns of relative risks of falling differed among types of facilities. The highest relative risk of fall in long-term care facilities and nursing homes was nurses' prediction, followed by history of fall and altered mentation. In contrast, that in general hospitals was mobility. In long-term care facilities, history of falls (odds 3.68, 95CI: 1.47-9.23) and interaction (history of falls and assistance with toileting) (odds 3.13, 95CI: 1.48-6.64) showed significance on adjusted-odds ratios for fall. History of falls, altered mentation, and assistance with toileting may be used to screen patients at a high risk for fall at admission.

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The purpose of this study was to develop a fall prevention program adapted to the individual risks of elderly patients in a long-term care facility by increasing the caregiving skills and motivation of the staff members. The fall prevention program was created by synthesizing information based on evidence-based practice and action research methodology was chosen to complete the development of the program. There were 31 participating patients in the intervention ward and 20 patients in the control ward. The Generalized Self-efficacy Scale and the Social Support Scale were used to evaluate fall prevention skills the motivation of the staff members. The fall prevention program helped to reduce injuries from 41.9% to 9.7% among the elderly participants and to increase emotional support and self-efficacy among the staff members. Empowerment was considered to be a driving force. The fall prevention program was shown to be acceptable for use among elderly individuals in a long-term care facility.

Aim:The purpose of this study was to develop an exercise program for elderly individuals in a long-term care facility. Developed through the synthesis of evidence-based nursing with the use of available research related to falls and exercise, the program was designed to increase balance, mobility, and muscle strength in the lower extremities in order to prevent falls and improve the self-efficacy of the patients. Methods: We developed an exercise program consisting of a warm-up, static stretching, muscle strengthening in the lower extremities, toe exercises, proprioceptive neuromuscular facilitation, and cooldown. The study design was a prospective clinical trial. The intervention period was 3 months, with the outcomes measured before and after intervention and 3 months after cessation of the intervention. The 30 participants were elderly residents of a long-term care facility, 16 of whom were in the intervention group and 14 of whom were in the control group. The outcome values were mobility, muscle strength in the lower extremities, postural sway, fall efficacy, and the number of fallers and falls. The Friedman test was used to analyze the effectiveness of the outcomes. Results: The intervention group showed increased balance, maintained mobility, and showed a decreased number of fallers and falls, although the muscle strength and fall efficacy did not increase. No trainingrelated medical problems occurred. Conclusion: The exercise program was shown to be acceptable to use for the prevention of falls among elderly individuals in a long-term care facility. METHODS Study designThe study design was a 3 month, quasi-experimental clinical trial with an intervention ward and a control ward. Subjects and settingThe subjects were recruited from two long-term care wards in a long-term care facility, 50 beds in each, located in the middle-western region of Japan. The