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| 老年类风湿关节炎患者跌倒风险主观感知与临床评估一致性影响因素分析 |
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| 投稿时间：2026-04-17 修订日期：2026-06-26 |
| DOI： |
| 中文关键词: 类风湿关节炎 老年人 跌倒风险 风险评估：影响因素 |
| 英文关键词:Rheumatoid arthritis Aged Fall risk Subjective perception Clinical assessment Influencing factors |
| 基金项目: |
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| 中文摘要: |
| 【摘要】 目的：探讨老年类风湿关节炎（RA）患者跌倒风险主观感知与临床评估的一致性，并分析一致性的影响因素。方法：本研究采用横断面研究方法，于2025年9月至2026年1月期间，采用便利抽样方法，选取贵州中医药大学第二附属医院风湿免疫科234例老年RA住院患者为研究对象。分别运用FRQ量表和Morse跌倒风险评估量表分别进行主观感知与临床评估。采用Kappa一致性检验评估两者的一致性，采用Logistic回归分析一致性的影响因素。结果：234例患者中，主观感知与临床评估一致者137例（58.5%），不一致者97例（41.5%），其中主观评估低于临床评估76例（78.4%），高于临床评估21例（21.6%）。Kappa值为0.155（P=0.017）。多因素Logistic回归分析显示，多因素分析显示，关节畸形（OR=2.547, 95%CI 1.119～5.797）和使用轮椅（OR=6.025, 95%CI 1.440～25.209）是评估一致性的独立危险因素；中等收入、合并1～3种合并症及中低疾病活动度则为保护因素（均P<0.05）。结论：老年RA患者跌倒风险主观感知与临床评估一致性偏低，以主观评估低于临床评估为主。临床工作者应在早期对老年RA患者开展跌倒风险评估，将主观感知与临床评估对照分析，针对性地制定个体化干预措施。 |
| 英文摘要: |
| 【Abstract】Objective: To explore the consistency between subjective fall risk perception and clinical assessment in elderly patients with rheumatoid arthritis (RA), and to analyze the influencing factors of assessment bias.Method: A cross-sectional study was conducted from September 2025 to January 2026. A total of 234 elderly RA inpatients were selected by convenience sampling from the Department of Rheumatology and Immunology, the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine. The Fall Risk Questionnaire (FRQ) and Morse Fall Risk Assessment Scale were used to conduct subjective perception and clinical assessment, respectively. Kappa consistency test and Logistic regression analysis were performed.Results: Results Among 234 patients, 137 (58.5%) showed consistency between subjective perception and clinical assessment, while 97 (41.5%) showed inconsistency, including 76 (78.4%) with subjective assessment lower than clinical assessment and 21 (21.6%) higher. The Kappa value was 0.155 (P=0.017). Multivariate Logistic regression analysis showed that joint deformity (OR=2.547, 95%CI: 1.119-5.797) and use of wheelchair (OR=6.025, 95%CI: 1.440-25.209) were independent risk factors for the consistency; moderate income, 1-3 comorbidities, and moderate-to-low disease activity were protective factors (all P<0.05).Conclusion: The consistency between subjective fall risk perception and clinical assessment in elderly RA patients is low, predominantly characterized by subjective assessment lower than clinical assessment. Clinical workers should conduct early fall risk assessments, compare subjective perception with clinical assessment results, and formulate targeted individualized interventions accordingly. |
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