@article{oai:dwcla.repo.nii.ac.jp:00002081,
 author = {小笠, 美春 and Ogasa, Miharu and 當目, 雅代 and Toume, Masayo and 天野, 功士 and Amano, Koji and 森島, 千都子 and Morishima, Chizuko},
 journal = {同志社看護, Doshisha kango},
 month = {Mar},
 note = {application/pdf, AA12746582-20210414-15, Purpose：The prior literature relating to falls in the field of orthopedic surgery was analyzed from the perspective of the internal factors and the external environmental factors influencing
patients who suffer falls, in order to identify risk factors for falls in orthopedic surgery patients as a preliminary step toward the development of fall risk prevention training materials for nursing students.
Methods：The web version of Igaku Chuo Zasshi (a medical database) was used to search for original articles in the field of nursing using the key words “fall” and “orthopedic” connected
by the logical operator “and.” A total of 41 articles that mention risk factors for falls in orthopedic patients were included in the analysis. From the articles that were analyzed, data that were extracted relating to the time of occurrence of the fall, the patient’s behavior leading up to the fall, internal factors, and external environmental factors were coded and the numbers of the respective data were calculated.
Results：Most of the falls among orthopedic patients occurred “less than a week after surgery,” “after starting to leave the bed,” and “after changing mobility aids,” and most of the falls occurred “during the day.” The most common behaviors of patients leading to falls were “using the toilet” and “movement/transfer.” Internal factors specific to orthopedic patients that were extracted included “muscle weakness/decreased physical strength,” “gait disturbance,” “pain,” “use of mobility aids,” “impaired balance,” “limited range of motion due to immobilizing brace,” “overconfidence,” “lack of awareness of danger or of the condition,” “assumptions,” and “a spirit of self-reliance/ambition.” External factors specific to orthopedic patients included “the space surrounding the bed,” “the location of the call button,” “the location of items used by the patient,” “the arrangement of mobility aids,” “the arrangement of footwear,” and “the location of the toilet paper.”
Discussion：The development of training materials that address toilet behavior together with cultivation of better understanding of patients on the basis of first-hand exposure to patients’
experiences through the use of braces and mobility aids specific to orthopedic patients, load restriction, etc. are effective in increasing the sensitivity of nursing students to the risk of
falling.

目　的：看護学生の転倒・転落に対する危険予知トレーニング教材を開発する前段階として，整形外科領域の転倒・転落に関する先行文献から，転倒・転落を患者の「内的要因」と環境の「外的
要因」の視点から分析し，整形外科患者の転倒・転落のリスク要因の特徴を明らかにすることである。
方　法：医学中央雑誌Web 版を使用して，キーワードは「転倒・転落」「整形外科」を論理演算子and でつなぎ，看護領域の原著論文を検索した。そのうち，整形外科患者の転倒・転落のリスク
要因に言及している文献41 件を分析対象とした。分析対象文献について，転倒・転落の発生時期，転倒・転落につながった患者の行動，内的要因，外的要因のそれぞれにおいて抽出されたデータをコード化し，そのデータ数を算出した。
結　果：整形外科患者の転倒・転落は，「術後1 週間未満」や「離床開始後」，「移動補助具の変更後」に多く，1 日の中では「日中」に多く発生していた。転倒・転落につながった患者の行動としては「排泄」や「移動・移乗」が多かった。整形外科患者に特有な内的要因として，「筋力低下・体力低下」，「歩行障害」，「疼痛」，「移動補助具の使用」，「バランス機能の低下」，「固定装具による可動域制限」，「過信」「危険や状態の認識不足」，「思い込み」，「自立心・意欲」等が抽出された。また，整形外科患者に特有な外的要因として，「ベッド周囲のスペース」や「ナースコールの位置」，「使用物品の位置」，「移動補助具の配置」，「履物の配置」，「トイレットペーパーの位置」等が抽出された。
考　察：看護学生の転倒・転落の危険予知の感受性を高めるためには，排泄行動を取り上げたトレーニング教材を開発するとともに，整形外科患者に特有な固定装具装着や移動補助具の使用，荷重制限などの患者体験によって，自らの体験をもとに対象理解を深めることが効果的である。, 報告},
 pages = {15--26},
 title = {整形外科病棟入院患者の転倒・転落のリスク要因に関する文献検討},
 volume = {6},
 year = {2021},
 yomi = {オガサ, ミハル and トウメ, マサヨ and アマノ, コウジ and モリシマ, チズコ}
}