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Abstract

INTRODUZIONE: Le cadute in ospedale sono un rilevante problema anche in ambito pediatrico. Al momento non esistono scale per la valutazione del rischio di cadute pediatriche (PFRAS) validate in italiano. Obiettivi: effettuare la validazione in italiano della scala Humpty-Dumpty Falls Scale (HDFS); valutare la sua performance predittiva; stimare la frequenza delle cadute nei bambini ospedalizzati e analizzare le associazioni tra le variabili cliniche dei bambini e l'evento caduta.


METODI: La prima fase è consistita nella validazione linguistico-culturale italiana della HDFS. La seconda, nella valutazione della performance della HDFS italiana su 1500 bambini ospedalizzati. La terza, nella modifica della HDFS italiana per migliorarne la performance. La quarta fase è consistita nell’analisi della frequenza delle cadute e delle possibili associazioni tra queste ed alcune variabili cliniche dei pazienti.


RISULTATI: La versione italiana della HDFS (HDFS-ita) ha validità (SCVI=0.92) e affidabilità inter-valutatori (Cohen’s kappa=0.965) soddisfacenti ma ha mostrato scarse sensibilità (77.8%) e specificità (36.6%). È stata quindi approntata una versione modificata (HDFS-ita-M) con tre soli items e cut-off 7, solo per soggetti da 1 a 15 anni. Sebbene migliore della HDFS-ita, la performance della HDFS-ita-M rimane però non ottimale (Sensibilità=77.8%, Specificità=53.3%, ROC-AOC=0.670). La frequenza di cadute di bambini ospedalizzati è stata 6.38 per mille bambini (CI95% 3.36–12.08) con picco tra i bambini da 3 a 6 anni (11.28 per mille bambini, CI95% 3.84–32.63). I disturbi motori o della deambulazione (p=0.005), l’enuresi (p=0.0002), l’essere in stanza singola (p=0.04), l’essere ricoverato in reparti di neuropsichiatria o neurologia pediatrica (p=0.001), e una diagnosi di patologia neuropsichiatrica (p=0.02) sono associati alle cadute in modo statisticamente significativo.


DISCUSSIONE: La HDFS-ita-M mostra una performance migliore della HDFS-ita ma ancora poco soddisfacente. Ulteriori studi sono necessari per determinare un set affidabile di variabili utili a predire il rischio di cadute dei bambini in ospedale. Questo studio fornisce dati sulla frequenza e sui possibili fattori di rischio delle cadute di bambini in ospedale che potranno essere utili agli ospedali pediatrici nella pianificazione delle misure di sicurezza dei pazienti


PAROLE CHIAVE: Cadute accidentali, bambini, scale di valutazione del rischio, ospedali pediatrici, gestione del rischio.

Parole chiave

cadute accidentali bambini scale di valutazione rischio gestione rischio Accidental falls pediatric hospitals risk assessment scales risk management

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Ciofi, D., Albolino, S., Dagliana, G., Biermann, K., Savelli, A., Frangioni, G., Fantoni, M., Gheri, C., Neri, S., Festini, F., & Collaborative study group, T. P. F. (2021). Studio osservazionale multicentrico sulle cadute dei bambini ospedalizzati e validazione linguistico-culturale della Humpty Dumpty Fall Scale. PROFESSIONI INFERMIERISTICHE, 73(4), 296–305. Recuperato da https://www.profinf.net/pro3/index.php/IN/article/view/855
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