Gibson, K., Greene, D. P., Sample, P. L., and Cabrera, C. (2010). Fall Prevention: Relatedness of Adherence to Recommendations and Self-Rated Knowledge. Physical & Occupational Therapy in Geriatrics, 28(3), 215-224.
The article discusses the factors that contribute singly or in combination to older adult falls is the history of falling, fear of falling as well as self-efficacy to avoid falling. The mindset orientation of the individual on their likelihood to fall has a significant impact in response to a particular situation. The multifactor approach in preventing a fall is the most effective figuring in the home modifications and fall-prevention education, Community-based fall-prevention programs are important. The paper advances to suggest that the level of adherence to the recommendation has a corresponding gain in knowledge as well as improved (motivation) to fall prevention.
The research methods involved analysis of data collected from the Fall Prevention Program (western United States) and interviews of 120 interviewees, all responded. Pearson product-moment and Spearman’s rho correlations were used and correlation of data as analyzed on adherence to fall prevention recommendations, preliminary concern for falling, rated self-heath, and personal rated fall prevention knowledge. The fundamental correlation was revealed as follows:
- Falling during first 3 project months r=0.201, p=0.028
- Low self-rated health r=0.304, p=0.001
- Initial concern for falling r=0.27, p=0.003)
Correlation r=0.2 corresponds to 4 percent variability, hence, adherence to recommendation relates to other determinants other than concern for falling. Notwithstanding, the interrelationship between concern and adherence, in any case, suggests the expectation of a traumatic experience may lead one to approve to being helped to prevent a future fall. Among the limitations are data analyzed was not originally designed for the research topic, information was dependent on self-reporting.
Dickinson A, Machen I, Horton K, Jain D, Maddex T, Cove J. (2011). Fall prevention in the community: What older people say they need. Br J Community Nurs. 16(4), 174-80.
Old people, 65 years and above experience Hip fractures from falls. Fall prevention can only be effective when older people attend, take part and adhere to fall prevention education provided by the National Institute for Health and Clinical Excellence (NICE) in 2004. The research advanced to discover opinions, preferences and experiences of old people relative to fall prevention intervention in an effort to find obstacles and contributing factors to commitment and participation to fall prevention interventions (Melnyk, & Fineout-Overholt, 2010).
The methodology involved a qualitative grounded-theory approach undertaken. Subsequently, two researchers handled 17 groups of participants (older people) where n=122. Interviews, as well as focus groups, were completely transliterated and anonymized. Qualitative data analysis was undertaken. All the interviewees had the same experiences on factors impacting their participation and adherence. Among the facilitators were knowledge availability, the content of the intervention, accessibility of falls clinic, postural stability or exercise class, and appropriate level of activity. The reach limitations were language barrier (South Asian and Chinese), perceived lack of benefits, health issues and inadequate time. General adherence and participation to the intervention were facilitated by a multiplicity of benefits to the old people like improved physical strength and balance, health advice and encouragement as well as assessment. Evaluations of fall prevention activities are fundamental in reducing negative effects and outcomes.
Bleijlevens M.H., Hendriks M.R., Van Haastregt J.C., Crebolder H.F., and Van Eijk J.T. (2010). Lessons learned from a multidisciplinary fall-prevention program: The occupational-therapy element. Scand J Occup Ther. 17(4), 319-25
The paper advanced to get insight into the contribution of occupational therapy constituent of a multidisciplinary fall prevention program in an effort to reduce old-age falls and functional decline. Occupational therapy is a useful environmental risk evaluation that is effected in recommendations in terms of services and enhancement devices on behavior change. It appears more beneficial to have a home assessment subsequent to environmental modification in fall prevention initiatives. Unfortunately, there is a lack of enough evidence for the efficiency of home assessment and modifications in fall prevention. Home hazard reduction is an efficient approach to prevent falls limited to older people who experienced falls or mobility impairment, however, it is unsuitable for the general population, it also depends on behavior change.
The research design adopted was descriptive and exploratory where both qualitative and quantitative data were collected and analyzed using SPSS. The occupational therapy program used was provided by the therapist involved functional and surrounding evaluation to identify risk features for novel falls. The study population consisted of 166 people (28 withdrew from the study) aged over 65 years attending A &E service offered by the hospitals subsequent to falls. Over 2/3 of all recommendations related to instructions for behavior change and 46 percent corresponded to the right use of home adaptations and helpful devices. According to the study, results and discussions of the results reveal that occupational therapy programs ought not to be implemented in their present form I of regular care.
Summary of Article: Qualitative study on the impact of falling in frail older persons and family caregivers: Foundations for an intervention to prevent falls
The paper advanced to identify the effects of falling for frail dwelling community of older individuals with or lacking cognitive impairments and passed through fall while in their primary family caregivers. The methodology involved interviewing ten patients and ten caregivers. Many of the interviewees were not able to identify the cause of the falls. Other patients excluded the notion that fall prevention is possible and fear of falling may be lessened.
A number of caregivers rated the result of caregiving cognitive problems required more efforts beyond their falls and presumed fall prevention would be irrelevant since the caregiver cognitive impairment, physical difficulties, old age and other personalities were pronounced. Ultimately, falling has a significant impact on physical and emotional orientation for patients and caregivers. A fall-prevention program should concentrate on bringing down the effects of falling. It should also enhance self-efficacy and activity assumption. Discussion of the causes of falls is fundamental. Caregivers have to learn the best way to handle the results of CRs’ falling and cognitive impairment with is significant in the foundation of fall prevention.
Dempsey J. (2008). Risk assessment and fall prevention: Practice development in action. Contemp Nurse. 29(2), 123-34.
Nurses have a role in providing services to patients and careful supervision. Thus nurses influence the knowledge on the best way to assess risk and prevent adverse effects of falling for old age individuals for example familiarity with geriatric patients. The research endeavored to bring out the development of a reduced risk assessment chart on the series of action research.
The population consisted of nurses in two medical wards recording the highest number of falls. The methodology adopted a professionalizing strategy that included negotiation, planning, action, assessment and withdrawal, marking the structure for the research in four rounds of analysis. The process was important in exposing nurses to the significance of clinical research. It increases the discernment of nurses to similar cases of risk assessment. Inability to use the chart hinders the effectiveness of the risk assessment and fails to consider patients with unpredictable true falls. The CCHFRAC is a significant risk assessment tool for patients’ nursing services.
Canadian Nurses’ Experience
Collaboration of caregivers, nurses and other healthcare providers is fundamental in fall prevention and related risks. In essence, the Geriatric Emergency Management Falls Intervention Team as illustrated in this research paper advances to find the impact of collaboration on interdisciplinary fall prevention to older adults. Public health clinical as well as work-related therapists evaluated collaboration preceding and subsequent to fall prevention intervention. The research revealed diffident improvement in collaboration consequences and a decline in preventable risk determinants.
The study indicated successful participation by interdependence to interdisciplinary teamwork and enhanced service delivery to older people. The limitation was inadequate time. However, complex concerns beyond the research protocol and communication difficulties were evident. The results are significant in eliciting feedback between care nurses and enhancing corroborating on evaluations. Again, the occupational therapy service is significant in meeting opportune and comprehensive assessment and providing an opening for coordinated care and effective service delivery.
Stapleton C., Houg, P., Oldmeadow, L., Bull, K., Hill, K., Greenwood, K., (2009). Innovations in Aged Care: Four-item fall risk screening tool for sub-acute and residential aged care: The first step in fall prevention. Australasian Journal on Ageing. 28 (3).
This research attempts to investigate the reliability, correctness and acquiescence of a transitory fall risk screening tool in sub-acute and residential aged care. The study incorporated a 9 item instrument, developed by an expert. Subsequently, extensive and intensive literature reviews were undertaken to have a broad overview. The population consisted of a sample of 291 individuals admitted at Peninsular Health, Australia. Items were assessed for their capability to forecast fluctuations as per the screening tools.
Reliability was examined among six nurses. Subsequently, results indicated that majority extrapolative items were recent falls of 0.81, psychological status indicated 0.56, medications 0.46 and cognition 0.4 c2 (4, n = 291) = 89.89, P < 0.0001. The final 4-item tool (PH-FRAT) shows an 80% accuracy of the results, sensitivity ER 70.2%, specificity ER 68.8% and high reliability, ICC = 0.79. The level of reliability revealed a high level of reliance, as such, used in 50 local sub-acute residential aged care. The four-times PH FRAT is a fundamental moderately, projecting, dependable and brief technique to be applied by nursing and patient care in the screening fall risk prevention.
Arnold, C. M., Sran, M. M., and Harrison, E. L. (2008). Exercise for Fall Risk Reduction in Community-Dwelling Older Adults: A Systematic Review. Physiother Can, 60(4), 358–372.
This paper investigates the effects of working out on falls and fall risk reduction in dwelling communities of older people and advances to present an up-to-date synthesis of result measures for evaluation of fall risk in these communities. A series of reviews was undertaken to factor in the English language articles between the year 2000 to 2006 and accessible by means of CINAHL, EMBASE and AMED. Part of the randomized controlled health care trials utilized an exercise or physical activity intervention and involved the collaboration of older people beyond 50 years. The approach of methodological quality for internal validity was undertaken by two self-governing reviewers.
The examination recovered 156 abstracts, 22 article types of research met the interior validity criteria. Both, modified and group exercise programs were found to be efficient in bringing down and fall risk. “The optimal type, frequency, and dose of exercise to achieve a positive effect have not been determined” (Arnold, Sran, and Harrison, 2008). A number of outcome procedures have been applied to measure fall risk, particularly for balance. Falls and fall risk can be brought down with exercise involvements in the community-dwelling older people, though the most operative exercise variables are unidentified. Forthcoming research in populations with comorbidities acknowledged to intensify fall risk will assist to determine the specific optimal conditions of fall prevention programs. According to the research provided in this article, poor balance presents a basic governing factor for falls; this provides a fundamental measure of the chosen factors for assessing patients that are described as the ones that are at risk of falling. The main factor for falls, as stated in the article, is a poor balance, and thus, it is important to choose the most effective measure of this variable while “accessing those patients who are considered to be at risk of falling” (Arnold, Sran, and Harrison, 2008).
Fukukawa, Y., Kozakai, R., Niino, N., Nishita, Y., Ando, F., Shimokata, H., (2008). Social Support as a Moderator in a Fall Prevention Program for Older Adults. Journal of Gerontological Nursing. 34 (5:19).
The research advances to identify the moderating impacts of social support in a fall prevention program for a community consisting of older people. Twenty-six
Japanese older people beyond the age of sixty-five years and older took part in a 2-month exercise program and were assessed in anthropometrical, physical, and psychological operative at baseline, two months (involvement termination), and five months (three months later intervention conclusion). Evaluations revealed that the program did not advance older adults’ body mass index, balance, or walking speed (McNeill et al. 2006). On the other hand, sampled interviewees’ fall self-efficacy fundamentally escalated from baseline to intervention termination and was upheld at an advanced level at the five-month post-intervention follow-up.
References
Arnold, C. M., Sran, M. M., and Harrison, E. L. (2008). Exercise for Fall Risk Reduction in Community-Dwelling Older Adults: A Systematic Review. Physiother Can, 60(4), 358–372.
McNeill, L.H., Wyrwich, K.W., Brownson, R.C., Clark, E.M., & Kreuter, M.W. (2006). Individual, social environmental, and physical environmental influences on physical activity among black and white adults: A structural equation analysis. Annals of Behavioral Medicine, 31, 36-44.
Melnyk, B., & Fineout-Overholt, E. (2010). Evidence-based practice in nursing and healthcare: A guide to best practice, 2nd ed. Philadelphia: Lippincott Williams & Wilkins.