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Vandervelde S, Vlaeyen E, de Casterlé BD, Flamaing J, Valy S, Meurrens J, Poels J, Himpe M, Belaen G, Milisen K. Strategies to implement multifactorial falls prevention interventions in community-dwelling older persons: a systematic review. Implement Sci 2023; 18:4. [PMID: 36747293 PMCID: PMC9901093 DOI: 10.1186/s13012-022-01257-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 12/16/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND One-third of the community-dwelling older persons fall annually. Guidelines recommend the use of multifactorial falls prevention interventions. However, these interventions are difficult to implement into the community. This systematic review aimed to explore strategies used to implement multifactorial falls prevention interventions into the community. METHODS A systematic search in PubMed (including MEDLINE), CINAHL (EBSCO), Embase, Web of Science (core collection), and Cochrane Library was performed and updated on the 25th of August, 2022. Studies reporting on the evaluation of implementation strategies for multifactorial falls prevention interventions in the community setting were included. Two reviewers independently performed the search, screening, data extraction, and synthesis process (PRISMA flow diagram). The quality of the included reports was appraised by means of a sensitivity analysis, assessing the relevance to the research question and the methodological quality (Mixed Method Appraisal Tool). Implementation strategies were reported according to Proctor et al.'s (2013) guideline for specifying and reporting implementation strategies and the Taxonomy of Behavioral Change Methods of Kok et al. (2016). RESULTS Twenty-three reports (eighteen studies) met the inclusion criteria, of which fourteen reports scored high and nine moderate on the sensitivity analysis. All studies combined implementation strategies, addressing different determinants. The most frequently used implementation strategies at individual level were "tailoring," "active learning," "personalize risk," "individualization," "consciousness raising," and "participation." At environmental level, the most often described strategies were "technical assistance," "use of lay health workers, peer education," "increasing stakeholder influence," and "forming coalitions." The included studies did not describe the implementation strategies in detail, and a variety of labels for implementation strategies were used. Twelve studies used implementation theories, models, and frameworks; no studies described neither the use of a determinant framework nor how the implementation strategy targeted influencing factors. CONCLUSIONS This review highlights gaps in the detailed description of implementation strategies and the effective use of implementation frameworks, models, and theories. The review found that studies mainly focused on implementation strategies at the level of the older person and healthcare professional, emphasizing the importance of "tailoring," "consciousness raising," and "participation" in the implementation process. Studies describing implementation strategies at the level of the organization, community, and policy/society show that "technical assistance," "actively involving stakeholders," and "forming coalitions" are important strategies. TRIAL REGISTRATION PROSPERO CRD42020187450.
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Affiliation(s)
- Sara Vandervelde
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Centre of Expertise for Falls and Fracture Prevention Flanders, KU Leuven, Kapucijnenvoer 35 blok d bus 7001, 3000 Leuven, Belgium
| | - Ellen Vlaeyen
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Centre of Expertise for Falls and Fracture Prevention Flanders, KU Leuven, Kapucijnenvoer 35 blok d bus 7001, 3000 Leuven, Belgium
- Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan, 3590 Diepenbeek, Belgium
| | - Bernadette Dierckx de Casterlé
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35 blok d bus 7001, 3000 Leuven, Belgium
| | - Johan Flamaing
- Department of Public Health and Primary Care, Gerontology and Geriatrics, Kapucijnenvoer 35 blok d bus 7001, 3000 Leuven, Belgium
- Department of Geriatric Medicine, University Hospital Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Sien Valy
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Centre of Expertise for Falls and Fracture Prevention Flanders, KU Leuven, Kapucijnenvoer 35 blok d bus 7001, 3000 Leuven, Belgium
| | - Julie Meurrens
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Centre of Expertise for Falls and Fracture Prevention Flanders, KU Leuven, Kapucijnenvoer 35 blok d bus 7001, 3000 Leuven, Belgium
| | - Joris Poels
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Centre of Expertise for Falls and Fracture Prevention Flanders, KU Leuven, Kapucijnenvoer 35 blok d bus 7001, 3000 Leuven, Belgium
| | - Margot Himpe
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Centre of Expertise for Falls and Fracture Prevention Flanders, KU Leuven, Kapucijnenvoer 35 blok d bus 7001, 3000 Leuven, Belgium
| | - Goedele Belaen
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Centre of Expertise for Falls and Fracture Prevention Flanders, KU Leuven, Kapucijnenvoer 35 blok d bus 7001, 3000 Leuven, Belgium
| | - Koen Milisen
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Centre of Expertise for Falls and Fracture Prevention Flanders, KU Leuven, Kapucijnenvoer 35 blok d bus 7001, 3000 Leuven, Belgium
- Department of Geriatric Medicine, University Hospital Leuven, Herestraat 49, 3000 Leuven, Belgium
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Van Dam PJ, Reid L, Elliott S, Dwyer M. Evaluating a Novel Extended Scope of Occupational Therapy Service Aimed at Hospital Avoidance in Tasmania, Australia, from the Perspective of Stakeholders. Healthcare (Basel) 2022; 10:healthcare10050842. [PMID: 35627979 PMCID: PMC9140654 DOI: 10.3390/healthcare10050842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 12/10/2022] Open
Abstract
The Australian state of Tasmania has seen a spike in Emergency Department presentations in recent years, particularly among the elderly. A novel extended scope occupational therapy (ESOT) service was implemented by the Tasmanian Health Service, aimed at supporting hospital avoidance. Clients were referred to the ESOT service by other services after being assessed as having a high risk of imminent hospital presentation. Occupational Therapists provided short-term interventions related to falls, mobility, nutrition, and initiated onward referrals to other services. A convergent parallel mixed methods design was used to evaluate the ESOT service. Quantitative data from routinely collected administrative records and a purpose-built survey of referring clinicians were used alongside qualitative data from semi-structured interviews with clients/carers, to enable the triangulation of data. Quantitative data were analysed using descriptive statistics, while qualitative data collected in interviews were thematically analysed. A total of 104 extended scope interventions were provided to 100 clients. Most clients were able to stay at home. Qualitative data revealed that mobility, support, and facilitating access to support services were factors which added value to the client and carer experience. In conclusion, the ESOT program contributed to potentially avoiding hospital admissions and to improving the quality of life of participating clients.
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Affiliation(s)
- Pieter Jan Van Dam
- School of Nursing, College of Health and Medicine, University of Tasmania, 4–8 Bass Hwy, Burnie, TAS 7320, Australia;
| | - Leah Reid
- Royal Hobart Hospital, Tasmanian Health Service, 48 Liverpool St., Hobart, TAS 7000, Australia;
- Correspondence:
| | - Sarah Elliott
- Royal Hobart Hospital, Tasmanian Health Service, 48 Liverpool St., Hobart, TAS 7000, Australia;
| | - Mitchell Dwyer
- Tasmanian School of Medicine, College of Health and Medicine, University of Tasmania, Medical Sciences Precinct, 17 Liverpool St., Hobart, TAS 7000, Australia;
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Santos PHFD, Rodrigues JP, Stival MM, Félix NDDC, Lima LRD, Funghetto SS. Specialized nursing terminology for the prevention of falls in the elderly in primary care. Rev Esc Enferm USP 2021; 55:e20210271. [PMID: 34673879 DOI: 10.1590/1980-220x-reeusp-2021-0271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 08/31/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to build a specialized nursing terminology for the prevention of falls in the elderly in primary healthcare, based on the ICNP®. METHOD this is a methodological study developed in two stages: (1) identification of relevant terms for the prevention of falls in the elderly in official documents; (2) cross mapping of the identified terms with the terms contained in the ICNP® Seven-Axis Model, version 2019/2020. RESULTS a total of 13,408 terms was extracted from official documents, which were submitted to manual screening, resulting in the inclusion of 391 relevant terms. Cross mapping revealed 283 constant terms (67.8% with level of equivalence 1; 32.2% with level of equivalence 2) and 108 non-constant terms (88.9% with level of equivalence 5; 6.5% with level of equivalence 4; 4.6% with level of equivalence 3). In the set of constant terms, the terms of the Focus (43.1%), Action (26.1%), and Means (13.1%) axes stood out; in non-constant terms there was a predominance of the Focus (38.0%), Means (23.1%), and Judgment (15.7%) axes. CONCLUSION we obtained a specialized nursing terminology that will support the development of nursing diagnoses, outcomes, and interventions to contribute to the prevention of falls in the elderly in primary healthcare.
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Park S. A study on the perception of hand washing and health status in Korean adults. Medicine (Baltimore) 2021; 100:e24421. [PMID: 33546088 PMCID: PMC7837834 DOI: 10.1097/md.0000000000024421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/29/2020] [Accepted: 01/03/2021] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT This study aimed to investigate the perception about hand washing and health status among Koreans using the data from the Community Health Survey.We examined the differences in the perceptions about hand washing and health statuses of 220,440 participants of the 2017 community health survey. The sample was divided into groups based on demographic variables, perceptions about hand washing, and prevalence of metabolic diseases. Participants' demographic characteristics were analyzed using frequency, and perceptions about hand washing and subjective health status-related parameters were analyzed using t tests. The prevalence of metabolic disorder was analyzed with χ2 tests.There were significant differences in subjective health status, subjective oral health status, and perceived obesity in the positive and negative hand washing perception groups (P < .01). The prevalence rate of hypertension and diabetes mellitus significantly differed in the positive and negative hand washing perception groups (P < .01), but no differences were observed for hyperlipidemia (P < .01).This study showed that positive hand washing perception is associated with good health care practices. The perceptions of hand washing, which are formed during early childhood, were closely associated with health status. This finding could be useful evidence for developing programs focusing on major health behaviors and levels of health.
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