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Mackenzie L, Le VT, Nguyen DMN, Dao THP. The Vietnamese version of the Home Falls and Accidents Screening Tool (HOME FAST) - A preliminary study of validity and inter-rater reliability. Front Public Health 2023; 11:1170000. [PMID: 37228736 PMCID: PMC10203153 DOI: 10.3389/fpubh.2023.1170000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 04/18/2023] [Indexed: 05/27/2023] Open
Abstract
Introduction The Vietnamese Home Falls and Accidents Screening Tool (HOME FAST) was developed to measure the number of home hazards present in the homes of older Vietnamese people and the risk of falls. Methods The HOME FAST and the HOME FAST manual were translated into Vietnamese by an independent translator and underwent backward translation by local health professionals into English to evaluate the accuracy of the translation. A panel of 14 Vietnamese health professionals evaluated the validity of the HOME FAST translation and rated the clarity and cultural relevance of each item. Ratings were evaluated using the content validity index (CVI). Reliability in ratings of the HOME FAST was evaluated using intra-class correlations (ICC), and ratings took place within the homes of two older Vietnamese people by six assessors. Results In all, 22 out of 25 Vietnamese HOME FAST items were considered to have met content validity standards using the CVI. The ICC for home visit one was 0.94 (95% CI 0.87-0.97) and for home visit two was ICC 0.95 (95% CI 0.91-0.98) indicating high reliability. Discussion and conclusion Bathroom items showed the most inconsistency in ratings indicating cultural differences in bathing activities. Descriptors of HOME FAST items will be reviewed for use in Vietnam to account for cultural and environmental differences. A larger pilot study is planned with older people living in the community in Vietnam to include calendar ascertainment of falls to determine if home hazards are associated with falling.
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Affiliation(s)
- Lynette Mackenzie
- Discipline of Occupational Therapy, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Darlington, NSW, Australia
| | - Van Thanh Le
- Rehabilitation Department, Faculty of Nursing and Medical Technology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Doan Mai Ngoc Nguyen
- Rehabilitation Department, Faculty of Nursing and Medical Technology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Thy Hoang Phuong Dao
- Rehabilitation Department, Faculty of Nursing and Medical Technology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
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Meekes WM, Korevaar JC, Leemrijse CJ, van de Goor IA. Practical and validated tool to assess falls risk in the primary care setting: a systematic review. BMJ Open 2021; 11:e045431. [PMID: 34588228 PMCID: PMC8483054 DOI: 10.1136/bmjopen-2020-045431] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 08/18/2021] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE Although several falls risk assessment tools are available, it is unclear which have been validated and which would be most suitable for primary care practices. This systematic review aims to identify the most suitable falls risk assessment tool for the primary care setting (ie, requires limited time, no expensive equipment and no additional space) and that has good predictive performance in the assessment of falls risk among older people living independently. DESIGN A systematic review based on prospective studies. METHODS An extensive search was conducted in the following databases: PubMed, Embase, CINAHL, Cochrane and PsycINFO. Tools were excluded if they required expensive and/or advanced software that is not usually available in primary care units and if they had not been validated in at least three different studies. Of 2492 articles published between January 2000 and July 2020, 27 were included. RESULTS Six falls risk assessment tools were identified: Timed Up and Go (TUG) test, Gait Speed test, Berg Balance Scale, Performance Oriented Mobility Assessment, Functional Reach test and falls history. Most articles reported area under the curve (AUC) values ranging from 0.5 to 0.7 for these tools. Sensitivity and specificity varied substantially across studies (eg, TUG, sensitivity:10%-83.3%, specificity:28.4%-96.6%). CONCLUSIONS Given that none of the falls risk assessment tools had sufficient predictive performance (AUC <0.7), other ways of assessing high falls risk among independently living older people in primary care should be investigated. For now, the most suitable way to assess falls risk in the primary care setting appears to involve asking patients about their falls history. Compared with the other five tools, the falls history requires the least amount of time, no expensive equipment, no training and no spatial adjustments. The clinical judgement of healthcare professionals continues to be most important, as it enables the identification of high falls risk even for patients with no falls history. TRIAL REGISTRAION NUMBER The Netherlands Trial Register, NL7917; Pre-results.
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Affiliation(s)
- Wytske Ma Meekes
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | | | | | - Ien Am van de Goor
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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Predictive validity of three home fall hazard assessment tools for older adults in Thailand. PLoS One 2020; 15:e0244729. [PMID: 33382812 PMCID: PMC7774965 DOI: 10.1371/journal.pone.0244729] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 12/15/2020] [Indexed: 01/28/2023] Open
Abstract
This study aimed to examine the predictive validity of two internationally well-known instruments, the Modified Home Falls and Accidents Screening Tool (Modified HOME FAST) and the Modified Home Falls and Accidents Screening Tool-Self Report (Modified HOME FAST-SR), and the newly developed Thai Home Falls Hazard Assessment Tool (Thai-HFHAT) (69 items) in predicting falls among older Thai adults. It also aimed to examine the predictive validity of the two abbreviated versions (44 and 27 items) of the Thai-HFHAT, which were developed post hoc to accommodate older adults’ limited literacy and poor vision and to facilitate the identification of high-impact home fall hazards that are prevalent in the Thailand context. A prospective cohort study was conducted among 450 participants aged 60 years and above who were assessed by the aforementioned tools at baseline, for which data on fall incidence were then collected during the one-year follow-up. The Cox proportional hazard model was applied to estimate hazard ratios (HRs); then, Harrell’s C-statistics and receiver operating characteristic (ROC) analyses were conducted to identify the best cutoff point, sensitivity and specificity for each instrument. The results showed that the fall hazard rate was 2.04 times per 1,000 person-days. Taking into account both the predictive validity and applicability, the Thai-HFHAT (44 items) was found to be the most suitable screening tool due to its highest sensitivity and specificity (93% and 72%) at the cutoff score of 18. In conclusion, our study showed that these internationally validated home fall hazard assessment tools were quite applicable for Thailand, but further tailoring the tools into a specific local context yielded even more highly valid tools in predicting fall risk among older Thai adults. Although these findings were well reproducible by inferring from the internal validation results, further external validation in the independent population is necessary.
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Tsuchiya-Ito R, Tajima M, Slaug B. Housing Assessment Tools Developed or Adapted for Use in East and Southeast Asia: A Scoping Review. JOURNAL OF AGING AND ENVIRONMENT 2020. [DOI: 10.1080/26892618.2020.1833397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Rumiko Tsuchiya-Ito
- Research Department, Institute for Health Economics and Policy, Tokyo, Japan
- Dia Foundation for Research on Ageing Societies, Tokyo, Japan
| | - Miki Tajima
- Dia Foundation for Research on Ageing Societies, Tokyo, Japan
| | - Björn Slaug
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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Melo Filho J, Valderramas S, Vojciechowski AS, Mackenzie L, Gomes ARS. The Brazilian version of the Home Falls and Accidents Screening Tool (HOME FAST): translation, cross-cultural adaptation, validation and reliability. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2020. [DOI: 10.1590/1981-22562020023.190180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Objective: to translate and cross-culturally adapt the Home Falls and Accidents Screening Tool - HOME FAST into Brazilian Portuguese and to evaluate its construct validity and intra-and inter-rater reliability. Method: a cross-sectional study was carried out that included older people aged 60 years or older. Translation and cross-cultural adaptation were carried out in the following stages: 1. Translation, 2. Synthesis, 3. Back translation, 4. Expert panel (review and pre-final version), 5. Pre-testing, 6. Analysis by the expert panel and the final version of the instrument. The Berg Balance Scale - BBS was used to test construct validity (Spearman correlation coefficient). Additionally, intra-and inter-rater reliability analysis was conducted using the Intraclass Correlation Coefficient (ICC) and the Bland-Altman plot. Results were considered significant at p<0.05. Results: the HOME FAST-Brazil was applied to 53 older people with a mean age of 71(5) years; 79% (42) of whom were female and 21% (11) of whom were male. The translation and cross-cultural adaptation process resulted in similar versions among translations. The correlation of the total score of HOME FAST-Brazil with the BBS was ρ=-0.241, p=0.041. The reliability rate was ICC=0.99 and 0.92 (intra-and inter-rater, respectively). Conclusion: The HOME FAST-Brazil, translated and cross-culturally adapted to Brazilian Portuguese, was shown to have construct validity and excellent intra-and inter-rater reliability.
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Park J, Lee K, Lee K. Association between urinary urgency and falls among rural dwelling older women. J Adv Nurs 2019; 76:846-855. [PMID: 31808191 DOI: 10.1111/jan.14284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 10/08/2019] [Accepted: 11/27/2019] [Indexed: 11/29/2022]
Abstract
AIM To examine the association between urinary urgency and falls in older women living in rural areas in South Korea. DESIGN A secondary analysis was conducted using cross-sectional data. METHODS This study used dataset obtained from 246 women aged 65 years or older living in 15 rural mountain communities in South Korea between February 2016-March 2016. Falls were measured by self-reports including the number, location, reasons of falls during the past year. Frequency of urinary urgency and nocturia were assessed by self-reports. Covariates included age, body mass index, self-reported health problems. Mixed-effects negative binomial regression was used to analyse the association between urinary urgency and the number of falls. RESULTS The mean age of the 246 women was 77.3 years. Among the sample, 30.1% experienced at least one fall in the past year and 16% had required hospital treatments. The analysis showed that urinary urgency and osteoporosis were significantly associated with a greater number of falls after adjusting for other covariates. Among those who had experienced falls, nearly 60% reported that the reasons for falls were environmental factors, such as slippery floors or uneven sidewalks/thresholds. CONCLUSION Improving urinary urgency may be a strategy to decrease the fall risk in older women. Accordingly, community nurses can provide intervention programs on lifestyle and behavioural changes such as bladder training, dietary modification and pelvic floor muscle training. Interventions for fall prevention need to be developed while considering the unique features of indoor and outdoor environments. IMPACT The findings have implications for healthcare providers and policy makers with regard to the development of safer indoor and outdoor environments for older women living in rural areas by remodelling their residential spaces and neighbourhoods. In addition, more prospective studies using larger samples are needed to investigate the causal mechanism between urinary urgency and falls.
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Affiliation(s)
- Jeongok Park
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea
| | - Kyoungjin Lee
- Yonsei University College of Nursing, Seoul, South Korea
| | - Kayoung Lee
- Yonsei University College of Nursing, Seoul, South Korea
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Sørensen GV, Jørgensen MG, Ryg J, Masud T, Andersen S. Development, feasibility, acceptability, and adjustment of a portable, multifactorial falls risk test battery for community-dwelling older adults. COGENT MEDICINE 2019. [DOI: 10.1080/2331205x.2019.1674099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Gustav V. Sørensen
- Department of Geriatric Medicine, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Martin G. Jørgensen
- Department of Geriatric Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - Jesper Ryg
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Tahir Masud
- Department of Healthcare for Older People, Nottingham University Hospitals NHS Trust, Nottingham, England
| | - Stig Andersen
- Department of Geriatric Medicine, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Elfering A, Kottwitz MU, Häfliger E, Celik Z, Grebner S. Interruptions, Unreasonable Tasks, and Quality-Threatening Time Pressure in Home Care: Linked to Attention Deficits and Slips, Trips, and Falls. Saf Health Work 2018; 9:434-440. [PMID: 30559992 PMCID: PMC6284161 DOI: 10.1016/j.shaw.2018.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 01/16/2018] [Accepted: 02/03/2018] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND In industrial countries, home care of community dwelling elderly people is rapidly growing. Frequent injuries in home caregivers result from slips, trips, and falls (STFs). The current study tests attentional cognitive failure to mediate the association between work stressors and STFs. METHODS A sample of 125 home caregivers participated in a questionnaire study and reported work interruptions, unreasonable tasks, quality-threatening time pressure, conscientiousness, attentional cognitive failures, and STFs. RESULTS In structural equation modeling, the mediation model was shown to fit empirical data. Indirect paths with attentional cognitive failures as the link between work stressors and STF were all significant in bootstrapping tests. An alternative accident-prone person model, that suggests individual differences in conscientiousness to predict attentional cognitive failures that predict more frequent work stressors and STFs, showed no significant paths between work conditions and STFs. CONCLUSION To prevent occupational injury, work should be redesigned to reduce work interruptions, unreasonable tasks, and quality-threatening time pressure in home care.
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Affiliation(s)
- Achim Elfering
- University of Bern, Switzerland
- National Center of Competence in Research, Affective Sciences, University of Geneva, CISA, Geneva, Switzerland
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Blanchet R, Edwards N. A need to improve the assessment of environmental hazards for falls on stairs and in bathrooms: results of a scoping review. BMC Geriatr 2018; 18:272. [PMID: 30413144 PMCID: PMC6234792 DOI: 10.1186/s12877-018-0958-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 10/19/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Falls occurring on stairs or in bathrooms are associated with a high risk of injuries among older adults. Home environmental assessments are frequently used to guide fall-prevention interventions. The aims of this review were to describe how, where, by whom, and for whom environmental hazard checklists are used, and to examine the characteristics of environmental hazard assessment checklists with specific attention to features of bathrooms and stairs/steps assessed in them. METHODS Studies published before January 5, 2018, were identified using several databases. Publications reporting the use and/or evaluation of environmental hazard checklists were eligible if they assessed bathrooms or stairs/steps in homes of older adults (≥65 years). Content analysis was conducted on publications that provided a complete list of specific environmental hazards assessed. Checklist items related to bathrooms and stairs/steps were extracted and categorized as structural or non-structural and as objective or subjective. RESULTS 1119 studies were appraised. A pool of 136 published articles and 4 checklists from the grey literature were included in this scoping review. Content analysis was conducted on 42 unique checklists. There was no widely used checklist and no obvious consensus definition of either environmental hazards overall or of single hazards listed in checklists. Checklists varied greatly with respect to what rooms were assessed, whether or not outdoor stair/steps hazards were assessed, and how responses were coded. Few checklists examined person-environment fit. The majority of checklists were not oriented towards structural hazards in bathrooms. Although the majority of checklists assessing stair/steps hazards evaluated structural hazards, most features assessed were not related to the construction geometry of stairs/steps. Objective features of bathrooms and stairs/steps that would deem them safe were rarely specified. Rather, adequacy of their characteristics was mostly subjectively determined by the evaluator with little or no guidance or training. CONCLUSION The lack of standard definitions and objective criteria for assessing environmental hazards for falls is limiting meaningful cross-study comparisons and slowing advances in this field. To inform population health interventions aimed at preventing falls, such as building code regulations or municipal housing by-laws, it is essential to include objectively-assessed structural hazards in environmental checklists.
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Affiliation(s)
- Rosanne Blanchet
- School of Nursing, University of Ottawa, 1 Stewart Street, Room 212, Ottawa, ON K1H 8M5 Canada
| | - Nancy Edwards
- School of Nursing, University of Ottawa, 1 Stewart Street, Room 205, Ottawa, ON K1H 8M5 Canada
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Mackenzie L, Byles J. Scoring the home falls and accidents screening tool for health professionals (HOME FAST-HP): Evidence from one epidemiological study. Aust Occup Ther J 2018; 65:346-353. [DOI: 10.1111/1440-1630.12467] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Lynette Mackenzie
- Faculty of Health Sciences; Discipline of Occupational Therapy; University of Sydney; Lidcombe NSW Australia
| | - Julie Byles
- Faculty of Health and Medicine; School of Medicine and Public Health; Research Centre for Generational, Health and Ageing; University of Newcastle; Callaghan NSW Australia
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Romli MH, Tan MP, Mackenzie L, Lovarini M, Kamaruzzaman SB, Clemson L. Factors associated with home hazards: Findings from the Malaysian Elders Longitudinal Research study. Geriatr Gerontol Int 2017; 18:387-395. [DOI: 10.1111/ggi.13189] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/22/2017] [Accepted: 08/27/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Muhammad H Romli
- Department of Nursing and Rehabilitation, Faculty of Medicine and Health Sciences; University Putra Malaysia; Serdang Malaysia
- Discipline of Occupational Therapy, Faculty of Health Sciences, Cumberland Campus; University of Sydney; Sydney New South Wales Australia
| | - Maw P Tan
- Aging and Age Associated Disorders Research Group, Faculty of Medicine; University of Malaya; Kuala Lumpur Malaysia
| | - Lynette Mackenzie
- Discipline of Occupational Therapy, Faculty of Health Sciences, Cumberland Campus; University of Sydney; Sydney New South Wales Australia
| | - Meryl Lovarini
- Discipline of Occupational Therapy, Faculty of Health Sciences, Cumberland Campus; University of Sydney; Sydney New South Wales Australia
| | - Shahrul B Kamaruzzaman
- Aging and Age Associated Disorders Research Group, Faculty of Medicine; University of Malaya; Kuala Lumpur Malaysia
| | - Lindy Clemson
- Discipline of Occupational Therapy, Faculty of Health Sciences, Cumberland Campus; University of Sydney; Sydney New South Wales Australia
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Romli MH, Mackenzie L, Lovarini M, Tan MP, Clemson L. The interrater and test-retest reliability of the Home Falls and Accidents Screening Tool (HOME FAST) in Malaysia: Using raters with a range of professional backgrounds. J Eval Clin Pract 2017; 23:662-669. [PMID: 28105771 DOI: 10.1111/jep.12697] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 11/29/2016] [Accepted: 11/29/2016] [Indexed: 11/30/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES Falls can be a devastating issue for older people living in the community, including those living in Malaysia. Health professionals and community members have a responsibility to ensure that older people have a safe home environment to reduce the risk of falls. Using a standardised screening tool is beneficial to intervene early with this group. The Home Falls and Accidents Screening Tool (HOME FAST) should be considered for this purpose; however, its use in Malaysia has not been studied. Therefore, the aim of this study was to evaluate the interrater and test-retest reliability of the HOME FAST with multiple professionals in the Malaysian context. METHODS A cross-sectional design was used to evaluate interrater reliability where the HOME FAST was used simultaneously in the homes of older people by 2 raters and a prospective design was used to evaluate test-retest reliability with a separate group of older people at different times in their homes. Both studies took place in an urban area of Kuala Lumpur. RESULTS Professionals from 9 professional backgrounds participated as raters in this study, and a group of 51 community older people were recruited for the interrater reliability study and another group of 30 for the test-retest reliability study. The overall agreement was moderate for interrater reliability and good for test-retest reliability. The HOME FAST was consistently rated by different professionals, and no bias was found among the multiple raters. CONCLUSION The HOME FAST can be used with confidence by a variety of professionals across different settings. The HOME FAST can become a universal tool to screen for home hazards related to falls.
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Affiliation(s)
- Muhammad Hibatullah Romli
- Discipline of Occupational Therapy, University of Sydney, Lidcombe, NSW, Australia.,Department of Nursing and Rehabilitation, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Lynette Mackenzie
- Faculty of Health Sciences, Discipline of Occupational Therapy, University of Sydney, Lidcombe, NSW, Australia
| | - Meryl Lovarini
- Faculty of Health Sciences, Discipline of Occupational Therapy, University of Sydney, Lidcombe, NSW, Australia
| | - Maw Pin Tan
- Ageing and Age Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Lindy Clemson
- Faculty of Health Sciences, Discipline of Occupational Therapy, University of Sydney, Lidcombe, NSW, Australia
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Romli MH, Mackenzie L, Lovarini M, Tan MP, Clemson L. The Clinimetric Properties of Instruments Measuring Home Hazards for Older People at Risk of Falling: A Systematic Review. Eval Health Prof 2016; 41:82-128. [PMID: 29415567 DOI: 10.1177/0163278716684166] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Home hazards are associated with falls among older people living in the community. However, evaluating home hazards is a complex process as environmental factors vary according to geography, culture, and architectural design. As a result, many health practitioners commonly use nonstandardized assessment methods that may lead to inaccurate findings. Thus, the aim of this systematic review was to identify standardized instruments for evaluating home hazards related to falls and evaluate the clinimetric properties of these instruments for use by health practitioners. A systematic search was conducted in the Medline, CINAHL, AgeLine, Web of Science databases, and the University of Sydney Library CrossSearch Engine. Study screening, assessment, and quality ratings were conducted independently. Thirty-six studies were identified describing 19 instruments and three assessment techniques. The clinimetric properties varied between instruments. The Home Falls and Accidents Screening Tool, Home Safety Self-Assessment Tool, In-Home Occupational Performance Evaluation, and Westmead Home Safety Assessment were the instruments with high potential for evaluating home hazards associated with falls. Health practitioners can choose the most appropriate instruments for their practice, as a range of standardized instruments with established clinimetric properties are available.
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Affiliation(s)
- Muhammad Hibatullah Romli
- 1 Occupational Therapy, University of Sydney, NSW, Australia.,2 Faculty of Medicine and Health Sciences, Department of Nursing and Rehabilitation, Universiti Putra Malaysia, Selangor, Malaysia
| | | | - Meryl Lovarini
- 1 Occupational Therapy, University of Sydney, NSW, Australia
| | - Maw Pin Tan
- 3 Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Lindy Clemson
- 1 Occupational Therapy, University of Sydney, NSW, Australia
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El Fakiri F, Kegel AA, Schouten GM, Berns MPH. Ethnic Differences in Fall Risk Among Community-Dwelling Older People in the Netherlands. J Aging Health 2016; 30:365-385. [PMID: 27913764 DOI: 10.1177/0898264316679531] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study measures the prevalence of falls and fear of falling among a population sample aged ≥65 years from different ethnic minorities living in the Netherlands, and examines whether ethnicity contributed to the differences in fall risk. METHOD We analyzed data from 8,892 Dutch, Moroccan, Turkish, and Surinamese participants. Descriptive statistics and multiple regression analyses were conducted with falls and fear of falling as the dependent variable and ethnicity as the independent variable. RESULTS Moroccan, Turkish, and Surinamese older adults had a significantly higher odds ratio (OR) for fear of falling than their Dutch counterparts (OR = 2.13, 95% confidence interval [CI] = [1.05, 4.31]; OR = 2.09, 95% CI = [1.07, 4.09]; and OR = 2.49, 95% CI = [1.53, 4.03], respectively). The association between ethnicity and falling disappeared after controlling for socio-demographic and health characteristics. DISCUSSION Dutch minority older adults were at higher risk for fear of falling than their Dutch counterparts. The study underlines the need for targeting culture-sensitive interventions.
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Affiliation(s)
| | - Amber A Kegel
- 1 Public Health Service of Amsterdam, The Netherlands
| | - Gea M Schouten
- 2 Public Health Service of Rotterdam-Rijnmond, The Netherlands
| | - Mary P H Berns
- 3 Municipal Health Service Haaglanden, The Hague, The Netherlands
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Romli MH, Mackenzie L, Lovarini M, Tan MP. Pilot study to investigate the feasibility of the Home Falls and Accidents Screening Tool (HOME FAST) to identify older Malaysian people at risk of falls. BMJ Open 2016; 6:e012048. [PMID: 27531736 PMCID: PMC5013375 DOI: 10.1136/bmjopen-2016-012048] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE The relationship between home hazards and falls in older Malaysian people is not yet fully understood. No tools to evaluate the Malaysian home environment currently exist. Therefore, this study aimed to pilot the Home Falls and Accidents Screening Tool (HOME FAST) to identify hazards in Malaysian homes, to evaluate the feasibility of using the HOME FAST in the Malaysian Elders Longitudinal Research (MELoR) study and to gather preliminary data about the experience of falls among a small sample of Malaysian older people. DESIGN A cross-sectional pilot study was conducted. SETTING An urban setting in Kuala Lumpur. PARTICIPANTS 26 older people aged 60 and over were recruited from the control group of a related research project in Malaysia, in addition to older people known to the researchers. PRIMARY OUTCOME MEASURE The HOME FAST was applied with the baseline survey for the MELoR study via a face-to-face interview and observation of the home by research staff. RESULTS The majority of the participants were female, of Malay or Chinese ethnicity and living with others in a double-storeyed house. Falls were reported in the previous year by 19% and 80% of falls occurred at home. Gender and fear of falling had the strongest associations with home hazards. Most hazards were detected in the bathroom area. A small number of errors were detected in the HOME FAST ratings by researchers. CONCLUSIONS The HOME FAST is feasible as a research and clinical tool for the Malaysian context and is appropriate for use in the MELoR study. Home hazards were prevalent in the homes of older people and further research with the larger MELoR sample is needed to confirm the validity of using the HOME FAST in Malaysia. Training in the use of the HOME FAST is needed to ensure accurate use by researchers.
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Affiliation(s)
- Muhammad Hibatullah Romli
- Discipline of Occupational Therapy, University of Sydney, Lidcombe, New South Wales, Australia
- Department of Nursing and Rehabilitation, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Lynette Mackenzie
- Discipline of Occupational Therapy, University of Sydney, Lidcombe, New South Wales, Australia
| | - Meryl Lovarini
- Discipline of Occupational Therapy, University of Sydney, Lidcombe, New South Wales, Australia
| | - Maw Pin Tan
- Faculty of Medicine, University of Malaya, Malaysia
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Mackenzie L. Evaluation of the clinical utility of the Home Falls and Accidents Screening Tool (HOME FAST). Disabil Rehabil 2016; 39:1489-1501. [DOI: 10.1080/09638288.2016.1204015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Lynette Mackenzie
- Discipline of Occupational Therapy, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
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Robnett RH, Bliss S, Buck K, Dempsey J, Gilpatric H, Michaud K. Validation of the Safe at Home Screening with Adults Who Have Acquired Brain Injury. Occup Ther Health Care 2015; 30:16-28. [PMID: 26053430 DOI: 10.3109/07380577.2015.1044691] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The Safe at Home Screening (SAH) is an occupational therapy assessment tool designed to quickly assess home safety awareness and skills through the use of mock hazardous situations in a kitchen setting. The SAH has been standardized on community-dwelling adults. This research project involves psychometric analyses using the SAH on a sample of adults with acquired brain injuries (ABI; N = 31), and compares their SAH outcome scores with those of the Kohlman Evaluation of Living Skills (KELS). The scores on the two tests were found to be moderately correlated. An aspect of content validity was explored by asking the clients' occupational therapists to make predictions about their clients' functioning in the realm of home safety. Correlations between the expert opinions of potential client scores and actual SAH test scores were moderate.
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Affiliation(s)
- Regula H Robnett
- a Occupational Therapy , University of New England , Portland , ME , USA
| | - Stephanie Bliss
- a Occupational Therapy , University of New England , Portland , ME , USA
| | - Kari Buck
- a Occupational Therapy , University of New England , Portland , ME , USA
| | - Jennifer Dempsey
- a Occupational Therapy , University of New England , Portland , ME , USA
| | - Heidi Gilpatric
- a Occupational Therapy , University of New England , Portland , ME , USA
| | - Katherine Michaud
- a Occupational Therapy , University of New England , Portland , ME , USA
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Abstract
ABSTRACTAs populations age, increased focus is given to the importance of enabling older people to age in place. The study reported in this paper explored the extent to which older people considered their homes and neighbourhoods to be ‘supportive’, and sought to increase understanding of the needs and experiences of older people and their expectations of future housing needs. This paper reports qualitative data from the Housing and Independent Living (HAIL) study carried out in Australia. Semi-structured interviews were conducted with 202 community-dwelling people aged 75–79 years. Interviews were transcribed, coded and analysed using computer-assisted qualitative analysis and a narrative approach to identify broad themes. Thematic analysis was used to examine and understand how occupants subjectively viewed their homes, and how they planned to adapt/modify either their activities or homes to accommodate changing needs. Six key themes emerged, namely housing choice, attachment to place, financial issues, changes to the home over time, transport, and anticipating the future. In this study, people who most strongly identified with and felt connected to their neighbours/communities had more positive perceptions of their homes and communities, and may be better able to remain in their home despite increasing disability or frailty. Housing policies and home and urban design should ensure home and neighbourhood environments are safe, accessible, promote positive associations, and are adaptable to facilitate independence and accommodate change as people age.
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Mikolaizak AS, Simpson PM, Tiedemann A, Lord SR, Caplan GA, Bendall JC, Howard K, Close JCT. Intervention to prevent further falls in older people who call an ambulance as a result of a fall: a protocol for the iPREFER randomised controlled trial. BMC Health Serv Res 2013; 13:360. [PMID: 24070456 PMCID: PMC3849451 DOI: 10.1186/1472-6963-13-360] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 09/18/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND An increasing number of falls result in an emergency call and the subsequent dispatch of paramedics. In the absence of physical injury, abnormal physiological parameters or change in usual functional status, it could be argued that routine conveyance by ambulance to the Emergency Department (ED) is not the most effective or efficient use of resources. Further, it is likely that non-conveyed older fallers have the potential to benefit from timely access to fall risk assessment and intervention. The aim of this randomised controlled trial is to evaluate the effect of a timely and tailored falls assessment and management intervention on the number of subsequent falls and fall-related injuries for non-conveyed older fallers. METHODS Community dwelling people aged 65 years or older who are not conveyed to the ED following a fall will be eligible to be visited at home by a research physiotherapist. Consenting participants will receive individualised intervention strategies based on risk factors identified at baseline. All pre-test measures will be assessed prior to randomisation. Post-test measures will be undertaken by a researcher blinded to group allocation 6 months post-baseline. Participants in the intervention group will receive individualised pro-active fall prevention strategies from the clinical researcher to ensure that risk factors are addressed adequately and interventions carried out. The primary outcome measure will be the number of falls recorded by a falls diary over a 12 month period. Secondary outcome measures assessed six months after baseline will include the subsequent use of medical and emergency services and uptake of recommendations. Data will be analysed using the intention-to-treat principle. DISCUSSION As there is currently little evidence regarding the effectiveness or feasibility of alternate models of care following ambulance non-conveyance of older fallers, there is a need to explore assessment and intervention programs to help reduce subsequent falls, related injuries and subsequent use of health care services. By linking existing services rather than setting up new services, this pragmatic trial aims to utilise the health care system in an efficient and timely manner. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN 12611000503921.
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Affiliation(s)
- A Stefanie Mikolaizak
- Neuroscience Research Australia, University of New South Wales, Barker Street, Randwick, 2031 Sydney, NSW, Australia
| | | | - Anne Tiedemann
- The George Institute for Global Health, The University of Sydney, Sydney, Australia
| | - Stephen R Lord
- Neuroscience Research Australia, University of New South Wales, Barker Street, Randwick, 2031 Sydney, NSW, Australia
| | - Gideon A Caplan
- Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | | | - Kirsten Howard
- School of Public Health, University of Sydney, Sydney, Australia
| | - Jacqueline CT Close
- Neuroscience Research Australia, University of New South Wales, Barker Street, Randwick, 2031 Sydney, NSW, Australia
- Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
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Elfering A, Grebner S, Boillat C. Busy at Work and Absent-Minded at Home. SWISS JOURNAL OF PSYCHOLOGY 2013. [DOI: 10.1024/1421-0185/a000114] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This study investigates whether cognitive failures mediate the potential influence of work demands and conscientiousness on body balance problems and domestic near-falls at home after work. The participants were 109 employees (55% female). We used the Workplace Cognitive Failure Scale (WCFS) to measure the frequency of failure in memory function, failure in attention regulation, and failure in action execution. Performance constraints, time pressure, and concentration demands were assessed by the Instrument for Stress-Oriented Task Analysis (ISTA). In a structural equation model, work-related cognitive failure significantly mediated the influence of work demands on after-work domestic body balance problems encountered in the previous 4 weeks. Work-related cognitive failure did not mediate the directional link between conscientiousness and body balance problems. Mental work demands have aftereffects after work is finished. The risk of domestic fall is due in part to cognitive failure that reflects cognitive strain from mental workload. Work redesign is likely to reduce the risk of falling not only at work, but also after work at home.
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Affiliation(s)
- Achim Elfering
- Department of Psychology, University of Bern, Switzerland
| | - Simone Grebner
- Department of Psychology, University of Bern, Switzerland
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Byles JE, Mackenzie L, Redman S, Parkinson L, Leigh L, Curryer C. Supporting housing and neighbourhoods for healthy ageing: Findings from the Housing and Independent Living Study (HAIL). Australas J Ageing 2012; 33:29-35. [DOI: 10.1111/j.1741-6612.2012.00646.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Julie E Byles
- Research Centre for Gender, Health and Ageing; University of Newcastle; Newcastle New South Wales Australia
- Hunter Medical Research Institute Public Health Capacity Building Group; University of Newcastle; Newcastle New South Wales Australia
- Australian Longitudinal Study on Women's Health; University of Newcastle; Newcastle New South Wales Australia
| | - Lynette Mackenzie
- Faculty of Health Sciences; University of Sydney; Sydney New South Wales Australia
| | - Sally Redman
- Sax Institute, Haymarket; Sydney New South Wales Australia
- School of Public Health; University of Sydney; Sydney New South Wales Australia
| | - Lynne Parkinson
- Research Centre for Gender, Health and Ageing; University of Newcastle; Newcastle New South Wales Australia
- School of Psychology; University of Newcastle; Newcastle New South Wales Australia
- Australasian Journal on Ageing; Richmond Victoria Australia
| | - Lucy Leigh
- Research Centre for Gender, Health and Ageing; Faculty of Health; University of Newcastle; Newcastle New South Wales Australia
| | - Cassie Curryer
- Research Centre for Gender, Health and Ageing; Faculty of Health; University of Newcastle; Newcastle New South Wales Australia
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Byles JE, Dobson A. The value of time in longitudinal studies of ageing. Lessons from the Australian Longitudinal Study on Women's Health. Australas J Ageing 2011; 30 Suppl 2:6-12. [DOI: 10.1111/j.1741-6612.2011.00531.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Hassani Mehraban A, Mackenzie LA, Byles JE. A self-report home environment screening tool identified older women at risk of falls. J Clin Epidemiol 2011; 64:191-9. [DOI: 10.1016/j.jclinepi.2010.02.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2009] [Revised: 02/11/2010] [Accepted: 02/19/2010] [Indexed: 11/15/2022]
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Abstract
SummaryAppropriate social and medical interventions may help maintain independence in older people. Determinants of functional decline, disability and reduced independence are recognized and specific interventions target the treatment of clinical conditions, multiple health problems and geriatric conditions, prevention of falls and fractures, and maintenance of physical and cognitive function and social engagement.Preventive strategies to identify and treat diverse unmet needs of older people have been researched extensively. We reviewed systematically recent randomized controlled trials evaluating these ‘complex’ interventions and incorporated the findings of 21 studies into an established meta-analysis that included 108,838 people in 110 trials. There was an overall benefit of complex interventions in helping older people to live at home, explained by reduced nursing home admissions rather than death rates. Hospital admissions and falls were also reduced in intervention groups. Benefits were largely restricted to earlier studies, perhaps reflecting general improvements in health and social care for older people. The wealth of high-quality trial evidence endorses the value of preventive strategies to help maintain independence in older people.
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