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Hill AM, Vaz S, Francis-Coad J, Flicker L, Morris ME, Weselman T. 'You Just Struggle on Your Own': Exploring Older People and Their Caregivers' Perspectives About Falls Prevention Education in Hospitals. Int J Older People Nurs 2024; 19:e12628. [PMID: 38995867 DOI: 10.1111/opn.12628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 05/15/2024] [Accepted: 06/07/2024] [Indexed: 07/14/2024]
Abstract
BACKGROUND Providing older patients with an opportunity to participate in individualised falls preventive education, has been shown to reduce hospital falls. However, few studies have explored older peoples' perspectives of hospital falls prevention education. This study aimed to explore older people and their caregivers' knowledge and awareness about hospital falls prevention, including their reflections on the education they received when hospitalised. METHODS A qualitative, exploratory study with focus groups and semistructured interviews was conducted. Participants were a purposively selected sample of community-dwelling older people (65+ years) admitted to a hospital in the past 5 years and caregivers of older people. Data were thematically analysed using deductive and inductive approaches, and a capability-opportunity-motivation-behaviour model was applied to understand key determinants of implementing falls education for hospitalised older people. RESULTS Participants' [n = 46 (older people n = 37, age range 60-89 years), caregivers n = 9] feedback identified five themes: distress and disempowerment if the participant did have a hospital fall or nearly fell, anxiety and uncertainty about what behaviour was required while in hospital, insufficient and inconsistent falls prevention education, inadequate communication and underlying attitudes of ageism. Applying a behaviour change model suggested that older people and their caregivers did not develop falls prevention knowledge, awareness or motivation to engage in falls prevention behaviour. Older people were also provided with limited opportunities to engage in falls preventive behaviour while in hospital. CONCLUSION Older people in our study received sporadic education about falls prevention during their hospital admissions which did not raise their awareness and knowledge about the risk of falls or their capability to engage in safe falls preventive behaviour. Conflicting messages may result in older people feeling confused and anxious about staying safe in hospital.
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Affiliation(s)
- Anne-Marie Hill
- School of Allied Health, WA Centre for Health & Ageing, University of Western Australia, Crawley, Western Australia, Australia
| | - Sharmila Vaz
- School of Allied Health, WA Centre for Health & Ageing, University of Western Australia, Crawley, Western Australia, Australia
- Murdoch University, Murdoch, Western Australia, Australia
| | - Jacqueline Francis-Coad
- School of Allied Health, WA Centre for Health & Ageing, University of Western Australia, Crawley, Western Australia, Australia
| | - Leon Flicker
- School of Allied Health, WA Centre for Health & Ageing, University of Western Australia, Crawley, Western Australia, Australia
| | - Meg E Morris
- Academic and Research Collaborative in Health (ARCH), La Trobe University, Melbourne, Victoria, Australia
- Victorian Rehabilitation Centre, Healthscope, Melbourne, Victoria, Australia
| | - Tammy Weselman
- School of Allied Health, WA Centre for Health & Ageing, University of Western Australia, Crawley, Western Australia, Australia
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van Sambeek J, Metzelthin S, Zwakhalen S, Vluggen S. Identifying personal beliefs of nursing staff about encouraging psychogeriatric nursing home residents in daily activities: A qualitative study. Nurs Open 2023; 10:2229-2239. [PMID: 36397286 PMCID: PMC10006583 DOI: 10.1002/nop2.1473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 10/14/2022] [Accepted: 10/22/2022] [Indexed: 11/21/2022] Open
Abstract
AIM To identify personal beliefs of Dutch nursing staff about encouraging psychogeriatric nursing home residents in daily activities. DESIGN Qualitative study following COREQ guidelines. METHODS Fifteen semi-structured interviews with Dutch nursing staff of wards hosting psychogeriatric residents were conducted in Spring 2021. Data were systematically analysed through deductive coding analysis in NVivo. RESULTS Most nurses indicated to encourage residents frequently to perform activities independently, although many also indicated to take over tasks habitually. Nurses seemed to show sufficient awareness, reflected by adequate knowledge of what encouraging residents entailed and insight in the risks of not encouraging residents. Nurses' motivation to encourage residents seemed high, reflected by expressing multiple advantageous and few disadvantageous beliefs and a high willingness to encourage residents. Managerial support was perceived ambiguous. Self-efficacy was perceived high, although little time, staffing shortages and resistance of residents reduced self-efficacy. Nurses were often unable to anticipate such situations and expressed the need of skills, e.g. patience.
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Affiliation(s)
- Joyce van Sambeek
- Department of Health Services ResearchCare and Public Health Research InstituteMaastricht UniversityMaastrichtThe Netherlands
| | - Silke Metzelthin
- Department of Health Services ResearchCare and Public Health Research InstituteMaastricht UniversityMaastrichtThe Netherlands
- Living Lab in Aging and Long‐Term CareMaastrichtThe Netherlands
| | - Sandra Zwakhalen
- Department of Health Services ResearchCare and Public Health Research InstituteMaastricht UniversityMaastrichtThe Netherlands
- Living Lab in Aging and Long‐Term CareMaastrichtThe Netherlands
| | - Stan Vluggen
- Department of Health Services ResearchCare and Public Health Research InstituteMaastricht UniversityMaastrichtThe Netherlands
- Living Lab in Aging and Long‐Term CareMaastrichtThe Netherlands
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Redley B, Taylor N, Hutchinson AM. Barriers and enablers to nurses' use of harm prevention strategies for older patients in hospital: A cross-sectional survey. J Adv Nurs 2022; 78:3710-3720. [PMID: 35451523 PMCID: PMC9790359 DOI: 10.1111/jan.15269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 03/22/2022] [Accepted: 04/02/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Preventable harms during hospitalization pose a major challenge for health systems globally. Nurse-led strategies provide comprehensive harm prevention to keep the most vulnerable patients safe in hospital, but gaps in care are common. Nursing roles and activities to prevent harm to patients during acute hospitalization are poorly understood. AIM The aim of this study was to identify nurses' perceived enablers and barriers to the implementation of comprehensive harm prevention for older people admitted to an acute hospital setting. DESIGN Anonymous, online, cross-sectional survey. METHODS The adapted Influences on Patient Safety Behaviours Questionnaire (IPSBQ) was used to collect data from nurses working on five general medicine wards across three hospitals of a single tertiary health service in Australia in 2019. Participants also rated their perceptions of overall quality of care, missed care and awareness of strategies for an eight-factor framework for comprehensive harm prevention. The STROBE reporting checklist was used. RESULTS Ward response rates between 35% and 58% resulted in 132 complete questionnaires for analyses. High mean scores for behavioural regulation (3.28), beliefs about capabilities (2.96) and environmental context and resources (2.73) indicated these domains were perceived by nurses as enablers. Low mean scores for the domains of intentions (1.65), beliefs about consequences (1.69), optimism (1.72) and professional role and identity (1.85) indicated these were barriers to comprehensive harm prevention by nurses. High perceived quality of care (scored 9-10/10) (p = .024), and awareness of strategies for the eight-factor framework (p = .019) were significant enablers of comprehensive harm prevention. CONCLUSION Targeted evidence-based strategies that include education, persuasion, incentivization, coercion and modelling would be most useful for promoting comprehensive harm prevention by nurses. However, to be most effective the harm prevention strategy may need to be tailored for each ward.
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Affiliation(s)
- Bernice Redley
- School of Nursing and Midwifery and Centre for Quality and Patient Safety, Institute for Health TransformationDeakin UniversityBurwoodVictoriaAustralia
| | - Natalie Taylor
- Implementation Science and Health Systems, School of Population HealthUniversity of New South WalesSydneyNSWAustralia
| | - Alison M. Hutchinson
- School of Nursing and Midwifery and Centre for Quality and Patient Safety, Institute for Health TransformationDeakin UniversityBurwoodVictoriaAustralia
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Frederiksen KO, Nørgaard B, Bruun IH. How to Improve Hospitalized Older Adults’ Activity Level: A Mixed Methods Study. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2022. [DOI: 10.1080/02703181.2022.2121884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
| | - Birgitte Nørgaard
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Inge Hansen Bruun
- Department of Physical and Occupational Therapy, Lillebaelt Hospital, Kolding, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Bruun IH, Frederiksen KO, Nørgaard B. Attendance of Physical and Occupational Therapists Improves Older Hospitalized Adults’ Activity Levels. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2022. [DOI: 10.1080/02703181.2022.2116523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Inge Hansen Bruun
- Department of Physical and Occupational Therapy, Lillebaelt Hospital, Kolding, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | | | - Birgitte Nørgaard
- Department of Public Health, University of Southern Denmark, Odense, Denmark
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Dahlke S, Hunter KF, Fox MT, Davidson S, Perry N, Watts LT, Martin LS, Butler JI, Raymond C, Chasteen AL, McCleary L, Boscart V, Moody E. Awakening Canadians to ageism: a study protocol. BMC Nurs 2021; 20:192. [PMID: 34627234 PMCID: PMC8502289 DOI: 10.1186/s12912-021-00713-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/24/2021] [Indexed: 12/02/2022] Open
Abstract
Background Making fun of growing older is considered socially acceptable, yet ageist humour reinforces negative stereotypes that growing old is linked with physical and mental deterioration, dependence, and less social value. Such stereotypes and discrimination affect the wellbeing of older people, the largest demographic of Canadians. While ageism extends throughout professions and social institutions, we expect nurses—the largest and most trusted group of healthcare professionals—to provide non-ageist care to older people. Unfortunately, nurses working with older people often embrace ageist beliefs and nursing education programs do not address sufficient anti-ageism content despite gerontological nursing standards and competencies. Methods To raise awareness of ageism in Canada, this quasi-experimental study will be supported by partnerships between older Canadians, advocacy organizations, and academic gerontological experts which will serve as an advisory group. The study, guided by social learning theory, will unfold in two parts. In Phase 1, we will use student nurses as a test case to determine if negative stereotypes and ageist perceptions can be addressed through three innovative e-learning activities. The activities employ gamification, videos, and simulations to: (1) provide accurate general information about older people, (2) model management of responsive behaviours in older people with cognitive impairment, and (3) dispel negative stereotypes about older people as dependent and incontinent. In Phase 2, the test case findings will be shared with the advisory group to develop a range of knowledge mobilization strategies to dispel ageism among healthcare professionals and the public. We will implement key short term strategies. Discussion Findings will generate knowledge on the effectiveness of the e-learning activities in improving student nurses’ perceptions about older people. The e-learning learning activities will help student nurses acquire much-needed gerontological knowledge and skills. The strength of this project is in its plan to engage a wide array of stakeholders who will mobilize the phase I findings and advocate for positive perspectives and accurate knowledge about aging—older Canadians, partner organizations (Canadian Gerontological Nurses Association, CanAge, AgeWell), and gerontological experts.
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Affiliation(s)
- Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405 - 87 Ave NW, Edmonton, AB, T6G 1C9, Canada.
| | - Kathleen F Hunter
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405 - 87 Ave NW, Edmonton, AB, T6G 1C9, Canada
| | - Mary T Fox
- School of Nursing, Faculty of Health, York University Centre for Aging Research and Education, HNES suite 343, 4700 Keele St, Toronto, ON, M3J 1P3, Canada
| | - Sandra Davidson
- Faculty of Nursing, University of Calgary, 2800 University Way N.W., 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Nicole Perry
- National Programs, HelpAge Canada, 1300 Carling Avenue, Ottawa, ON, K1Z 7L2, Canada
| | - Laura Tamblyn Watts
- CanAge, Factor - Inwentash Faculty of Social Work, University of Toronto 246 Bloor St West, Toronto ON M5S 1V4, Toronto, ON, M5S 1V4, Canada
| | - Lori Schindel Martin
- Canadian Gerontological Nursing Association, PO Box 64009, Royal Bank Plaza, Toronto, ON, M5J 2T6, Canada
| | - Jeffrey I Butler
- School of Nursing, York University Centre for Aging Research and Education, Faculty of Health, York University; Faculty of Nursing, University of Alberta, HNES suite B05, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Christy Raymond
- Faculty of Nursing, MacEwan University, 5-111C, Robbins Health Learning Centre, 10910-104 Ave NW, Edmonton, AB, T5J 4S2, Canada
| | - Alison L Chasteen
- Department of Psychology, University of Toronto, 100 St. George Street, Toronto, ON, M5S 3G3, Canada
| | - Lynn McCleary
- Faculty of Applied Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON, L2S 3A1, Canada
| | - Veronique Boscart
- School of Health and Life Sciences, Conestoga College Institute of Technology and Advanced Learning, 299 Doon Valley Drive, Kitchener, ON, N2G 4M4, Canada
| | - Elaine Moody
- School of Nursing, Dalhousie University, Room N19 Forrest Bldg., Dalhousie University, University Avenue, PO Box 15000 5869, Halifax, NS, B3H 4R, Canada
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