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Lin FF, Yang WY, Zhou JX, Cao LY, Huang LL. Retrospective Investigation and Research on Fall Events Among Hospitalized Patients in the Rehabilitation Department. Risk Manag Healthc Policy 2024; 17:1069-1078. [PMID: 38699655 PMCID: PMC11063461 DOI: 10.2147/rmhp.s445808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 04/01/2024] [Indexed: 05/05/2024] Open
Abstract
Objective We investigated the clinical characteristics, fall outcomes, and related factors of falls in patients who were hospitalized in the rehabilitation department, and explored strategies to reduce the incidence of falls and prevent falls in patients. Methods Data from 60 patients who fell in the rehabilitation department between 2016 and 2021 were analyzed for clinical characteristics, associated factors, incidence of falls, injuries, and patient demographics. Under the random stratified sampling method, 60 patients who did not fall during the same period were selected as the control group, and relevant data was collected. Measurement data were compared using an independent sample t-test. Enumeration data were compared using chi-squared (χ2) test was employed to compare these data between the two groups. Non-parametric data were analyzed using the Mann-Whitney U-test. Factors potentially influencing falls were scrutinized through both univariate and binary logistic regression analyses. Results The median annual incidence of falls among patients who were hospitalized in the rehabilitation department was 0.04%, while the overall fall injury rate was 60%. Falls were most prevalent within 30 days of hospitalization (71.67%). The most common fall-related condition was craniocerebral disease (83.33%). The incidents of falls location of fall were mainly reported in nearby areas of rehabilitation ward (70%). Most accidents occurred between 7:00 a.m.-12:00 p.m. and 3:01 p.m.-6:00 p.m. (63.33%), and dyskinesia was the most common cause of falls (71.67%). There were 39 patients (65.00%) with Barthel Index (BI) scores ranging between 40-60. Conclusion Patients in the rehabilitation department had a greater incidence of falls and fall injuries. Within 30 days of admission, patients with moderately dependent craniocerebral disorders and dyskinesia frequently experienced falls during typical daytime shifts in areas characterized by endemic conditions.
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Affiliation(s)
- Fang-Fang Lin
- Department of Rehabilitation, Ningde Municipal Hospital Affiliated to Ningde Normal University, Ningde, 352000, People’s Republic of China
| | - Wei-Yuan Yang
- Department of Rehabilitation, Ningde Municipal Hospital Affiliated to Ningde Normal University, Ningde, 352000, People’s Republic of China
| | - Jun-Xiang Zhou
- Department of Rehabilitation, Ningde Municipal Hospital Affiliated to Ningde Normal University, Ningde, 352000, People’s Republic of China
| | - Luo-Yuan Cao
- Department of Central Laboratory, Ningde Municipal Hospital Affiliated to Ningde Normal University, Ningde, 352000, People’s Republic of China
| | - Ling-Ling Huang
- Department of Rehabilitation, Ningde Municipal Hospital Affiliated to Ningde Normal University, Ningde, 352000, People’s Republic of China
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Ong MF, Soh KL, Saimon R, Saidi HI, Tiong IK, Myint WW, Mortell M, Japar S. Predictors of fall protection motivation among older adults in rural communities in a middle-income country: A cross-sectional study using the Protection Motivation Theory. J Adv Nurs 2024. [PMID: 38606809 DOI: 10.1111/jan.16190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 03/14/2024] [Accepted: 03/28/2024] [Indexed: 04/13/2024]
Abstract
AIMS To evaluate factors associated with fall protection motivation to engage in fall preventive behaviour among rural community-dwelling older adults aged 55 and above using the protection motivation theory scale. DESIGN A cross-sectional study. METHODS The study was conducted in a healthcare clinic in Malaysia, using multistage random sampling from November 2021 to January 2022. Three hundred seventy-five older adults aged 55 and older were included in the final analysis. There were 31 items in the final PMT scale. The analysis was performed within the whole population and grouped into 'faller' and 'non-faller', employing IBM SPSS version 26.0 for descriptive, independent t-test, chi-square, bivariate correlation and linear regressions. RESULTS A total of 375 older participants were included in the study. Fallers (n = 82) and non-fallers (n = 293) show statistically significant differences in the characteristics of ethnicity, assistive device users, self-rating of intention and participation in previous fall prevention programmes. The multiple linear regression model revealed fear, coping appraisal and an interaction effect of fear with coping appraisal predicting fall protection motivation among older adults in rural communities. CONCLUSION Findings from this study demonstrated that coping appraisal and fear predict the protection motivation of older adults in rural communities. Older adults without a history of falls and attaining higher education had better responses in coping appraisal, contributing to a reduction in perceived rewards and improving protection motivation. Conversely, older adults from lower education backgrounds tend to have higher non-preventive behaviours, leading to a decline in fall protection motivation. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE These results contribute important information to nurses working with older adults with inadequate health literacy in rural communities, especially when planning and designing fall prevention interventions. The findings would benefit all nurses, healthcare providers, researchers and academicians who provide care for older adults. PATIENT OR PUBLIC CONTRIBUTION Participants were briefed about the study, and their consent was obtained. They were only required to answer the questionnaire through interviews. Older individuals aged fifty-five and above in rural communities at the healthcare clinic who could read, write or understand Malay or English were included. Those who were suffering from mental health problems and refused to participate in the study were excluded from the study. Their personal information remained classified and not recorded in the database during the data entry or analysis.
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Affiliation(s)
- Mei Fong Ong
- Department of Nursing, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Department of Nursing, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia
| | - Kim Lam Soh
- Department of Nursing, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Rosalia Saimon
- Community Medicine and Public Health, Universiti Malaysia Sarawak, Kuching, Sarawak, Malaysia
| | - Hasni Idayu Saidi
- Department of Biomedical Science, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Ing Khieng Tiong
- Department of Geriatric Medicine, Ministry of Health Malaysia, Kuching, Sarawak, Malaysia
| | - Wai Wai Myint
- Medicine and Rehabilitation, Universiti Malaysia Sarawak, Kuching, Sarawak, Malaysia
| | | | - Salimah Japar
- Department of Nursing, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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Ong MF, Soh KL, Saimon R, Tiong IK, Saidi HI, Mortell M. Psychometric evaluation of the Protection Motivation Theory scale in assessing fall protection motivation among older adults to reduce fall risk. BMC Geriatr 2023; 23:703. [PMID: 37904086 PMCID: PMC10617071 DOI: 10.1186/s12877-023-04372-5] [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: 02/08/2023] [Accepted: 10/03/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Protection Motivation Theory could be another potential and good framework that addresses essential elements in a behavioural change leading to positive fall protective behaviours. The positive behavioural change could reduce the risk of falls and improve the quality of life of the older community. The study aims to evaluate the reliability and validity of the culturally adapted Protection Motivation Theory scale for older adults' fall protection motivation or protective behaviours to reduce fall risk. METHODS A cross-sectional study was conducted to establish a psychometric instrument validation. A total of 389 participants aged 55 years and above were included. The study was conducted in Sarawak, Malaysia, from November 2021 to January 2022 in two phases, translation of the PMT Scale, cross-cultural adaptation, face validation and pre-testing of the PMT Scale. The participants were selected using multistage random sampling in a primary healthcare clinic. Data entry and statistical analysis were performed using IBM SPSS version 26 for exploratory factor analysis and SmartPLS version 3.3.7 for confirmatory factor analysis using partial least square structural equation modelling. RESULTS The Kaiser-Meyer-Olkin value was 0.760, Bartlett's sphericity test was significant and the total variance explained was 61%. It identified 31 items within eight dimensions of the Protection Motivation Theory scale. The Higher Order Constructs' measurement model indicates that the convergent and discriminant validity were established (Cronbach's alpha and composite reliability: ≥ 0.740; average variance extracted: 0.619 to 0.935 and Henseler's Heterotrait-Monotrait criterion for all constructs' discriminant validity: < 0.9). Test-retest for the intraclass correlation coefficient was 0.745. The model's coefficient of determination demonstrated R2 = 0.375. CONCLUSION Overall, the Protection Motivation Theory Scale has established its reliability and validity for assisting older adults in the community. The Protection Motivation Theory Scale could be used in fall prevention interventions by promoting fall protective behaviours to reduce fall risk among community-dwelling older adults. The scale could assist healthcare providers in assessing the intention of older adults to use fall protective behaviours to reduce fall risk and serve as an alternative reference in developing fall prevention education in a fall prevention strategy.
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Affiliation(s)
- Mei Fong Ong
- Department of Nursing, Universiti Putra Malaysia, Serdang, Selangor, 43400, Malaysia.
- Department of Nursing, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, 94300, Malaysia.
| | - Kim Lam Soh
- Department of Nursing, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, 94300, Malaysia.
| | - Rosalia Saimon
- Community Medicine and Public Health, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, 94300, Malaysia
| | - Ing Khieng Tiong
- Department of Geriatric Medicine, Institute of Sarawak Heart Centre/Sarawak General Hospital (Ministry of Health Malaysia), Kota Samarahan, Sarawak, 94300, Malaysia
| | - Hasni Idayu Saidi
- Department of Biomedical Science, Universiti Putra Malaysia, Serdang, Selangor, 43400, Malaysia
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Cao YT, Wang JJ, Yang YT, Zhu SJ, Zheng LD, Lu WW, Zhu R, Wu T. Effect of home-based exercise programs with e-devices on falls among community-dwelling older adults: a meta-analysis. J Comp Eff Res 2022; 11:1201-1217. [PMID: 36148921 DOI: 10.2217/cer-2022-0130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To explore the effectiveness of home-based exercise programs with e-devices (HEPEs) on falls among community-dwelling older adults. Methods: Twelve randomized controlled trials were included in the meta-analysis considering four fall-related outcomes. Results: HEPEs significantly reduced the rate of falls (risk ratio: 0.82; 95% CI: 0.72-0.95; p = 0.006) and improved lower extremity strength (mean difference: -0.94; 95% CI: -1.71 to -0.47; p < 0.001). There was a significant improvement favoring HEPEs on balance if the participants were aged >75 years (mean difference: -0.55; 95% CI: -1.05 to -0.05; p = 0.03), or the intervention duration was at least 16 weeks (mean difference: -0.81; 95% CI: -1.58 to -0.05; p = 0.04). Conclusion: HEPEs demonstrated an overall positive effect on falls among community-dwelling older adults.
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Affiliation(s)
- Yu-Ting Cao
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, 200092, China.,Key Laboratory of Spine & Spinal Cord Injury Repair & Regeneration of the Ministry of Education, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Jian-Jie Wang
- Key Laboratory of Spine & Spinal Cord Injury Repair & Regeneration of the Ministry of Education, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Yi-Ting Yang
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, 200092, China.,Key Laboratory of Spine & Spinal Cord Injury Repair & Regeneration of the Ministry of Education, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Shi-Jie Zhu
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, 200092, China.,Key Laboratory of Spine & Spinal Cord Injury Repair & Regeneration of the Ministry of Education, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Liang-Dong Zheng
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, 200092, China.,Key Laboratory of Spine & Spinal Cord Injury Repair & Regeneration of the Ministry of Education, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Wei-Wei Lu
- Zhongshan Hospital, Fudan University, Shanghai, 200030, China
| | - Rui Zhu
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, 200092, China.,Key Laboratory of Spine & Spinal Cord Injury Repair & Regeneration of the Ministry of Education, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Tao Wu
- Shanghai University of Medicine & Health Sciences, Shanghai, 201318, China
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Shaw L, Kiegaldie D, Heng H, Morris ME. Interprofessional education to implement patient falls education in hospitals: Lessons learned. Nurs Open 2022; 10:36-47. [PMID: 35739642 PMCID: PMC9748046 DOI: 10.1002/nop2.1276] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 04/11/2022] [Accepted: 05/27/2022] [Indexed: 01/04/2023] Open
Abstract
AIM The aim of this study was to design, deliver and evaluate an interprofessional education programme for healthcare professionals on how to implement a modified version of the safe recovery programme to prevent falls in hospitalized patients. DESIGN Mixed methods design incorporating pre- and post education surveys and individual semi-structured interviews. METHODS Thirty-four health professional participants attended a 1-h face-to-face or Zoom® interprofessional education session to learn how to deliver an evidence-based patient falls prevention education strategy, the modified Safe Recovery Programme. RESULTS A 1-hour education session was insufficient to build full confidence to deliver the Safe Recovery Programme. There was no statistically significant change in participant views on interprofessional collaboration. Participants recommended prior consultation and preparation before delivery of IPE, with additional opportunities for discussion and feedback during implementation with patients. The findings highlight the importance of interprofessional education for evidence-based interventions in hospitals. Health professionals value education that is timely, interactive, realistic and engaging.
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Affiliation(s)
- Louise Shaw
- Faculty of Health Science, Youth and Community StudiesHolmesglen InstituteMoorabbinVictoriaAustralia,School of Allied Health, Human Services and SportLa Trobe UniversityBundooraVictoriaAustralia
| | - Debra Kiegaldie
- Faculty of Health Science, Youth and Community StudiesHolmesglen InstituteMoorabbinVictoriaAustralia,Eastern Health Clinical SchoolMonash UniversityMelbourneVictoriaAustralia,HealthscopeHolmesglen Private HospitalMoorabbinVictoriaAustralia
| | - Hazel Heng
- Academic and Research Collaborative in HealthLa Trobe UniversityBundooraVictoriaAustralia,Northern HealthEppingVictoriaAustralia
| | - Meg. E. Morris
- Academic and Research Collaborative in HealthLa Trobe UniversityBundooraVictoriaAustralia,Victorian Rehabilitation CentreGlen WaverlyVictoriaAustralia,College of Healthcare SciencesJames Cook UniversityDouglasQueenslandAustralia
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