Conectar
The purpose of this study was to describe the strategies older adults use to maintain their balance and prevent themselves from falling in the hospital.
The Expanded Health Belief Model served as the theoretical framework for this qualitative descriptive study.
Audio-recorded, semi-structured interviews were conducted with 15 (N = 15) older adults (female 53.3%), mean age of 77 (SD 9.9) admitted to a rural community hospital in the United States. Each transcript was analysed independently by two researchers using content analysis before reaching consensus. Sample size was guided by thematic saturation. Trustworthiness was ensured by using the criteria outlined by Lincoln and Guba.
Four main themes emerged: My Balance Problem is My Personal Responsibility, Self-efficacious Common-Sense Balance Management Strategies, Hospital Staff as Contributors or Disruptors of My Balance Management, and My Needs for Balance Management Support. The older adults used extensive mental efforts in planning and executing personal strategies to maintain balance and viewed this as their personal responsibility. Their self-efficacious balance management strategies included observing the environment, assessing furniture and equipment, staying focused, and moving slowly. Assistance from hospital staff members either supported or disrupted the older adults' balance management efforts. The older adults desired to learn more about fall prevention in the hospital. The older adults found physical guidance, demonstration and verbal guidance to be the preferred method of learning.
Rurally hospitalised older adults employ independent, self-efficacious balance management strategies.
Older adults' personal balance management strategies must be recognised by healthcare workers.
Future inpatient fall prevention interventions and policies must focus on exploring hospitalised older adults' optimal and suboptimal balance management behaviours to develop patient-centred fall prevention interventions to decrease inpatient falls among older adults.
The Consolidated Criteria for Reporting Qualitative Research.
No patient or public contribution.
To examine how perceived balance problems are associated with self-reported falls in the past month after controlling for known correlates of falls among older adults.
Approximately 30% of adults age 65 and older fall each year. Most accidental falls are preventable, and older adults' engagement in fall prevention is imperative. Limited research suggest that older adults do not use the term ‘fall risk’ to describe their risk for falls. Instead, they commonly use the term ‘balance problems’. Yet, commonly used fall risk assessment tools in both primary and acute care do not assess older adults' perceived balance.
The Health Belief Model and the concept of perceived susceptibility served as the theoretical framework. A retrospective, cross-sectional secondary analysis using data from the National Health and Aging Trends Study from year 2015 was conducted. The outcome variable was self-reported falls in the last month.
A subsample of independently living participants (N = 7499) was selected, and 10.3% of the sample reported a fall. Multiple logistic regression analysis revealed that the odds of reporting a fall in the past month was 3.4 times (p < .001) greater for participants who self-reported having a balance problem compared to those who did not. In contrast, fear of falling and perceived memory problems were not uniquely associated with falls. Using a mobility device, reporting pain, poor self-rated health status, depression and anxiety scores were also associated with falling.
Older adults' perceived balance problem is strongly associated with their fall risk. Perceived balance may be important to discuss with older adults to increase identification of fall risk. Older adults' perceived balance should be included in nursing fall risk assessments and fall prevention interventions. A focus on balance may increase older adults' engagement in fall prevention.
FreshRSS 