scholarly journals 136 Barriers to Discussing Fall Prevention with Healthcare Professionals amongst Community-Dwelling Singaporean Older Adults

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv28-iv33
Author(s):  
Nivedha Balachandar ◽  
Silvia Sim ◽  
Pey June Tan ◽  
Jagadish Mallya ◽  
Noor Hafizah Ismail ◽  
...  
Keyword(s):  
Older Adults ◽  
Fall Prevention ◽  
Fall Risk ◽  
Healthcare Professionals ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Cross Sectional Survey ◽  
Chi Square ◽  
Cross Sectional ◽  
Modifiable Factors

Abstract Introduction A multitude of modifiable factors can contribute to one’s fall risk. Healthcare professionals (HCP) are equipped to identify such factors, and make appropriate recommendations to help older adults prevent falls. However, there is limited evidence on the awareness and practice of this in Asian communities. Thus, this paper aims to understand the participation and barriers for community-dwelling Singaporeans to discuss falls with their HCPs. Methods A cross-sectional survey was conducted on a nationally-representative sample of Singaporeans aged ≥60 living in the community. Participants were asked if they have fallen in the past 12 months, if they discussed what they can do to avoid falls with their HCPs (doctor/nurse) and for their perceived barriers via a semi-structured questionnaire with multiple responses. Unstructured data was coded using content analysis by two researchers and pooled with structured data. Sub-group differences between fallers and non-fallers were anaylsed using chi square tests. Results Of 549 participants (70.6±6.9 years and 61% female), most (n=447, 81%) have never talked to their HCPs. More fallers discussed falls prevention with HCPs than non-fallers (p=0.037). The top barriers cited for discussing falls with HCPs – low perception of fall risk (55%) and misconceptions regarding falls and/or HCPs (29%) – were more prevalent amongst non-fallers (p=0.008) and fallers (p<0.001) respectively. Other barriers identified include competing priorities (8%) and actively taking alternate management to mitigate falls risk (4%). Discussion Fallers and non-fallers have different reasons behind not discussing falls with HCPs. Findings indicate that despite having higher fall risk, fallers may still not talk to HCPs as they are either unaware that fall risk can be mitigated, or of HCP’s role in fall prevention. Future studies should address fallers’ knowledge and attitudes to improve their participation in interventions in the community, and investigate health practitioners’ readiness to address concerns about falls.

scholarly journals EXPERIENCES AND FACILITATORS OF FALLS PREVENTION AMONG ETHNICALLY DIVERSE OLDER ADULTS: A QUALITATIVE STUDY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S854-S854
Author(s):  
Ladda Thiamwong ◽  
Norma E Conner
Keyword(s):  
Older Adults ◽  
Fall Prevention ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Ethnically Diverse ◽  
Role Identity ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Facilitators And Barriers ◽  
And Behaviors

Abstract Background: Falls increase as people age and decrease the quality of life. Even though fall interventions have received great attention, fall incidence rates have still arisen. In order for older adults to reap the benefits of evidence-based fall interventions, a challenge of implementation in the real world and right context must be met. Understanding experiences, facilitators, and barriers of fall prevention among four major ethnic groups in the Unites States could be extremely valuable. Objective: The aim of this study was to describe experiences and highlight facilitators and barriers on fall and fear of falling interventions among ethnically diverse community-dwelling older adults. Methods: Four ethnically specified (African American, Asian, Hispanic and Non-Hispanic White) focus groups were conducted. A total of 28 older adults and four family caregivers were interviewed. Interviews covered experiences on falls and fear of falling, attitudes, factors, consequences, risk assessment, and interventions. Data were organized and analyzed with the NViVo software. Results: Falls related experiences and behaviors were multifaceted and varied. Three themes related to falls experiences and behaviors were identified, 1) falls prevention versus fear of falling amplification; 2) role identity, culture and family considerations; and 3) take care of you, take care of me. Facilitators of fall prevention were integration of individual learning within a group meeting, providing appropriate assistive devices and promoting environmental safety. Barriers were inconsistent fall risk assessments, low fall risk awareness and acknowledgment, and balance and visual impairment.

Falls Risks and Prevention Behaviors Among Community-Dwelling Homebound and Non-Homebound Older Adults

2016 ◽  
Vol 37 (9) ◽  
pp. 1085-1106 ◽  
Author(s):  
Carri Casteel ◽  
Jennifer Jones ◽  
Paula Gildner ◽  
James M. Bowling ◽  
Susan J. Blalock
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Negative Binomial ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Falls Risk ◽  
Homebound Older Adults ◽  
Risk Factors For Falls

The objectives were to examine falls risk factors to determine how the magnitude of risk may differ between homebound and non-homebound older adults, and to describe falls prevention behaviors and participation in falls prevention education. A cross-sectional survey was conducted with convenience samples of community-dwelling older adults recruited through Meals on Wheels programs (homebound, n = 80) and senior centers (non-homebound, n = 84) in North Carolina. Data were collected during home visits and included an interview and medication inventory. Multivariate negative binomial regression with robust variance estimation modeled risk factors for falls. Risk factors for falls observed in both the homebound and non-homebound populations are consistent with what is known in the literature. However, the magnitude of the risk was higher in the homebound than in the non-homebound population with respect to vision impairments, number of high-risk and over-the-counter medications, and use of walking aids .Few participants reported participating in a falls prevention program.

scholarly journals The Association of Falls with Instability: An Analysis of Perceptions and Expectations toward the Use of Fall Detection Devices Among Older Adults in Malaysia

2021 ◽  
Vol 9 ◽  
Author(s):  
Kawthar Abdul Rahman ◽  
Siti Anom Ahmad ◽  
Azura Che Soh ◽  
Asmidawati Ashari ◽  
Chikamune Wada ◽  
...  
Keyword(s):  
Older Adults ◽  
Descriptive Analysis ◽  
Fall Detection ◽  
Community Dwelling ◽  
Cross Sectional Survey ◽  
Chi Square ◽  
Cross Sectional ◽  
Quantitative Descriptive Analysis ◽  
Perceptions And Expectations ◽  
Community Dwelling Older Adults

Background: Falls are a significant incident among older adults affecting one in every three individuals aged 65 and over. Fall risk increases with age and other factors, namely instability. Recent studies on the use of fall detection devices in the Malaysian community are scarce, despite the necessity to use them. Therefore, this study aimed to investigate the association between the prevalence of falls with instability. This study also presents a survey that explores older adults' perceptions and expectations toward fall detection devices.Methods: A cross-sectional survey was conducted involving 336 community-dwelling older adults aged 50 years and older; based on randomly selected participants. Data were analyzed using quantitative descriptive analysis. Chi-square test was conducted to investigate the associations between self-reported falls with instability, demographic and walking characteristics. Additionally, older adults' perceptions and expectations concerning the use of fall detection devices in their daily lives were explored.Results: The prevalence of falls was 28.9%, where one-quarter of older adults fell at least once in the past 6 months. Participants aged 70 years and older have a higher fall percentage than other groups. The prevalence of falls was significantly associated with instability, age, and walking characteristics. Around 70% of the participants reported having instability issues, of which over half of them fell at least once within 6 months. Almost 65% of the participants have a definite interest in using a fall detection device. Survey results revealed that the most expected features for a fall detection device include: user-friendly, followed by affordably priced, and accurate.Conclusions: The prevalence of falls in community-dwelling older adults is significantly associated with instability. Positive perceptions and informative expectations will be used to develop an enhanced fall detection incorporating balance monitoring system. Our findings demonstrate the need to extend the fall detection device features aiming for fall prevention intervention.

scholarly journals 111 Disparities between Actual and Perceived Fall Risk Affect Participation in 5 Fall Prevention Interventions

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv18-iv27
Author(s):  
Pey June Tan ◽  
Silvia Sim ◽  
Noor Hafizah Ismail ◽  
Jagadish Mallya ◽  
Angelique Chan ◽  
...  
Keyword(s):  
Older Adults ◽  
Fall Prevention ◽  
Fall Risk ◽  
Help Seeking ◽  
Fear Of Falling ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Risk Level ◽  
Prevention Interventions ◽  
Aware Group

Abstract Introduction Older adults have been found to under- or overestimate their fall risk. However, no studies have investigated implications on help-seeking behaviours in falls prevention. This study examines how disparities between actual and perceived fall risk affects participation in 5 fall prevention interventions among community-dwelling older adults in Singapore. Methods This was a cross-sectional survey of a nationally representative sample of community-dwelling adults aged ≥60 years in Singapore identified by stratified random sampling. Having previous falls in the past 12 months (faller/non-faller) indicated actual fall risk. Level of fear-of-falling (cut-off ≥23 on 16-item Falls Efficacy Scale International) was used as perceived fall risk (high/low). Four profiles based on combinations of actual and perceived risk were associated with participation in 5 fall prevention interventions in a multiple logistic regression. The model was adjusted for age, gender, ≥2 comorbidities and knowledge that the intervention is to prevent falls. Results Final analysis included 549 older adults (mean age 70.6±6.9 years, 61% females). Majority (46%) were in the Vigorous group (no falls, low fear), 35% Anxious (no falls, high fear), 11% Frail Aware (falls, high fear) and 8% Stoics (falls, low fear). Only those in Anxious and Frail Aware group were significantly more likely to have talked to a healthcare professional on strategies to avoid falls [OR 1.8 (1.1-3.1) and 3.2 (1.6-6.4) respectively] and made home modifications [OR 1.9 (1.3-2.8) and 2.0 (1.1-3.6)] after adjustments. No association was found for participation in exercise, medication review and falls education. Discussion Individual profiles with high fear-of-falling component have different help-seeking behaviours compared to those with low fear regardless of history of falls. However, individuals in Frail Aware group have higher likelihood to uptake the interventions compared to Anxious group. Future research should examine other drivers of behaviour that will influence participation in other interventions.

scholarly journals Understanding Falls in Multiple Sclerosis: Association of Mobility Status, Concerns About Falling, and Accumulated Impairments

2012 ◽  
Vol 92 (3) ◽  
pp. 407-415 ◽  
Author(s):  
Patricia Noritake Matsuda ◽  
Anne Shumway-Cook ◽  
Marcia A. Ciol ◽  
Charles H. Bombardier ◽  
Deborah A. Kartin
Keyword(s):  
Multiple Sclerosis ◽  
Fall Risk ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Health Concern ◽  
Cross Sectional Survey ◽  
Chi Square ◽  
Cross Sectional ◽  
Mobility Function ◽  
Activity Restrictions

Background Falls in people with multiple sclerosis (MS) are a serious health concern, and the percentage of people who restrict their activity because of concerns about falling (CAF) is not known. Mobility function and accumulated impairments are associated with fall risk in older adults but not in people with stroke and have not been studied in people with MS. Objective The purposes of this study were: (1) to estimate the percentage of people who have MS and report falling, CAF, and activity restrictions related to CAF; (2) to examine associations of these factors with fall status; and (3) to explore associations of fall status with mobility function and number of accumulated impairments. Design A cross-sectional survey was conducted. Methods A total of 575 community-dwelling people with MS provided information about sociodemographics, falls, CAF, activity restrictions related to CAF, mobility function, and accumulated impairments. Chi-square statistics were used to explore associations among these factors. Results In all participants, about 62% reported CAF and about 67% reported activity restrictions related to CAF. In participants who did not experience falls, 25.9% reported CAF and 27.7% reported activity restrictions related to CAF. Mobility function was associated with fall status; participants reporting moderate mobility restrictions reported the highest percentage of falls, and participants who were nonwalkers (ie, had severely limited self-mobility) reported the lowest percentage. Falls were associated with accumulated impairments; the participants who reported the highest percentage of 2 or more falls were those with 10 impairments. Limitations This cross-sectional study relied on self-reported falls, mobility, and impairment status, which were not objectively verified. Conclusions Both CAF and activity restrictions related to CAF were common in people with MS and were reported by people who experienced falls and those who did not. The association of fall status with mobility function did not appear to be linear. Fall risk increased with declining mobility function; however, at a certain threshold, further declines in mobility function were associated with fewer falls, possibly because of reduced fall risk exposure.

Oscillation between identities and Subjective psychological health objectives among an informed audience in therapeutic patient education

2018 ◽  
Vol 10 (1) ◽  
pp. 10202
Author(s):  
Sandrine Roussel ◽  
Alain Deccache ◽  
Mariane Frenay
Keyword(s):  
Patient Education ◽  
Psychological Health ◽  
Healthcare Professionals ◽  
Cross Sectional Survey ◽  
Chi Square ◽  
Cross Sectional ◽  
Therapeutic Patient Education ◽  
French Speaking ◽  
Health Objectives ◽  
Self Administered Questionnaire

Introduction: The implementation of Therapeutic Patient Education (TPE) remains a challenge. An exploratory study highlighted two tendencies among practitioners of TPE, which could hamper this implementation: an oscillation between identities (as caregivers versus as educators) and an inclination towards subjective psychological health objectives. Objectives: To verify whether these tendencies can be observed among an informed audience in TPE. Next, to explore the variables associated with one or other of these tendencies. Method: A quantitative cross-sectional survey by a self-administered questionnaire was carried out among 90 French-speaking healthcare professionals. Statistical analyses (chi-square, logistic regression) were then conducted. Results: Sixty percent of respondents displayed identity oscillation, which was found to be linked to task oscillation, patient curability, scepticism towards medicine and practising in France. Fifty-six percent pursued subjective psychological health objectives, which was found to be associated with health behaviour objectives and a locus of power in the healthcare relationship distinct from those seen in the pre-existing health models (biomedical, global). This tendency seems to constitute an alternative model of TPE. Discussion & conclusion: Identity oscillation and subjective psychological health objectives can be both observed. This study stresses the need to deliberate on the form(s) of TPE that is/are desired.

scholarly journals Religiosity and self-rated health among older adults in Colombia

2019 ◽  
pp. 67-76
Author(s):  
Carlos A Reyes Ortiz ◽  
Claudia Payan ◽  
Geraldine Altamar ◽  
Jose F Gomez Montes ◽  
Harold G Koenig
Keyword(s):  
Older Adults ◽  
Rural Areas ◽  
Community Dwelling ◽  
Cross Sectional Survey ◽  
Significant Interaction Effect ◽  
Cross Sectional ◽  
Self Rated Health ◽  
Urban And Rural Areas ◽  
Fair Poor ◽  
The Relationship

Objective: To identify the relationship between religiosity and self-rated health among older adults in Colombia. Methods: Data are drawn from the SABE (Salud, Bienestar y Envejecimiento) Colombia Study, a cross-sectional survey conducted in 2015 involving 18,871 community-dwelling adults aged 60 years and older living in urban and rural areas of Colombia. Religiosity was assessed by self-rated religiosity (how religious are you: not at all, somewhat or very). Self-rated health during previous 30 days was assessed as very good, good, fair, poor or very poor, analyzed as an ordinal variable(1-5) using weighted logistic regression, adjusting for confounders. Results: Those who were more religious were older, female, had lower socioeconomic status, and were more likely to be married. Multivariate analyses demonstrated that older adults who were more religious had better self-rated health (OR 0.92 95% CI 0.86- 0.99, p= 0.038); however, there was a significant interaction effect between gender and religiosity on self-rated health (p= 0.002), such that the relationship between religiosity and health was stronger in men (OR 0.86, 95% CI: 0.79-0.94, p= 0.001) but not significant in women. Conclusion: Older adults in Colombia who consider themselves more religious, especially men, are less likely to perceive their physical health as poor compared to those who are less religious.

scholarly journals Irish occupational therapists use of evidenced-based falls prevention programmes

2019 ◽  
Vol 48 (1) ◽  
pp. 17-30 ◽  
Author(s):  
Kim Lombard ◽  
Laura Desmond ◽  
Ciara Phelan ◽  
Joan Brangan
Keyword(s):  
Older Adults ◽  
Occupational Therapists ◽  
Exercise Programme ◽  
Falls Prevention ◽  
Evidence Based ◽  
Snowball Sampling ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Content Type ◽  
Prevention Programmes

Purpose As one ages, the risk of experiencing a fall increases and poses a number of serious consequences; 30 per cent of individuals over 65 years of age fall each year. Evidence-based falls prevention programmes demonstrate efficacy in reducing the rate and risk of falls among older adults, but their use in Irish occupational therapy practice is unknown. This study aims to investigate the implementation of falls prevention programmes by occupational therapists working with older adults in Ireland. Design/methodology/approach A cross-sectional survey was used to gather data on the use of falls prevention programmes among occupational therapists working with older adults in any clinical setting across Ireland. Purposeful, convenience and snowball sampling methods were used. The Association of Occupational Therapists of Ireland acted as a gatekeeper. Descriptive statistics and summative content analysis were used to analyse quantitative and qualitative data, respectively. Findings In all, 85 survey responses were analysed. Over 85 per cent of respondents reported “Never” using any of the evidence-based falls prevention programmes. The “OTAGO” Exercise Programme was the most “Frequently” used programme (9.5 per cent, n = 7); 29 respondents reported using “in-department” developed falls prevention programmes and 14 provided additional comments regarding current falls prevention practices in Ireland. Originality/value In the absence of Irish data on the subject, this study provides a benchmark to describe the use of evidence-based falls programmes by Irish occupational therapists with older adults.

Oncologists’ perspectives on medical marijuana for the elderly.

2019 ◽  
Vol 37 (31_suppl) ◽  
pp. 78-78
Author(s):  
Desiree Rachel Azizoddin ◽  
Andrea Catherine Enzinger ◽  
Alexi A. Wright ◽  
Miryam Yusufov ◽  
Fangxin Hong ◽  
...  
Keyword(s):  
Older Adults ◽  
Cancer Patients ◽  
Medical Marijuana ◽  
The Elderly ◽  
Cross Sectional Survey ◽  
Chi Square ◽  
Cross Sectional ◽  
Elderly Cancer Patients ◽  
Treatment Side Effects ◽  
Nationally Representative

78 Background: Cancer patients are increasingly using medical marijuana (MM) to manage symptoms and treatment side effects. Although cancer disproportionately affects the elderly, little is known about oncologists’ attitudes toward MM in this population. We surveyed US oncologists’ beliefs about the benefits of MM for older adults, and examined their associations with oncologists’ perceptions of MM efficacy and safety. Methods: 232 out of 400 randomly selected U.S. oncologists (63% response rate) completed a cross-sectional survey about their beliefs and recommendations regarding MM for cancer patients. Using Chi-square tests, we examined associations between oncologists’ demographics, their perceptions of geriatric MM use, as well as beliefs about comparative effectiveness of MM for cancer related symptoms, and comparative risks of MM to prescription opioids. Results: Among 232 oncologists included in this cohort, 109 (47.0%) reported that MM had at least some benefit for elderly cancer patients, 66 (28.4%) responded it was rarely or never beneficial, and 57 (24.6%) reported not knowing. There were no significant associations between oncologists’ beliefs about MM’s benefit for older adults and their sociodemographic characteristics. Those who believed MM was beneficial for the elderly were significantly more likely to report that MM was at least as effective as standard treatments for the following indications: coping (58.3% vs. 26.6%), appetite (83.3% vs 58.5%), depression (46.3% vs 25.0%), and nausea (66.7% vs 33.9%), respectively ( p < 0.001). In contrast, oncologists’ beliefs about MM for the elderly were not significantly associated with perceptions of the comparative risks of MM ( p > 0.05). Conclusions: In this nationally-representative sample of US oncologists, about half thought MM was beneficial for older adults with cancer. Oncologists’ support of MM for older adults was associated with perceptions of MM’s efficacy but was not associated with perceptions of MM’s risks. More research is needed regarding the safety and efficacy of MM to guide oncologists’ recommendations about its use in older adults.

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