Experiences of general practitioners, home care nurses, physiotherapists and seniors involved in a multidisciplinary home-based fall prevention programme: a mixed method study

ObjectiveOlder adults with vision impairment currently have no access to tailored fall prevention programmes. Therefore, the purpose of this study, nested within an ongoing randomised controlled trial (RCT), is to document the adaptation of an existing fall prevention programme and investigate the perspectives of instructors involved in delivery and the older adults with vision impairment receiving the programme (recipients).DesignWe documented programme adaptations and training requirements, and conducted semistructured, individual interviews with both the instructors and the recipients of the programme from 2017 to 2019. The content of each interview was analysed using behaviour change theory through deductive qualitative analysis.SettingNew South Wales and Australian Capital Territory, Australia.ParticipantsThe 11 trained instructors interviewed were employees of a vision rehabilitation organisation and had delivered at least one programme session as part of the RCT. The 154 recipients interviewed were community-dwelling adults aged ≥50 years with vision impairment and no diagnosis of dementia, and had completed their participation in the programme as part of the intervention group of the RCT.ResultsSix key themes were identified relating to recipient (delivery aptitude, social norms, habit formation) and instructor (individualised adaptation, complimentary to scope of practice, challenges to delivery) perspectives. With initial training, instructors required minimal ongoing support to deliver the programme and made dynamic adaptations to suit the individual circumstances of each recipient, but cited challenges delivering the number of programme activities required. Recipient perspectives varied; however, most appreciated the delivery of the programme by instructors who understood the impact of vision impairment.Conclusions and implicationsThis novel qualitative study demonstrates that the adapted programme, delivered by instructors, who already have expertise delivering individualised programmes to older people with vision impairment, may fill the gap for a fall prevention programme in this population.Trial registration numberACTRN12616001186448.

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Multicentre, randomised controlled trial of PDSAFE, a physiotherapist-delivered fall prevention programme for people with Parkinson’s

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2018-319448 ◽

2019 ◽

Vol 90 (7) ◽

pp. 774-782 ◽

Cited By ~ 15

Author(s):

Kim Chivers Seymour ◽

Ruth Pickering ◽

Lynn Rochester ◽

Helen C Roberts ◽

Claire Ballinger ◽

...

Keyword(s):

Randomised Controlled Trial ◽

Fall Prevention ◽

Controlled Trial ◽

Intervention Group ◽

Prevention Programme ◽

Control Group ◽

Chair Stand ◽

Subgroup Analyses ◽

Randomised Controlled ◽

Fall Prevention Programme

ObjectiveTo estimate the effect of a physiotherapist-delivered fall prevention programme for people with Parkinson’s (PwP).MethodsPeople at risk of falls with confirmed Parkinson’s were recruited to this multicentre, pragmatic, investigator blind, individually randomised controlled trial with prespecified subgroup analyses. 474 PwP (Hoehn and Yahr 1–4) were randomised: 238 allocated to a physiotherapy programme and 236 to control. All participants had routine care; the control group received a DVD about Parkinson’s and single advice session at trial completion. The intervention group (PDSAFE) had an individually tailored, progressive home-based fall avoidance strategy training programme with balance and strengthening exercises. The primary outcome was risk of repeat falling, collected by self-report monthly diaries, 0–6 months after randomisation. Secondary outcomes included Mini-BESTest for balance, chair stand test, falls efficacy, freezing of gait, health-related quality of life (EuroQol EQ-5D), Geriatric Depression Scale, Physical Activity Scale for the Elderly and Parkinson’s Disease Questionnaire, fractures and rate of near falling.ResultsAverage age is 72 years and 266 (56%) were men. By 6 months, 116 (55%) of the control group and 125 (61.5%) of the intervention group reported repeat falls (controlled OR 1.21, 95% CI 0.74 to 1.98, p=0.447). Secondary subgroup analyses suggested a different response to the intervention between moderate and severe disease severity groups. Balance, falls efficacy and chair stand time improved with near falls reduced in the intervention arm.ConclusionPDSAFE did not reduce falling in this pragmatic trial of PwP. Other functional tasks improved and reduced fall rates were apparent among those with moderate disease.Trial registration numberISRCTN48152791.

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A multifactorial fall prevention programme in the community-dwelling aged: predictors of adherence

European Journal of Public Health ◽

10.1093/eurpub/ckl272 ◽

2007 ◽

Vol 17 (5) ◽

pp. 464-470 ◽

Cited By ~ 43

Author(s):

N. M. Sjosten ◽

M. Salonoja ◽

M. Piirtola ◽

T. J. Vahlberg ◽

R. Isoaho ◽

...

Keyword(s):

Fall Prevention ◽

Community Dwelling ◽

Prevention Programme ◽

Predictors Of Adherence ◽

Fall Prevention Programme

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Evaluation of a comprehensive slip, trip and fall prevention programme for hospital employees

Ergonomics ◽

10.1080/00140130802248092 ◽

2008 ◽

Vol 51 (12) ◽

pp. 1906-1925 ◽

Cited By ~ 77

Author(s):

Jennifer L. Bell ◽

James W. Collins ◽

Laurie Wolf ◽

Raoul Grönqvist ◽

Sharon Chiou ◽

...

Keyword(s):

Fall Prevention ◽

Prevention Programme ◽

Hospital Employees ◽

Fall Prevention Programme

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A comprehensive home-care program for health promotion of mothers with preeclampsia: protocol for a mixed method study

Reproductive Health ◽

10.1186/s12978-019-0695-8 ◽

2019 ◽

Vol 16 (1) ◽

Author(s):

Zahra Rastegari ◽

Mohammad H. Yarmohammadian ◽

Fatemeh Mohammadi ◽

Shahnaz Kohan

Keyword(s):

Health Promotion ◽

Home Care ◽

Mixed Method ◽

Care Program ◽

Mixed Method Study

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A primary care based fall prevention programme

Physiotherapy Theory and Practice ◽

10.1080/095939899307810 ◽

1999 ◽

Vol 15 (2) ◽

pp. 121-133 ◽

Cited By ~ 10

Author(s):

Alison Allen ◽

Janet M. Simpson

Keyword(s):

Primary Care ◽

Fall Prevention ◽

Prevention Programme ◽

Fall Prevention Programme

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Process factors explaining the ineffectiveness of a multidisciplinary fall prevention programme: A process evaluation

BMC Public Health ◽

10.1186/1471-2458-8-332 ◽

2008 ◽

Vol 8 (1) ◽

Cited By ~ 21

Author(s):

Michel HC Bleijlevens ◽

Marike RC Hendriks ◽

Jolanda CM van Haastregt ◽

Erik van Rossum ◽

Gertrudis IJM Kempen ◽

...

Keyword(s):

Process Evaluation ◽

Fall Prevention ◽

Prevention Programme ◽

Process Factors ◽

Fall Prevention Programme

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Factors of Good Collaboration in Home-Based End-of-Life Care: A Questionnaire Survey of Japanese Home Care Nurses, Home Helpers, and Care Managers

Care Management Journals ◽

10.1891/1521-0987.16.3.129 ◽

2015 ◽

Vol 16 (3) ◽

pp. 129-140 ◽

Cited By ~ 7

Author(s):

Noriko Yamamoto-Mitani ◽

Ayumi Igarashi ◽

Maiko Noguchi-Watanabe ◽

Yukie Takemura ◽

Miho Suzuki

Keyword(s):

Home Care ◽

End Of Life ◽

Collaborative Work ◽

Care Managers ◽

Actual Experience ◽

Home Based ◽

Eol Care ◽

The Relationship ◽

Home Helpers ◽

Home Care Nurses

Good interprofessional work (IPW) is essential to provide quality home-based end-of-life (EOL) care. The purpose of this study was to explore the factors of “good collaboration,” as evaluated separately by home care nurses (HNs), home helpers (HHs), and care managers (CMs). The relationship was examined between their evaluation of good collaboration and their recent actual experience of interprofessional collaborative work for a home-based EOL case. The questionnaire was returned nationwide by 378 HNs, 305 HHs, and 476 CMs, and data were collected on 177 EOL cases from HNs, 84 cases from HHs, and 123 cases from CMs. Evaluation of good collaboration by HNs was associated with working with a CM with whom they had multiple collaborative experiences, the client being independent for their toileting until just before dying, and sharing information regarding the client’s EOL decision with an HH 1 month before dying. Evaluation of good collaboration by HHs was associated with working at an agency that collaborated with fewer CM agencies and working at an agency that allowed staff to visit dying clients. Evaluation of good collaboration by CMs was associated only with the client being dependent for toileting. Our results highlighted the characteristics of how each professional seeks to collaborate depending on their preparedness, contexts, and resultant expectations toward other professionals when entering the IPW for home-based EOL care. To promote good IPW for home-based EOL care further, professionals need to understand these differences among ourselves and try to meet others’ expectations.

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