Falls and Fear of Falling among Community-Dwelling Seniors: The Dynamic Tension between Exercising Precaution and Striving for Independence

2004 ◽  
Vol 23 (4) ◽  
pp. 307-318 ◽  
Author(s):  
Catherine Ward-Griffin ◽  
Sandra Hobson ◽  
Pauline Melles ◽  
Marita Kloseck ◽  
Anthony Vandervoort ◽  
...  

ABSTRACTThe purpose of this phenomenological study was to explore the everyday experience of community-dwelling elders, with particular attention to seniors' perceptions of safety, fear of falling, independence, and quality of life. We also aimed to identify contextual factors that influence the health of elders who had fallen and/or had a fear of falling. Data from in-depth interviews with a purposeful sample (n = 9) of elders were analysed using interpretative analysis procedures. Both individual and team analysis was undertaken until interpretations of the experiences of the participants were inductively developed and crystallized into a holistic interpretation of the participants' shared experience. The holistic experience was comprised of two opposing, dynamic life forces: exercising precaution and striving for independence. Within each life force, participants used five major strategies that simultaneously constrained and expanded their life space. Health-promoting practice and policy implications, as well as areas for further research, are discussed.

2015 ◽  
Vol 2 (2) ◽  
Author(s):  
La Rangki ◽  
Kusman Ibrahim ◽  
Aan Nuraeni

Jumlah pasien pasca kolostomi akibat kanker kolon dan rektal di Indonesia mengalami peningkatan yang signifikan. Kolostomi menyebabkan masalah fisik, psikososial dan spiritual serta ekonomi. Tenaga kesehatan terutama perawat perlu memberikan asuhan keperawatan terhadap pasien pasca kolostomi secara menyeluruh. Penelitian kualitatif terhadap pasien kolostomi sangat diperlukan sebagai upaya untuk mengungkap secara mendalam pengalaman hidup pasien pasca kolostomi dan menemukan new insight, sehingga dapat menambah pengetahuan perawat dalam upaya meningkatkan kualitas asuhan keperawatan yang diberikan pada pasien. Penelitian ini menggunakan metode kualitatif dengan pendekatan fenomenologi. Data didapatkan dengan wawancara mendalam terhadap delapan informan yang merupakan pasien rawat jalan, terdiri dari lima laki-laki dan tiga perempuan, usia antara 30 tahun sampai dengan 73 tahun. Lamanya hidup dengan kolostomi antara empat bulan sampai dengan enam tahun. Analisis hasil wawancara menggunakan metode Colaizzi. Tema yang didapatkan dari pengalaman hidup pasien kolostomi antara lain: keterbatasan dalam melakukan aktivitas sehari-hari, perubahan psikososial informan, perubahan dalam perilaku ibadah dan distres spiritual, perubahan pada aktivitas seksual, sumber-sumber dukungan bagi informan, upaya menjalani hidup dengan kolostomi, adaptasi terhadap perubahan yang terjadi, serta penyulit dalam menjalani hidup dengan kolostomi. Individu yang hidup dengan kolostomi mengalami keterbatasan dalam pemenuhan kebutuhan dasarnya, termasuk perubahan psikososial, distres spiritual dan masalah ekonomi. Berdasarkan penelitian ini, perawat disarankan memberikan dukungan dan dan perhatian pada pasien pasca kolostomi.Kata kunci: Kanker kolorektal, kolostomi, pengalaman hidup The Life Experiences of Patients with Post ColostomyAbstractThe number of patient with colostomy that it caused by colorectal cancer has been increasing significantlyin Indonesia. Colostomy was affected to physical, psychosocial, spiritual and economic of patients. Health providers, especially nurses need to provide holistic care for post colostomy patients. The aims of this qualitative study were to describe the life experience of post colostomy patients and to explore new insight of nursing interventions. The new insight would increase nurses’ knowledge and improve the quality of nursing care. This phenomenological study was obtained data using in-depth interviews to 8 informants. The informants consist of 5 men and 3 women. The characteristic of informants included age between 30-73 years, and the length of time living with a colostomy between 4 months to 6 years. The data were analyzed using the Colaizzi method. This study found several themes such as limited daily activities, psychosocial changes; spiritual distress; changes in sexualactivities;sources of support;live with a colostomy; live adaptation; the burdens living with a colostomy. Living with a colostomy faced problems including the limitation to fulfill their needs, psychosocial changes, spiritual distress, and economic problems. Based on those problems, nurses can give support and attention for post colostomy patients.Key words: Colorectal cancer, colostomy, life experiences


1970 ◽  
Vol 2 (2) ◽  
Author(s):  
La Rangki ◽  
Kusman Ibrahim ◽  
Aan Nuraeni

Jumlah pasien pasca kolostomi akibat kanker kolon dan rektal di Indonesia mengalami peningkatan yang signifikan. Kolostomi menyebabkan masalah fisik, psikososial dan spiritual serta ekonomi. Tenaga kesehatan terutama perawat perlu memberikan asuhan keperawatan terhadap pasien pasca kolostomi secara menyeluruh. Penelitian kualitatif terhadap pasien kolostomi sangat diperlukan sebagai upaya untuk mengungkap secara mendalam pengalaman hidup pasien pasca kolostomi dan menemukan new insight, sehingga dapat menambah pengetahuan perawat dalam upaya meningkatkan kualitas asuhan keperawatan yang diberikan pada pasien. Penelitian ini menggunakan metode kualitatif dengan pendekatan fenomenologi. Data didapatkan dengan wawancara mendalam terhadap delapan informan yang merupakan pasien rawat jalan, terdiri dari lima laki-laki dan tiga perempuan, usia antara 30 tahun sampai dengan 73 tahun. Lamanya hidup dengan kolostomi antara empat bulan sampai dengan enam tahun. Analisis hasil wawancara menggunakan metode Colaizzi. Tema yang didapatkan dari pengalaman hidup pasien kolostomi antara lain: keterbatasan dalam melakukan aktivitas sehari-hari, perubahan psikososial informan, perubahan dalam perilaku ibadah dan distres spiritual, perubahan pada aktivitas seksual, sumber-sumber dukungan bagi informan, upaya menjalani hidup dengan kolostomi, adaptasi terhadap perubahan yang terjadi, serta penyulit dalam menjalani hidup dengan kolostomi. Individu yang hidup dengan kolostomi mengalami keterbatasan dalam pemenuhan kebutuhan dasarnya, termasuk perubahan psikososial, distres spiritual dan masalah ekonomi. Berdasarkan penelitian ini, perawat disarankan memberikan dukungan dan dan perhatian pada pasien pasca kolostomi.Kata kunci:Kanker kolorektal, kolostomi, pengalaman hidup AbstractThe number of patient with colostomy that it caused by colorectal cancer has been increasing significantlyin Indonesia. Colostomy was affected to physical, psychosocial, spiritual and economic of patients. Health providers, especially nurses need to provide holistic care for post colostomy patients. The aims of this qualitative study were to describe the life experience of post colostomy patients and to explore new insight of nursing interventions. The new insight would increase nurses’ knowledge and improve the quality of nursing care. This phenomenological study was obtained data using in-depth interviews to 8 informants. The informants consist of 5 men and 3 women. The characteristic of informants included age between 30-73 years, and the length of time living with a colostomy between 4 months to 6 years. The data were analyzed using the Colaizzi method. This study found several themes such as limited daily activities, psychosocial changes; spiritual distress; changes in sexualactivities;sources of support;live with a colostomy; live adaptation; the burdens living with a colostomy. Living with a colostomy faced problems including the limitation to fulfill their needs, psychosocial changes, spiritual distress, and economic problems. Based on those problems, nurses can give support and attention for post colostomy patients.Key words: Colorectal cancer, colostomy, life experiences


2019 ◽  
Vol 60 (3) ◽  
pp. 525-534 ◽  
Author(s):  
Mei-Chen Chen ◽  
Hsiu-Li Huang ◽  
Yi-Chen Chiu ◽  
Ping-Keung Yip ◽  
Suh-Mian Wu ◽  
...  

Abstract Background and Objectives Improving quality of life for community-dwelling older persons with dementia symptoms (PWDS) and family caregivers requires promoting dementia-friendly communities (DFC). However, little is known regarding older Taiwanese Aboriginal PWDS’ experiences of living in the community. We explored these experiences for older Atayal PWDS and their families in Taiwan. Research Design and Methods This grounded theory research used in-depth interviews to explore the perspectives of older PWDS (n = 4), their family members (n = 3), and key persons (n = 10) in an Atayal community in northern Taiwan. Data were analyzed using constant comparative analysis. Participants were interviewed between January and May 2015. Results Participants’ experiences were captured by the overarching concept of “low dementia awareness, high family-like ambience in the community.” Despite the low/absent community awareness of dementia, older Atayal PWDS functioned as freely in the community as at home due to a family-like supportive environment. Aboriginal PWDS and their families also faced environmental challenges, e.g., environmental constraints and barriers to transportation access. Discussion and Implications Our results suggest that this Aboriginal community and culture offer important DFC components, and these strengths could be further studied to enhance DFC models elsewhere. Despite these strengths in supporting PWDS, environmental challenges to transportation access still cause difficulties for PWDS and their families and need improvement. The Atayal community’s low dementia awareness suggests that services introduced must be culturally appropriate and nondisruptive to existing supportive helping systems. Our study can be a model for future studies to understand and identify PWDS’ needs in Indigenous communities.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 906-906
Author(s):  
Christina Whitehouse ◽  
Janell Mensinger ◽  
Michelle McKay

Abstract Prior research suggests that diabetes is a risk factor for falling. Moreover, older adults with diabetes are more likely to experience hip fractures when compared to older adults without diabetes. Research has also shown a relationship between fear of falling and quality of life. This study aimed to examine the moderating role of diabetes in the relationship between fear of falling (FoF) and quality of life (QoL) among older adults in a program for all-inclusive care for the elderly (PACE). This was a retrospective single cohort study that included 84 older adults in a PACE program located in the Northeastern United States. Participants were 55 years of age or older (M=70.33; SD=6.46) and cognitively intact. Diabetes diagnosis (n=46) was determined according to chart review. Fear of Falling was assessed with the Falls Efficacy Scale-International, and the Short Form 12v2 (SF-12v2) was used to measure the quality of life, including physical and mental domains. Hayes’ Process Macro was used to conduct moderation analyses (model 1) controlling race, gender, age, and comorbidities. Alpha was set at .10 to account for low power to detect interaction effects with small groups. Our results indicate the interaction between diabetes status and FoF was significant for mental QoL (p=.09) and not significant for physical QoL (p=.99). The association between FoF with lower mental QoL was stronger for patients with diabetes than for patients without diabetes; this finding was not replicated for physical QoL. Regardless of diabetes status, physical QoL significantly decreased as FoF increased.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sophie Gottschalk ◽  
Hans-Helmut König ◽  
Michael Schwenk ◽  
Carl-Philipp Jansen ◽  
Corinna Nerz ◽  
...  

Abstract Background Previous research has shown that not only falls, but also fear of falling (FoF) influences health-related quality of life (HrQoL) negatively. The EQ-5D (consisting of an index and a visual analogue scale [EQ-VAS]) is a frequently used instrument to determine HrQoL in clinical studies and economic evaluations, but no previous study compared the association between FoF and the EQ-5D index with the association between FoF and the EQ-VAS. Moreover, factors that influence the association between FoF and HrQoL are rarely examined. Thus, this study aimed to examine the association between FoF and HrQoL and to examine factors that mediate the association. Methods FoF (Short Falls Efficacy Scale International) and HrQoL (EQ-5D descriptive system, EQ-5D index, and EQ-VAS) were assessed in a sample of community-dwelling older persons (≥70 years) participating in the baseline assessment of a randomized controlled trial (N = 309). Linear and logistic regression analyses were performed, adjusting for sociodemographic variables, frequency of falls, number of chronic conditions, functional mobility (Timed up-and-go test), and subjective functional capacity (LLFDI function and disability scales). Multiple regression models were used to test the mediating effects. Results Moderate or high FoF was prevalent in 66% of the sample. After adjusting for covariates, FoF was negatively associated with the EQ-5D index, but not with the descriptive system or the EQ-VAS. Subjective functional capacity partly mediated the association between FoF and the EQ-5D index and completely mediated the association between FoF and the EQ-VAS. Conclusion FoF was negatively associated with the EQ-5D index. As subjective functional capacity mediated the association between FoF and HrQoL, future interventions should account for subjective functional capacity in their design.


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