‘You Just Struggle on Your Own’: Exploring Older People and Their Caregivers' Perspectives About Falls Prevention Education in Hospitals

IF 1.6 4区医学 Q4 GERIATRICS & GERONTOLOGY International Journal of Older People Nursing Pub Date : 2024-07-12 DOI:10.1111/opn.12628

Anne-Marie Hill, Sharmila Vaz, Jacqueline Francis-Coad, Leon Flicker, Meg E. Morris, Tammy Weselman

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Abstract

Background

Providing older patients with an opportunity to participate in individualised falls preventive education, has been shown to reduce hospital falls. However, few studies have explored older peoples' perspectives of hospital falls prevention education. This study aimed to explore older people and their caregivers' knowledge and awareness about hospital falls prevention, including their reflections on the education they received when hospitalised.

Methods

A qualitative, exploratory study with focus groups and semistructured interviews was conducted. Participants were a purposively selected sample of community-dwelling older people (65+ years) admitted to a hospital in the past 5 years and caregivers of older people. Data were thematically analysed using deductive and inductive approaches, and a capability–opportunity–motivation–behaviour model was applied to understand key determinants of implementing falls education for hospitalised older people.

Results

Participants' [n = 46 (older people n = 37, age range 60–89 years), caregivers n = 9] feedback identified five themes: distress and disempowerment if the participant did have a hospital fall or nearly fell, anxiety and uncertainty about what behaviour was required while in hospital, insufficient and inconsistent falls prevention education, inadequate communication and underlying attitudes of ageism. Applying a behaviour change model suggested that older people and their caregivers did not develop falls prevention knowledge, awareness or motivation to engage in falls prevention behaviour. Older people were also provided with limited opportunities to engage in falls preventive behaviour while in hospital.

Conclusion

Older people in our study received sporadic education about falls prevention during their hospital admissions which did not raise their awareness and knowledge about the risk of falls or their capability to engage in safe falls preventive behaviour. Conflicting messages may result in older people feeling confused and anxious about staying safe in hospital.

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你只是在独自挣扎"：探讨老年人及其护理人员对医院预防跌倒教育的看法。

背景：为老年患者提供参与个性化跌倒预防教育的机会，已被证明可以减少医院跌倒。然而，很少有研究探讨老年人对医院跌倒预防教育的看法。本研究旨在探讨老年人及其护理人员对医院跌倒预防的了解和认识，包括他们对住院期间所接受教育的反思：方法：采用焦点小组和半结构化访谈的方式进行了一项定性探索性研究。研究对象是有目的性地抽取的过去 5 年中在医院住院的社区老年人（65 岁以上）以及老年人的照顾者。采用演绎法和归纳法对数据进行主题分析，并应用能力-机会-动机-行为模型来了解对住院老年人实施跌倒教育的关键决定因素：参与者[n=46（老年人 n=37，年龄范围为 60-89 岁），护理人员 n=9]的反馈意见确定了五个主题：如果参与者确实在医院跌倒或差点跌倒，则会感到痛苦和无能为力；对住院期间的行为要求感到焦虑和不确定；预防跌倒教育不足且不一致；沟通不足以及潜在的年龄歧视态度。应用行为改变模型表明，老年人及其护理人员并没有形成预防跌倒的知识、意识或参与预防跌倒行为的动机。老年人在住院期间参与预防跌倒行为的机会也很有限：结论：在我们的研究中，老年人在住院期间接受了零星的预防跌倒教育，但这并没有提高他们对跌倒风险的认识和知识，也没有提高他们采取安全的预防跌倒行为的能力。相互矛盾的信息可能会导致老年人对住院期间的安全感到困惑和焦虑。

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来源期刊

International Journal of Older People Nursing Nursing-Gerontology

CiteScore

3.60

自引率

9.10%

发文量

期刊介绍： International Journal of Older People Nursing welcomes scholarly papers on all aspects of older people nursing including research, practice, education, management, and policy. We publish manuscripts that further scholarly inquiry and improve practice through innovation and creativity in all aspects of gerontological nursing. We encourage submission of integrative and systematic reviews; original quantitative, qualitative, and mixed methods research; secondary analyses of existing data; historical works; theoretical and conceptual analyses; evidence based practice projects and other practice improvement reports; and policy analyses. All submissions must reflect consideration of IJOPN''s international readership and include explicit perspective on gerontological nursing. We particularly welcome submissions from regions of the world underrepresented in the gerontological nursing literature and from settings and situations not typically addressed in that literature. Editorial perspectives are published in each issue. Editorial perspectives are submitted by invitation only.