Older Adults' Perceptions Regarding the Role of Physical Therapists in Fall Prevention: A Qualitative Investigation.

Background and purpose: Falls are a leading cause of injury, morbidity, and mortality among older adults. Physical therapists are underutilized for fall prevention despite strong evidence and recommendations regarding their effectiveness. The purpose of this study was to explore older adults' awareness of and perceptions regarding the role of physical therapists for fall prevention. A secondary purpose of the study was to identify barriers to utilization of preventive rehabilitation services.

Methods: A qualitative, descriptive, phenomenological approach was used. Participant demographics and fall history were obtained with a standard questionnaire. Four focus groups were conducted with 27 community-dwelling older adults (average age = 78 years). Focus groups were recorded, transcribed, and coded using thematic analysis.

Results: Surveys indicated 37% of participants experienced a fall in the last year and 26% reported sustaining an injury. Four main themes and 5 subthemes about older adults' perceptions of physical therapy providers emerged: (1) awareness of fall prevention (subthemes: I can or have taken action to prevent falls, I don't think about it, and I am more careful); (2) learning how to fall and being able to get up from the floor; (3) limited knowledge regarding the role of physical therapists for fall prevention; and (4) a physical therapist should be seen for a specific problem, or after a fall (subthemes: perceived need and costs, and access requires a doctor's prescription).

Conclusion: Older adults lack awareness about the role of physical therapists for fall prevention, believing they should only seek treatment from a physical therapist to address a specific problem, or after a fall. The profession should consider addressing misconceptions and underutilization by educating the public that physical therapists can and do play an important role in the prevention of falls. Being explicit about the prevention of falls throughout an older adults' episode of care may further help reinforce the role of physical therapists for fall prevention and improve dissemination of this knowledge.