Accidental patient falls are becoming a major cause of concern for hospitalized inpatients. It is well known that patients who fall once during their hospital stay are more likely to fall again and that fall rates tend to be higher in hospitalized elderly individuals. Concerned health care team personnel recognize that many accidental patient falls may be predicted and, thus, prevented. The best tool to predict falls has not been determined yet. The purpose of this study was to compare the abilities of the Morse Fall Scale (MFS), the Functional Reach (FR) test, and the nurses' clinical judgment in predicting those inpatients on a rehabilitation unit and a geriatric medical ward who were most likely to fall. A total of 98 patients were screened in a 3-month period, with each patient undergoing all three instruments the same day. The results showed that the two objective standardized tests (i.e., MFS, FR) were time consuming and often inconvenient and were no better at prediction than the clinical judgments made by the primary nurses.

ObjectivesThere are multiple instruments for measuring multimorbidity. The main objective of this systematic review was to provide a list of instruments that are suitable for use in studies aiming to measure the association of a specific outcome with different levels of multimorbidity as the main independent variable in community-dwelling individuals. The secondary objective was to provide details of the requirements, strengths and limitations of these instruments, and the chosen outcomes.MethodsWe conducted the review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO registration number: CRD42018105297). We searched MEDLINE, Embase and CINAHL electronic databases published in English and manually searched the Journal of Comorbidity between 1 January 2010 and 23 October 2020 inclusive. Studies also had to select adult patients from primary care or general population and had at least one specified outcome variable. Two authors screened the titles, abstracts and full texts independently. Disagreements were resolved with a third author. The modified Newcastle-Ottawa Scale was used for quality assessment.ResultsNinety-six studies were identified, with 69 of them rated to have a low risk of bias. In total, 33 unique instruments were described. Disease Count and weighted indices like Charlson Comorbidity Index were commonly used. Other approaches included pharmaceutical-based instruments. Disease Count was the common instrument used for measuring all three essential core outcomes of multimorbidity research: mortality, mental health and quality of life. There was a rise in the development of novel weighted indices by using prognostic models. The data obtained for measuring multimorbidity were from sources including medical records, patient self-reports and large administrative databases.ConclusionsWe listed the details of 33 instruments for measuring the level of multimorbidity as a resource for investigators interested in the measurement of multimorbidity for its association with or prediction of a specific outcome.

Past research on life satisfaction is examined mostly at the individual level and with attention to the influence of demographics, personality, and intergroup factors. There has been little, if any, research on how historical narratives affect subjective satisfaction. The current study interviewed a national sample of 1,516 Singapore citizens on how they perceive the history of Singapore. The results identified three distinct narratives that can be broadly themed as Nation-Building, Conflicts and Contestations, and National Resilience events. Further analyses using hierarchical linear regression models showed that these events vary in their relationships to present and future life satisfaction, after controlling for past/current satisfaction and demographics. Interestingly, the Nation-Building narrative positively predicted present life satisfaction and negatively predicted future satisfaction. The narrative measuring National Resilience was positively linked to perceived current and future life satisfaction. The Conflicts and Contestations narrative, however, inversely predicted current life satisfaction only. The findings suggest that social constructions of history and shared memories provide a roadmap to understanding psychological well-being, sense of nationhood, and social resilience at the national level.

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