Comparison of Risk Factors of Falling for Psychiatric Inpatients and General Ward Inpatients Who Had Fallen

Abstract

BACKGROUND: For psychiatric patients, the issue of falling is complex. OBJECTIVE: The objective of this study was to compare the risk factors for falling in psychiatric inpatients and general ward inpatients who had fallen. METHODS: The researchers first derived official fall records for 122 psychiatric inpatients and then selected 122 psychiatric inpatients who had not fallen as well as 122 general ward patients who had fallen, matched for gender, age, and length of hospital stay at the time of the fall incident. RESULTS: After controlling other variables, multinomial logistic regression analysis revealed that psychiatric inpatients who had fallen and had dizziness (odds ratio [OR] = 7.11, p < .001), had an unsteady gait (OR = 1.97, p = .030), or were not using aids (OR = 0.42, p = .042) were at greater risk of falling than those who had not fallen. The researchers also found that general ward inpatients who had fallen and had higher Charlson Comorbidity Index scores (OR = 1.77, p < .001), were clear-headed (OR = 27.15, p = .001), had dizziness (OR = 11.55, p < .001), were unable to walk (OR = 64.28, p < .001), or were using aids (OR = 3.86, p = .001) were at greater risk of falling than those who had not fallen before. CONCLUSIONS: The causes of falling among psychiatric inpatients and general ward inpatients are different. Medical personnel should understand the medications and attributes of patients for an accurate assessment of their risk factors for falling and thus implement fall prevention measures and health education to reduce falls.

Factors associated with risk of falling among younger inpatients in a mental health setting—A systematic review

“…Six studies were excluded for the reasons listed in Figure 1. Another four studies were identified from the reference list, and nine studies were included in this review (Aso & Okamura, 2019; Chang & Jen, 2021; Lu et al, 2018; Seeherunwong et al, 2022). The search strategy is presented in the PRISMA framework, shown in Figure 1.…”

“…Three studies were conducted in the United States (Estrin et al, 2009; Lavsa et al, 2010; Tsai et al, 1998) and Taiwan (Chan et al, 2013; Chang & Jen, 2021; Lu et al, 2018), one study in China (An et al, 2009), Japan (Aso & Okamura, 2019) and Thailand (Seeherunwong et al, 2022). The duration of study timeframe ranges from 3 months (Aso & Okamura, 2019) to 5 years (Chang & Jen, 2021; Estrin et al, 2009; Lavsa et al, 2010; Seeherunwong et al, 2022).…”

“…These include difficulty in mobility (Tsai et al, 1998), impaired mobility (Estrin et al, 2009), restricted mobility and impaired gait (Chan et al, 2013), Romberg quotients for sway (Aso & Okamura, 2019) and unsteady gait (Chang & Jen, 2021). Seeherunwong et al, 2022;Tsai et al, 1998).…”

“…Risk factors including dizziness, generalised weakness, confusion, impaired consciousness and elimination problems were reported by two or more studies. In particular, people with physical complaints on the day of the fall (OR = 3.31) (Estrin et al, 2009), co-occurring physical illness (OR = 2.97) (Seeherunwong et al, 2022) and those reporting dizziness were a higher risk of a fall (OR = 7.11) (Chang & Jen, 2021).…”

“…As summarised by McMinn et al (2016), risk factors for falls and injuries among older inpatients in mental health unit include age, poor nutrition, medical illnesses, mental disorders, psychiatric treatments, mobility, visual perception and sleep. In a recent study, Chang and Jen (2021) reported that psychiatric inpatients who had dizziness, unsteady gait and not using aids were at greater risk of falling. Tängman et al (2010) found that acute side effects of drugs including neuroleptics accounted for more than half of the falls.…”