Compliance Concering External Protectors for Hip Fractures among the Institutionalized Elderly in Japan.

Yasumura, Seiji; Suzuki, Takao; Yoshida, Hideyo; Ishizaki, Tatsuro; Yukawa, Harumi; Watanabe, Shuichiro; Kumagai, Shinya; Shibata, H.; Nakamura, Tetsurō; Niino, Naoakira; Haga, H.; Imuta, Hiromi; Abe, Hiromi; Fukao, Akira

doi:10.3143/geriatrics.36.268

Cited by 12 publications

(7 citation statements)

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“…The attitude of the staff in institutions is a crucial factor for getting good compliance. 14 19-21 The reasons for stopping use of hip protectors reported in our study support the findings of Yasumura et al 22 The reasons for drop out were difficulty in wearing the hip protector and delay in using the toilet.…”

Section: Comparison With Other Studiessupporting

confidence: 82%

Compliance with external hip protectors in nursing homes in Norway

Forsén

Sandvig²,

Schuller³

et al. 2004

Inj Prev

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Objectives:To investigate compliance with hip protector use.Design:Observational prospective study.Setting:19 nursing homes (1040 beds).Subjects:All residents during an 18 month period were included in this study.Intervention:Hip protectors were introduced as a regular part of health care service for all residents. Residents at high risk were encouraged to use hip protectors regularly. Each nursing home had a contact person.Main outcome measures:The percentage of residents accepting the hip protector offer, probability of continued use, reasons for terminating use, and percentage of falls with hip protector were evaluated.Results:Fifty five percent of the residents accepted the hip protector offer. The percentage increased by age, but showed no significant dependence on gender, profession of the contact person, or size of nursing home. The probability of continued use showed no significant dependence on age and gender. Nursing homes with a nurse as contact person showed 51% higher risk of residents terminating regular hip protector use than nursing homes with a physiotherapist as contact person (relative risk (RR) 1.51, 95% confidence interval (CI) 1.11 to 2.05, p = 0.008). The corresponding result for large (75–92 beds) compared with small (24–68 beds) nursing homes was RR = 1.44 (95% CI 1.02 to 2.02, p = 0.036). Seventy six percent of 2323 falls occurred while using hip protectors.Conclusion:The contact person and size of the nursing home seemed to be important factors for continued use of hip protectors while age and gender seemed to be less important.

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Section: Comparison With Other Studiessupporting

confidence: 82%

Compliance with external hip protectors in nursing homes in Norway

Forsén

Sandvig²,

Schuller³

et al. 2004

Inj Prev

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“…It is difficult to compare the compliance in this study with the compliance in the other studies because purchasers are a very selected population. In the other studies, a prospective design was used [3,[17][18][19][20][21][22][23][24]. Table 2 shows the acceptance and compliance and the determinants of compliance with wearing hip protectors in these studies.…”

Section: Resultsmentioning

confidence: 99%

“…Compliance varied between 20% and 92% [3,11,[16][17][18][19][20][21][22][23][24][25][26][27]29,30,32,47]. The median acceptance and compliance were 68% (interquartile range 57-70%) and 56% (interquartile range 41-73%), respectively.…”

Section: Discussionmentioning

confidence: 99%

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Acceptance and Compliance with External Hip Protectors: A Systematic Review of the Literature

Schoor

Devillé

Bouter

et al. 2002

Osteoporosis International

131

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Abstract. Hip fractures may be prevented by the use of external hip protectors, but compliance is often poor. Therefore, the objective of this study was to assess the determinants of compliance with hip protectors by systematically reviewing the literature. A literature search was performed in PubMed, Embase and the Cochrane Library. Primary acceptance with hip protectors ranged from 37% to 72% (median 68%); compliance varied between 20% and 92% (median 56%). However, in most studies it was not very clear how compliance was defined (e.g., average wearing time on active days and during waking hours, number of user-days per all available follow-up days, percentage falls with hip protector) and how it was measured. To provide more insight in the compliance percentages, the different methods of defining and measuring compliance were presented for the selected studies, when provided. Because of the heterogeneity in study design of the selected studies and the lack of quantitative data in most studies, results regarding the determinants of compliance could not be statistically pooled. Instead a qualitative summary of the determinants of compliance was given. The reasons most frequently mentioned for not wearing hip protectors, were: not being comfortable (too tight/ poor fit); the extra effort (and time) needed to wear the device; urinary incontinence; and physical difficulties/ illnesses. In conclusion, compliance is a very complex, but important issue in hip protector research and implementation. Based on the experiences of elderly people who wear the hip protectors, adjustments should be made to the protector and the underwear, while maintaining the force attenuation capacity. Furthermore, methods to improve the compliance should be developed, and their effectiveness tested.

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“…Other researchers have not found independent associations with mobility problems or a history of falls and fractures (Cryer et al 2006;Kurrle et al 2004). Type of hip protector does not seem to be important in some studies (Bentzen et al 2008b;O'Halloran et al 2005), while others have found higher compliance with soft hip protectors compared to hard ones Yasumura et al 1999). Meyer et al (2003) state that training of the nursing staff, and provision of hip protectors free of charge can increase the use of hip protectors.…”

Section: Introductionmentioning

confidence: 96%

Predictors of uptake and adherence to the use of hip protectors among nursing-home residents

2008

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The aim of the present study was to identify predictors for initial uptake and adherence with the use of hip protectors when offering hip protectors free of charge to nursing-home residents. An 18 months prospective follow up study was carried out in 18 Norwegian nursing homes. One thousand two hundred and thirty-six residents were included in the study of which 604 started to use a hip protector. A multivariate logistic regression model was used to identify predictors for the initial uptake. A Cox proportional hazard model was used to identify predictors for adherence. A stepwise backward strategy was used in both the logistic and in the Cox regression. The effect of nursing homes as clusters was adjusted for in the analysis. The uptake rate among all residents was 46% and the adherence was approximately 75% after 3 months, and approximately 60% after 18 months. Female gender [odds ratio (OR): 1.54, 95% CI: 1.06-2.24, = 0.022], previous fractures (OR: 1.67, 95% CI: 1.02-2.75, = 0.043), previous falls (OR: 2.08, 95% CI: 1.35-3.19, < 0.001) and memory (not able to memorise: OR: 3.71, 95% CI: 2.09-6.59, < 0.001, large problems with memorising: OR: 2.85, 95% CI: 1.81-4.49, < 0.001, medium problems with memorising: OR: 2.45, 95% CI: 1.39-4.33, = 0.002, some problems with memorising: OR: 1.99, 95% CI: 1.14-3.48, = 0.016) seemed to be important predictors for uptake. Among those who took up the offer male gender (HR: 1.71, 95% CI: 1.00-2.91, = 0.049), memory (not able to memorise: HR: 0.26, 95% CI: 0.14-0.50, < 0.001, large problems with memorising: HR: 0.32, 95% CI: 0.22-0.45, < 0.001, medium problems with memorising: HR: 0.46, 95% CI: 0.30-0.73, < 0.001, some problems with memorising: HR: 0.49, 95% CI: 0.32-0.73, = 0.001) and bowel incontinence (HR: 0.41, 95% CI: 0.25-0.66, < 0.001) were predictors for a lower probability of ending hip protector use. Factors related to a high risk of falling were important predictors for both uptake and adherence. The fact that neither memory impairments nor incontinence (bowel) seemed to be barriers to hip protector use is important since these characteristics are common among nursing-home residents and tertiary prevention such as the use of hip protectors is probably the most feasible intervention to prevent hip fractures in this group.

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Compliance Concering External Protectors for Hip Fractures among the Institutionalized Elderly in Japan.

Cited by 12 publications

References 0 publications

Compliance with external hip protectors in nursing homes in Norway

Compliance with external hip protectors in nursing homes in Norway

Acceptance and Compliance with External Hip Protectors: A Systematic Review of the Literature

Predictors of uptake and adherence to the use of hip protectors among nursing-home residents

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