Factors associated with the initial acceptance of hip protectors amongst older people in residential care

Cryer, Colin; Knox, Anne; Stevenson, Ellen M

doi:10.1093/ageing/afj020

Cited by 11 publications

(12 citation statements)

References 11 publications

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“…Our study supports the findings of a higher uptake among female residents found in the study of Hubacher and Wettstein (2001). Cryer et al (2006) did also find a higher uptake among female residents however, the difference was not significant. Even though female residents were more prone to take up the offer than male residents, once they had started male residents had a lower probability of ending hip protector use than female residents.…”

Section: Discussionsupporting

confidence: 91%

“…A high number of risk factors for falls, previous falls, high degree of disability, and female sex have also been shown to influence adherence positively (Hubacher and Wettstein 2001;O'Halloran et al 2005; Thompson et al 2005;van Schoor et al 2003;Warnke et al 2004). 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).…”

Section: Introductionmentioning

confidence: 95%

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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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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 95%

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

2008

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“…Compliance was enhanced when caregivers were convinced of the ability of hip protectors to reduce risk for injury from falls, 52,53,57,63 and diminished when caregivers were conflicted about their effectiveness. 53,54,67,75,78 Davies et al 53 (2004) concluded that residents were more likely to wear hip protectors when caregivers understood the value of their use.…”

Section: Caregiver Level Characteristicsmentioning

confidence: 99%

Facilitators of and Barriers to Hip Protector Acceptance and Adherence in Long-term Care Facilities: A Systematic Review

Korall

Feldman

Scott

et al. 2015

Journal of the American Medical Directors Association

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“…A number of cost-benefit studies between 2004 and 2006 proved the efficacy of MIPP and hip protectors in residential elderly patients, and some studies did so also in the independently living [42][43][44][45][46][47]. There were also studies where the question of efficacy remained unresolved: the main reasons for failure were always low compliance and adherence, which are higher in care-dependent residential patients, thus leading to better results [48][49][50][51][52].…”

Section: Common Risk Factors For Fallsmentioning

confidence: 99%

Hip, Osteoporosis: New Paradigm

Komadina¹

2008

Eur J Trauma Emerg Surg

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Osteoporosis is the most common metabolic bone disease. Recently, the paradigm for diagnosis and treatment of osteoporosis has undergone changes due to new findings on this disease. With the arrival of densitometers that could measure BMD we started using medications that block further degradation of density and repair the densitometric results. More recent findings, however, suggest that the BMD value influences the predicted success of future fracture prevention in less than 50%. The remainder is attributed to bone quality. There are a number of risk factors for osteoporotic fractures, some of greater and some of lesser significance. A small external force is necessary to cause an osteoporotic fracture; otherwise, the osteoporotic bone still does not break. The dominant factor in a fracture is therefore the fall of the elderly patient. Falls are preventable, although most are benign and injury free. Only in the recent decade have we started paying attention to the fall phenomenon, which does not only involve accidents, but is also a consequence of the normal aging process. Incidence of falls and hip fractures in residential elderly patients can be reduced with a multifactorial interdisciplinary prevention program (MIPP):• Staff training • Adaptation of environment • Gait and mobility exercise • Technical accessories • Revision of pharmacotherapy (psychotropics) • Hip protectors • Post-fall problem-solving conferences. Mobility exercise is useful in elderly groups; however, the maintenance of mobility is not linked to a reduction of fall risk. Hip protectors are protective pads designed to cover the greater trochanter and attenuate or disperse the force of fall sufficiently to prevent a hip fracture. A number of cost-benefit studies on residential elderly patients between 2004 and 2006 proved the efficacy of MIPP and hip protectors, and some studies did so also on those patients living independently. Unfortunately, as much as 75% of women and 90% ofmen at high risk in nursing homes are not investigated, and 75% of those affected are not treated.

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Factors associated with the initial acceptance of hip protectors amongst older people in residential care

Cited by 11 publications

References 11 publications

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

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

Facilitators of and Barriers to Hip Protector Acceptance and Adherence in Long-term Care Facilities: A Systematic Review

Hip, Osteoporosis: New Paradigm

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