‘I don't want to impose on anybody’: Older people and their families discuss their perceptions of risk, cause and care in the context of falls

Kerr, Lucille; Newman, Paula; Russo, Philip

doi:10.1111/opn.12578

Cited by 4 publications

(2 citation statements)

References 20 publications

(28 reference statements)

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“…The inability to mitigate their risk of falling resulted in older people feeling anxious and uncertain about how to undertake tasks, such as toileting safely, and participants stated that they felt deterred from seeking information and assistance. These findings compare to a recent study that interviewed older people who fell in hospital and reported that they experienced inadequate communication, ageism and anxiety about maintaining their dignity, particularly when needing to use the toilet (Kerr, Newman, and Russo 2023). Recent reviews, including a scoping review that included 41 studies from 12 countries, have found that hospitalised older people had limited knowledge about hospital falls risk and their experiences of falls prevention education were inconsistent (Dolan, Slebodnik, and Taylor‐Piliae 2022; Dabkowski et al.…”

Section: Discussioncontrasting

confidence: 53%

‘You Just Struggle on Your Own’: Exploring Older People and Their Caregivers' Perspectives About Falls Prevention Education in Hospitals

Hill,

Vaz,

Francis‐Coad

et al. 2024

Int J Older People Nursing

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BackgroundProviding older patients with an opportunity to participate in individualised falls preventive education, has been shown to reduce hospital falls. However, few studies have explored older peoples' perspectives of hospital falls prevention education. This study aimed to explore older people and their caregivers' knowledge and awareness about hospital falls prevention, including their reflections on the education they received when hospitalised.MethodsA qualitative, exploratory study with focus groups and semistructured interviews was conducted. Participants were a purposively selected sample of community‐dwelling older people (65+ years) admitted to a hospital in the past 5 years and caregivers of older people. Data were thematically analysed using deductive and inductive approaches, and a capability–opportunity–motivation–behaviour model was applied to understand key determinants of implementing falls education for hospitalised older people.ResultsParticipants' [n = 46 (older people n = 37, age range 60–89 years), caregivers n = 9] feedback identified five themes: distress and disempowerment if the participant did have a hospital fall or nearly fell, anxiety and uncertainty about what behaviour was required while in hospital, insufficient and inconsistent falls prevention education, inadequate communication and underlying attitudes of ageism. Applying a behaviour change model suggested that older people and their caregivers did not develop falls prevention knowledge, awareness or motivation to engage in falls prevention behaviour. Older people were also provided with limited opportunities to engage in falls preventive behaviour while in hospital.ConclusionOlder people in our study received sporadic education about falls prevention during their hospital admissions which did not raise their awareness and knowledge about the risk of falls or their capability to engage in safe falls preventive behaviour. Conflicting messages may result in older people feeling confused and anxious about staying safe in hospital.

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Section: Discussioncontrasting

confidence: 53%

‘You Just Struggle on Your Own’: Exploring Older People and Their Caregivers' Perspectives About Falls Prevention Education in Hospitals

Hill,

Vaz,

Francis‐Coad

et al. 2024

Int J Older People Nursing

View full text Add to dashboard Cite

show abstract

“…Participants who had fallen or nearly fallen, as well as those who did not fall while in hospital, reported similar experiences. These findings compare to a recent study conducted in the UK that found older adults who fell in hospital experienced inadequate communication, ageism and anxiety about maintaining their dignity, particularly when needing to use the toilet [41]. An Australian study also found that hospitalised older adults had limited knowledge about hospital falls risk and their experiences of falls prevention education were inconsistent [26].…”

Section: Discussionmentioning

confidence: 68%

“You just struggle on your own:” Exploring older consumers’ perspectives about falls prevention education in hospitals

Hill,

Vaz,

Francis-Coad

et al. 2023

Preprint

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IntroductionWhile individualised falls preventive education has been effective in reducing hospital falls among older patients, there is a dearth of research exploring consumers’ perspectives on hospital falls prevention education.ObjectiveThis study aimed to explore the knowledge of older consumers regarding preventing falls in hospital and their reflections on the education received during hospitalisation.MethodsA qualitative, exploratory study incorporating focus groups and semi-structured interviews was undertaken. The participants consisted of a purposively selected sample of community-dwelling consumers aged 65 and above (n=39 older adults and n=9 family carers of older adults) who had been admitted to a hospital within the past five years. Thematic analysis, incorporating deductive and inductive approaches, was applied and a capability-opportunity-motivation-behaviour model was utilised to comprehend the key determinants influencing the implementation of falls education for hospitalised older adults.ResultsFeedback from the participants (n=46, 25 females, age range 60 to 89 years) revealed five key themes: distress and disempowerment resulting from hospital falls, anxiety and uncertainty regarding required behaviour while hospitalised, insufficient and inconsistent falls prevention education, inadequate communication, and underlying ageism attitudes. These themes converged to provide the overarching theme: “This [support and education available to engage in safe falls prevention behavior] wasn’t what we expected!” Application of the behaviour change model indicated that older consumers often did not acquire falls prevention knowledge, awareness or motivation, and had limited opportunities to engage in falls preventive behaviour during hospitalisation.DiscussionIn summary, older consumers receive sporadic falls prevention education during hospital admissions, which fails to raise their awareness and knowledge of falls risks or their capability to engage in safe preventive behaviours. Conflicting messages contribute to consumer confusion and anxiety about maintaining safety during hospital stays.ConclusionFurther research is required to address these issues to enable older adults to undertake effective falls prevention behaviours in hospital settings. Hospital policies and guidelines need to prioritise falls prevention education. Policies can be designed to emphasise tailored education, effective communication, and the importance of addressing ageism to enhance patient safety and well-being.

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Nurses’ Fall Risk Judgements - Cognitive Biases and Contextual Factors Explaining Variability: A multi-centre cross-sectional study

Takase,

Kisanuki,

Yoko

et al. 2024

Preprint

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Background: Assessing fall risk is a complex process requiring the integration of diverse information and cognitive strategies. Despite this complexity, few studies have explored how nurses make these judgements. Moreover, existing research suggests variability in nurses' fall risk assessments, but the reasons for this variation and its appropriateness remain unclear. Objective: This study aimed to investigate how nurses judge fall risk, and the factors associated with their judgements. Methods: Using purposive sampling, 335 nurses from six hospitals in eastern Japan participated in an online survey. The participants rated the likelihood of falls in 18 patient scenarios and completed measures of base-rate neglect, belief bias, and availability bias. A linear mixed-effects regression tree was used to identify factors related to their judgements, and a linear mixed-effects regression model examined associations between judgement variability, cognitive biases, and clinical specialty. Results: Nurses' fall risk assessments were primarily influenced by whether patients called for assistance, followed by the use of sleeping pills, the presence of a tube or drain, and patient mobility status. Judgement variability was linked to nurses ' gender, education, clinical specialty, and susceptibility to availability bias. Conclusion: Variability in clinical judgement may be justified when reflecting personalised, context-specific care. However, inconsistencies arising from cognitive biases are problematic. Healthcare organisations should offer targeted training to enhance contextual expertise and reduce the influence of cognitive biases on fall risk assessments.

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‘I don't want to impose on anybody’: Older people and their families discuss their perceptions of risk, cause and care in the context of falls

Cited by 4 publications

References 20 publications

‘You Just Struggle on Your Own’: Exploring Older People and Their Caregivers' Perspectives About Falls Prevention Education in Hospitals

‘You Just Struggle on Your Own’: Exploring Older People and Their Caregivers' Perspectives About Falls Prevention Education in Hospitals

“You just struggle on your own:” Exploring older consumers’ perspectives about falls prevention education in hospitals

Nurses’ Fall Risk Judgements - Cognitive Biases and Contextual Factors Explaining Variability: A multi-centre cross-sectional study

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