Perspectives of older people about contingency planning for falls in the community: A qualitative meta-synthesis

Abstract

ObjectiveDespite consistent evidence for the positive impact of contingency planning for falls in older people, implementation of plans often fail. This is likely due to lack of recognition and knowledge about perspectives of older people about contingency planning. The objective of this research was to explore the perspectives of older people living in the community about use of contingency planning for getting help quickly after a fall.MethodA systematic literature search seeking qualitative research was conducted in April 2014, with no limit placed on date of publication. Medline, EMBASE, Ageline, CINAHL, HealthSource- Nursing/Academic Edition, AMED and Psych INFO databases were searched. Three main concepts were explored and linked using Boolean operators; older people, falls and contingency planning. The search was updated until February 2016 with no new articles found. After removal of duplicates, 562 articles were assessed against inclusion and exclusion criteria resulting in six studies for the meta-synthesis. These studies were critically appraised using the McMaster critical appraisal tool. Bespoke data extraction sheets were developed and a meta-synthesis approach was adopted to extract and synthesise findings.FindingsThree themes of ‘a mix of attitudes’, ‘careful deliberations’ and ‘a source of anxiety’ were established. Perspectives of older people were on a continuum between regarding contingency plans as necessary and not necessary. Levels of engagement with the contingency planning process seemed associated with acceptance of their risk of falling and their familiarity with available contingency planning strategies.ConclusionAvoiding a long lie on the floor following a fall is imperative for older people in the community but there is a lack of knowledge about contingency planning for falls. This meta-synthesis provides new insights into this area of health service delivery and highlights that implementation of plans needs to be directed by the older people rather than the health professionals.

Patients’ experiences and perspectives of patient-reported outcome measures in clinical care: A systematic review and qualitative meta-synthesis

“…Therefore, given that this systematic review aimed to summarise patients’ perspectives and experiences of the use of PROMs in routine care, this approcah was an ideal choice. Meta-ethnography is therefore well-established [ 22 ], rigorous, and underpinned by three stages of analysis [ 23 ] For the first stage of analysis, one reviewer (MS) read the studies multiple times and extracted study characteristics, key findings, and quotes from participants from the included studies into a predefined template on Microsoft Word. This was particularly useful in becoming familiar with, and understanding, the content of the included studies and starting to recognise emerging themes.…”

“…The third and final stage involved regular and systematic comparison and interpretation of the data, and synthesis into broad themes. As there is no one standard way to do this, this stage was informed by a previous systematic review which also used a meta-ethnographic approach [ 22 ].…”

“Wearables only work on patients that wear them”: Barriers and facilitators to the adoption of wearable cardiac monitoring technologies

“…Data extraction and synthesis were performed at multiple levels as established by similar studies in different fields. 15,16 Data (in the form of quotes) were extracted from the results and discussion sections of all included studies. 11 In the first level of data extraction and analysis two independent researchers (ST and CF) read the studies and took notes of initial findings including main themes and quotes and came up with descriptive categories.…”

Therapy options for those affected by a long lie after a fall: a scoping review

“…The studies included Fig. 1 Flow chart of search and screening process (a) individuals affected by long lies [15][16][17][18], (b) individuals who fell or were at risk of falling with limitations in their ability to get up from the floor [19][20][21][22][23][24][25], (c) providers of patients who experienced long lies [26,27], and participants with characteristics (b) and (c) [28]. 5 studies focused on (d) individuals with and without functional limitations; these were experimental laboratory studies [14,29,30] and comparative cross-sectional studies [31,32].…”