The relationship between the risk of falling and fear of falling among aged hospitalized patients

Abstract


 Background & Aim: Identifying aged people at risk of falls in hospitals is particularly important for the prevention of falls. A review of the literature revealed that the association of falls and fear of falls had not been investigated extensively in previous studies in Iran. This study aimed to determine the relationship between falling and fear of falling among aged hospitalized patients.
 Methods & Materials: In this descriptive-correlational study, 1123 subjects were recruited. Of all subjects, 385 aged hospitalized patients, 60 years old and above, were conveniently selected based on inclusion criteria in Shahroud Imam Hossein hospital from March to December 2016. Johns Hopkins fall risk assessment tool (JHFRAT) was used to evaluate the risk of falls among older adults and the Falling Efficiency Scale (FES) was applied to assess fear of falling. SPSS software version 19with the significance level of p<0.05. Chi-Square test and exact test of Fisher and logistic regression has been used for data analysis.
 Results: All aged patients (n=1123) admitted in the emergency room were assessed for eligibility to inclusion in the study. Of all subjects, 385 patients were included in this study. The subjects' mean of age was 71.68±4.32 years, age range: 60-84. Of all samples (n=385) of study 90 (23.4%), 151(39.2%) and 144 (37.4%) had a low, middle, and high risk of falls, respectively. Of all participants of the study, 193(51%) subjects were male and 192(49%) were female. One-third (36.4%) of the subjects had a fear of falls and (33.8%) experienced fall in the last six months before admission. A statistically significant relationship was found between the incidence of falls and fear of falling (P<0.001).
 Conclusion: This study found JHFRAT and FES as two applicable instruments for assessment of aged people. The result of this study concluded that evaluation of fear of falling and the risk of falls among aged hospitalized patients is recommended as a routine procedure to predict the risk of falls. Nurses are in the best position to evaluate the fear of falls and risk of falls, so it is recommended considering the fear of falls as a potential risk factor for falls in the hospital.

Fear of Falling among Older Patients Admitted to Hospital after Falls in Vietnam: Prevalence, Associated Factors and Correlation with Impaired Health-Related Quality of Life

“…The possible explanation is that all of our sample was patients who were using inpatient or outpatient services during the data collection period. This result is comparable to other studies performed in older people experiencing falls previously, such as in Japan (92%) [44] and Brazil (80.8% in those having ≥3 falls) [45], but higher than hospitalized older populations in Iran (36.4%) [17], Germany (62.8%) [16] and Australia (30%) [15]. A prior systematic review estimated that the prevalence of FOF in general older adults (including both older people with and without fall experience) was from 20.8% to 85% [1]; hence, it is understandable that our rate was significantly high.…”

“…A prior systematic review estimated that the prevalence of FOF in general older adults (including both older people with and without fall experience) was from 20.8% to 85% [1]; hence, it is understandable that our rate was significantly high. Moreover, all patients in our study were hospitalized due to fall injuries, which was one of main risk factors for FOF [6,7,10,13,14,17]. Whereas, the studies in Iran, Germany and Australia recruited patients with different health conditions [15][16][17].…”

“…Moreover, all patients in our study were hospitalized due to fall injuries, which was one of main risk factors for FOF [6,7,10,13,14,17]. Whereas, the studies in Iran, Germany and Australia recruited patients with different health conditions [15][16][17]. In addition, in this study, we used a single item with dichotomous choices (Yes/No) to measure the FOF.…”

“…However, the study was not conducted among older patients hospitalized due to falls, as well as the effect of FOF on patients' HRQOL. Although several previous studies in the world examined the FOF rates in hospitalized older individuals, they did not investigate factors associated with FOF in this population [15][16][17]. Therefore, this study aims to measure the prevalence of FOF in older patients admitted to the hospitals due to fall-injuries, determine associated factors with FOF, and examine the influence of FOF on HRQOL.…”

“…In addition, FOF lessens the confidence of the elderly in performing daily activities, limits their physical functionalities, and increases their social dependence, medication use, and healthcare cost [4,[10][11][12]. The prevalence of FOF in the elderly varies across settings from 12% to 65% in community samples, 28-95% among older people who ever experienced falls in their lifetime [6,7,10,13,14], and 30.0-62.8% in older populations admitted to the hospital [15][16][17]. Thus, thoroughly understanding the circumstance of FOF in specific settings as well as its associated factors are critically important to develop fall prevention strategies in the elderly population.…”