Background: Older adults are often reluctant to engage in fall prevention activities. Objectives: To understand how older adults respond to fall prevention and identify attributes that affect their responses to fall prevention. Methods: Qualitative content analysis of Fall Prevention Motivational Interviewing conversations that were conducted as an intervention for a fall prevention study in the USA. We report the methods, results and discussions using the COnsolidated criteria for REporting Qualitative research checklist. Results: Conversations from 30 participants were analysed. Participants showed various responses to fall prevention from acceptance and engagement to ambivalence to denial or giving up. Three attributes affecting how they responded to fall prevention were as follows: (a) their perception of fall risks, (b) their perception about fall prevention strategies and (c) self-identity. If participants perceived that their fall risks were temporary or modifiable, they were more likely to engage in fall prevention. If participants perceived that their fall risks were permanent or unmodifiable, they seemed to have difficulty accepting fall risks or gave up engaging in fall prevention strategies. Participants were more willing to adopt fall prevention strategies that involved minor adjustments but expressed more resistance to adopting strategies that required major adjustments. Further, their response to accepting or not accepting fall prevention was influenced by their perception of whether the fall risks and fall prevention strategies aligned with their self-identity. Conclusion: Findings underscore the importance of understanding older adults' selfidentify and perceptions about fall prevention. Relevance to clinical practice: Exploring older adults' self-identity and perceptions about fall prevention can be useful to support their engagement in fall prevention.
The purpose of this study was to explore the online discussions of postlicensure nursing students taking a community health course in an RN-to-BSN program. Final discussion forums asked students to share their perceptions and understandings of the public and community health nurses' role and practice after participating in a community health clinical course. Inductive content analysis was used to assess the narratives. Analysis of the discussions yielded two categories: (1) awareness by the RNs of their individual community and the context of the public and community health nursing role, and (2) increased understanding of the patients' experience with transitions between health care settings (home-hospital-home). This research suggests a need to assess practicing RNs' professional understanding and teaching of the public and community health nurses' role if they are to facilitate effective patient transitions home and into community-based settings.
Motivational Interviewing (MI) is an evidence-based approach for fostering behavior change and holds potential to engage patients in behavior change related to fall prevention. A two-arm, unblinded, pilot randomized controlled trial was conducted in a hospital setting to determine the feasibility (recruitment and retention), establish suitable procedures for the intervention (duration and quality of MI), and to test study measurements (fear of falling, importance and confidence related to fall prevention, patient activation, fall prevention behaviors, and fall rates). Participants were high fall risk older inpatients (age ≥ 65). The intervention arm received MI at one time during hospitalization in addition to routine hospital fall prevention intervention. The control arm received the routine hospital care for fall prevention only. Measures were collected at baseline, 2-days, 1-week, 1-month, and 3-month. A total of 120 inpatients were contacted by the study team and 67 were randomized: intervention arm (n=36) and control arm (n=31). Approximately 66% of participants completed the study at the 3-month data collection and MI intervention took an average of 21 minutes and was of adequate quality. The intervention group reported less fear of falling after the MI intervention and maintained fall prevention behaviors over time (p<.05). The study identified that MI for fall prevention at a hospital setting was feasible to deliver and provided insights into suitable study procedures and beginning evidence for a positive impact of MI.
Hospital nurses often experience challenges when teaching older adults about fall prevention strategies. The goal of this project was to provide evidence-based training to hospital nurses to facilitate patient engagement with fall prevention measures. Methods: An “Adapted” Motivational Interviewing (MI) for fall prevention (AMIFP) training in acute care was developed and introduced to nurses as part of a Veterans Affairs-Nursing Academic Partnership (VANAP) initiative. Pre/post surveys were completed by 61 nurses (71% response rate) at an acute care hospital in the United States. Results: After the single AMIFP training, nurses reported having increased knowledge about patient engagement related to fall prevention. Moreover, feelings of confidence related to using some MI skills for fall prevention increased after training. Conclusion: Even a brief AMIFP training for nurses can have a positive impact on improving hospital nurses’ knowledge and attitudes to engage patients in fall prevention education.
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