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

Korall, Alexandra M.B.; Feldman, Fabio; Scott, Vicky; Wasdell, Michael; Gillan, Roslyn; Ross, Donna Cohen; Thompson-Franson, Tracey; Leung, Pet-Ming; Lin, Lisa Y.

doi:10.1016/j.jamda.2014.12.004

Cited by 37 publications

(35 citation statements)

References 81 publications

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“…Within LTC, care providers are believed to play a particularly important role in influencing a resident’s decision to wear hip protectors on a regular basis (e.g., [39–46]). The overall commitment of paid care providers towards hip protectors has been identified as an important determinant of adherence, but empirical evidence is lacking [37]. To address this knowledge gap, our aim was to develop a valid and reliable tool to measure commitment to hip protectors among paid caregivers in LTC.…”

Section: Discussionmentioning

confidence: 99%

“…Determinants of adherence with hip protectors span different socio-ecological levels [37]. Because the majority of residents in LTC have some form of cognitive impairment (e.g., [38]) and all require at least partial assistance performing activities of daily living, the attitudes and subsequent behaviour of care providers is believed to be important in determining whether a resident will wear hip protectors on a regular basis (e.g., [39–46]).…”

Section: Introductionmentioning

confidence: 99%

“…For example, care providers are responsible for identifying residents likely to benefit and tolerate hip protectors, educating residents and family about the benefits of hip protectors, monitoring for signs of discomfort and pain, implementing interventions to optimize adherence, and continuously reassessing for eligibility [47]. In a recent systematic review on factors affecting use of hip protectors among residents in LTC, the commitment of care providers to hip protectors emerged as a facilitator of acceptance and/or adherence in nearly half of studies (46%) [37]. However, our understanding of the nature of commitment, along with its associated antecedents and outcomes, is constrained by the absence of a psychometrically valid assessment tool, and subsequently, reliance on relatively low-level evidence, namely expert opinion.…”

Section: Introductionmentioning

confidence: 99%

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Validation and psychometric properties of the commitment to hip protectors (C-HiP) index in long-term care providers of British Columbia, Canada: a cross-sectional survey

et al. 2017

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BackgroundIf worn during a fall, hip protectors substantially reduce risk for hip fracture. However, a major barrier to their clinical efficacy is poor user adherence. In long-term care, adherence likely depends on how committed care providers are to hip protectors, but empirical evidence is lacking due to the absence of a psychometrically valid assessment tool.MethodsWe conducted a cross-sectional survey in a convenience sample of 529 paid care providers. We developed the 15-item C-HiP Index to measure commitment, comprised of three subscales: affective, cognitive and behavioural. Responses were subjected to hierarchical factor analysis and internal consistency testing. Eleven experts rated the relevance and clarity of items on 4-point Likert scales. We performed simple linear regression to determine whether C-HiP Index scores were positively related to the question, “Do you think of yourself as a champion of hip protectors”, rated on a 5-point Likert scale. We examined whether the C-HiP Index could differentiate respondents: (i) who were aware of a protected fall causing hip fracture from those who were unaware; (ii) who agreed in the existence of a champion of hip protectors within their home from those who didn’t.ResultsHierarchical factor analysis yielded two lower-order factors and a single higher-order factor, representing the overarching concept of commitment to hip protectors. Items from affective and cognitive subscales loaded highest on the first lower-order factor, while items from the behavioural subscale loaded highest on the second. We eliminated one item due to low factor matrix coefficients, and poor expert evaluation. The C-HiP Index had a Cronbach’s alpha of 0.96. A one-unit increase in championing was associated with a 5.2-point (p < 0.01) increase in C-HiP Index score. Median C-HiP Index scores were 4.3-points lower (p < 0.01) among respondents aware of a protected fall causing hip fracture, and 7.0-points higher (p < 0.01) among respondents who agreed in the existence of a champion of hip protectors within their home.ConclusionsWe offer evidence of the psychometric properties of the C-HiP Index. The development of a valid and reliable assessment tool is crucial to understanding the factors that govern adherence to hip protectors in long-term care.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Validation and psychometric properties of the commitment to hip protectors (C-HiP) index in long-term care providers of British Columbia, Canada: a cross-sectional survey

et al. 2017

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“…LTC refers to sites for older adults where personal and nursing care is provided on a 24-h basis (eg, nursing homes, residential care facilities) 14. Approximately 60% of LTC residents fall at least once per year, and 30% of falls in LTC result in injury, rates that are two to three times higher than among older adults living independently 15–17.…”

Section: Introductionmentioning

confidence: 99%

Study protocol for the Flooring for Injury Prevention (FLIP) Study: a randomised controlled trial in long-term care

et al. 2016

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“…Hip protectors represent an attractive strategy for reducing hip fractures among high-risk fallers in long-term care facilities (Korall et al, 2015). Most of the hip protectors that are available in Korea are imported, so it does not accommodate Korean's elderly body type as well.…”

Section: Introductionmentioning

confidence: 99%

Hip Protector Design Process for the Korean Elderly

Jeon¹,

Kim²

2016

Fashion & Textile Research Journal

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: This research aims to propose an ergonomic design process for hip protector based on previous studies, existing products, multidisciplinary experts opinion, and wearing test. The elderly are more likely to suffer a hip fracture when they fall due to their physical changes in skeletal form, muscle quantity, bone density, and joint movement. A hip protector is an effective product to prevent hip fractures in the elderly but it also has a problem in that it is uncomfortable. Therefore there is a high chance that it won't be able to prevent hip fractures properly. Since the comfort of a hip protector is one of the most critical elements in preventing a hip fracture, we need to keep improving the hip protector for mobility and usability. Based on the previous studies and limitations of current hip protector products, we need to come up with an optimal design for the Korean elderly. First, knowledge has to be built relating to the ergonomic design of the hip protector considering body shape and size analysis using 3D-scan data, and biomechanical analysis on hip fracture. Second, we need to develop a design process including hip protector pattern design, and wearing evaluation with virtual system. Third, we suggest to reevaluate and verify the design procedure from impact evaluation using testing simulator, virtual evaluation of impact, to wearing comfort and usability evaluation. This design process presented in this study would be expected to contribute to the development of ergonomic hip protector which is suitable for the Korean elderly.

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

Cited by 37 publications

References 81 publications

Validation and psychometric properties of the commitment to hip protectors (C-HiP) index in long-term care providers of British Columbia, Canada: a cross-sectional survey

Validation and psychometric properties of the commitment to hip protectors (C-HiP) index in long-term care providers of British Columbia, Canada: a cross-sectional survey

Study protocol for the Flooring for Injury Prevention (FLIP) Study: a randomised controlled trial in long-term care

Hip Protector Design Process for the Korean Elderly

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