Health Practitioners’ Perceptions of Falls and Fall Prevention in Older People: A Metasynthesis

Abstract

Fall prevention has received a great deal of consideration and funding, however fall rates have not reduced accordingly. Health practitioners are key stakeholders in the process of implementing fall prevention evidence into their clinical assessment and management of older people at risk of falling. Investigating health practitioners’ clinical experiences and perceptions has been identified as a means to enhance the translation of knowledge. Four databases were searched for studies exploring health practitioners’ perceptions of falls and fall prevention. A metasynthesis of eight qualitative studies was conducted. The findings suggest that health practitioners face substantial barriers in the implementation of fall prevention practices. These include personal, interpersonal, and clinical barriers in addition to limitations of the research evidence. This knowledge hopes to enhance targeted dissemination of knowledge, reducing the research–practice gap and improving clinical outcomes for older people at risk of falls.

The tensions between micro-, meso- and macro-levels: physiotherapists’ views of their role towards fall prevention in the community – a qualitative study

“…Our informants stated the increased need for evidence-based knowledge among all team members, which is in line with the global emphasis on the need for applying research-based knowledge in clinical practice [37][38][39]. Furthermore, Van Rhyn and Barwick [39] conclude that practice should be evidencebased to reduce the frequency of falls, which fits it with the message of our informants, who were concerned about professional development and working with evidence-based methods. Hunt [43] argues that EBP is also important when professionals work as a team because it helps advance research to establish better methods of patient care.…”

“…Here, evidencebased practice (EBP) refers to the translation and integration of the best available research-based knowledge, clinical expertise and patient characteristics and preferences [36]. In this manner, people can receive the most effective evidencebased healthcare [37][38][39]. The informants stated that a barrier towards putting research-based knowledge into practice was that they needed more resources.…”

Physiotherapists’ perceptions of challenges facing evidence-based practice and the importance of environmental empowerment in fall prevention in the municipality – a qualitative study

“…Despite their awareness of the importance of research-based knowledge, their daily routines proved to be the superior winner. Lack-of-time is a common barrier cited worldwide in healthcare [ 15 , 25 , 54 ] and is one of the most frequent barriers to EBP implementation [ 55 ]. In addition, the given workload and routine demands in clinical practice were reported to serve as a barrier in several studies [ 25 , 56 ].…”

“…KT and the implementation is a multifactorial complex process [ 12 – 14 ]. Although there is ample research, falls have not been reduced, due to the limited implementation of evidence-based fall prevention into practice [ 15 – 18 ]. Several studies have examined the effects of organizational strategies for implementing improvements in patient care and organizational culture and found that factors such as organization and research admissions are of paramount importance to the success of KT and EBP [ 19 – 21 ].…”

A qualitative study exploring physical therapists’ views on the Otago Exercise Programme for fall prevention: a stepping stone to “age in place” and to give faith in the future

“…Although the research on fall prevention in older adults is comprehensive, there is a lack of knowledge about the clinical implementation of fall prevention programs (van Rhyn and Barwick, 2019). To improve the implementation of fall prevention programs at the individual, organizational, and societal levels, clinicians' experiences and understanding of fall prevention are of high interest (Child et al, 2012).…”