Perceptions Related to Falls and Fall Prevention Among Hospitalized Adults

Abstract

Background Prevention of falls during hospitalization depends in part on the behaviors of alert patients to prevent falls. Research on acutely ill patients’ intentions to behave in ways that help prevent falls and on the patients’ perceptions related to falls is limited. Objective To explore hospitalized adults’ perceptions related to risk for falling, fear of falling, expectations of outcomes of falling, and intention to engage in behaviors to prevent falls. Methods Adult, alert, acutely ill inpatients (N = 158) at risk for falling completed a survey consisting of 4 scales and 3 single items. Nurses’ assessments and patients’ perceptions of the risk for falling were compared. Results Decreased intentions to engage in behaviors to prevent falls were correlated with patients’ increased confidence in their ability to perform high-risk behaviors without help and without falling (P < .001), decreased fear of falling (P < .001), and decreased perceived likelihood of adverse outcomes if they did fall (P < .001). Although nurses’ assessments indicated a risk for falls, 55.1% of the patients did not perceive a high likelihood of falling while hospitalized. Whereas 75% of patients intended to ask for help before getting out of bed, 48% were confident that they could get out of bed without help and without falling. Conclusions Although assessments may indicate a risk for falling, acutely ill inpatients may not perceive they are likely to fall. Patients’ intentions to engage in behaviors to prevent falls vary with the patients’ fall-related perceptions of confidence, outcomes, and fear related to falling.

Person‐Centered Fall Risk Awareness Perspectives: Clinical Correlates and Fall Risk

“…Those with a low fall risk awareness in the Australian study were more likely to be male, younger, partnered, and privately insured; report better health; and have no history of falls . Lack of intention to engage in behaviors to prevent falls was correlated with hospitalized individuals’ greater confidence in their ability to perform high‐risk behaviors without help and without falling, which may place them at greater risk of falls. In another community‐based study in Sydney, Australia, fall risk awareness in older adults was assessed according to performance on the five‐domain Physiological Profile Assessment .…”

“…Older adults who do not perceive a high fall risk in their environment or underestimate their own personal risk of falling might not engage in fall prevention programs . Participants’ confidence in their ability to perform high‐risk behaviors without falling was negatively correlated with extent of engagement in behaviors to prevent falls …”

“…Fall risk awareness can determine older adults’ behaviors before or after a fall and affect fall prevention strategies. Although the role of various objective measures to assess risk of falls in older adults is established, the value of self‐reports of fall risk awareness in the context of falls is not well known . The prevalence of fall risk awareness, associated clinical variables, and predictive validity for falls in ambulatory community‐dwelling older adults without dementia participating in a prospective cohort study is reported …”

Falls Prevention in Hospitals-the Need for a New Approach an Integrative Article

“…This concept is similar to that used for personalized medicine, currently and widely spread around the globe. 34 Based on this approach, study by Twibell et al 35 suggested to measure the patient's perception of his condition and his behavioral intentions to prevent the fall. 35 This study was based on the assumption that preventing falls during hospitalization depends in part on the patient's perception and behavior to prevent falls.…”

“…34 Based on this approach, study by Twibell et al 35 suggested to measure the patient's perception of his condition and his behavioral intentions to prevent the fall. 35 This study was based on the assumption that preventing falls during hospitalization depends in part on the patient's perception and behavior to prevent falls. The findings suggest that patients with low intention to request assistance from the staff to prevent falls perceive little likelihood of falling and are confident to perform various actions that may increase the risk of falling.…”