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Perspectives of older adults regarding barriers and enablers to engaging in fall prevention activities after hospital discharge

journal contribution
posted on 27.11.2020, 05:49 by C Naseri, SM McPhail, TP Haines, Meg MorrisMeg Morris, R Shorr, C Etherton-Beer, J Netto, L Flicker, M Bulsara, DCA Lee, J Francis-Coad, N Waldron, A Boudville, AM Hill
© 2020 John Wiley & Sons Ltd Older adults recently discharged from hospital are at high risk of functional decline and falls. A tailored fall prevention education provided at hospital discharge aimed to improve the capacity of older adults to engage in falls prevention activities. What remains unknown are the factors affecting behaviour change after hospital discharge. This study identified the perceived barriers and enablers of older adults to engagement in fall prevention activities during the 6-month period post-discharge. An exploratory approach using interpretative phenomenological analysis focused on the lived experience of a purposive sample (n = 30) of participants. All were recruited as a part of an RCT (n = 390) that delivered a tailored fall prevention education program at three hospital rehabilitation wards in Perth, Australia. Data were collected at 6-month post-discharge using semi-structured telephone surveys. Personal stories confirmed that some older adults have difficulty recovering functional ability after hospital discharge. Reduced physical capability, such as experiences of fatigue, chronic pain and feeling unsteady when walking were barriers for participants to safely return to their normal daily activities. Participants who received the tailored fall education program reported positive effects on knowledge and motivation to engage in fall prevention. Participants who had opportunities to access therapy or social supports described more positive experiences of recovery compared to individuals who persevered without assistance. A lack of physical and social support was associated with apprehension and fear toward adverse events such as falls, injuries, and hospital readmission. The lived experience of participants following hospital discharge strongly suggested that they required more supports from both healthcare professionals and caregivers to ensure that their needs were met. Further research that evaluates how to assist this population to engage in programs that will mitigate the high risk of falls and hospital readmissions is required.

Funding

Authors SMM, TPH, MEM, CE-B, RS, MZ, LF, JF-C, D-CAL, NW, AB, A-MH received a grant from the National Health and Medical Research Council (Australia) to conduct a trial which investigated how to reduce falls and promote independence in older people after hospital discharge (Project App no: 1078918). CN received a postgraduate student stipend as part of the grant. This grant funding has not been received directly to the authors rather to the institutions they represent. The authors have not received financial support for this study. SMM receives career funding support from the National Health and Medical Research Council (Australia) (Project App no: 1090440).

National Health and Medical Research Council (Australia) | 1078918

National Health and Medical Research Council (Australia) | 1090440

History

Publication Date

01/09/2020

Journal

Health and Social Care in the Community

Volume

28

Issue

5

Pagination

13p. (p. 1710-1722)

Publisher

Wiley

ISSN

0966-0410

Rights Statement

The Author reserves all moral rights over the deposited text and must be credited if any re-use occurs. Documents deposited in OPAL are the Open Access versions of outputs published elsewhere. Changes resulting from the publishing process may therefore not be reflected in this document. The final published version may be obtained via the publisher’s DOI. Please note that additional copyright and access restrictions may apply to the published version.