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J Am Geriatr Soc. 2019 Nov;67(11):2274-2281. doi: 10.1111/jgs.16053. Epub 2019 Jul 2.

Evaluation of Tailored Falls Education on Older Adults' Behavior Following Hospitalization.

Author information

1
School of Physiotherapy and Exercise Sciences, Faculty of Health Science, Curtin University, Perth, Western Australia, Australia.
2
School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.
3
Centre for Functioning and Health Research, Metro South Health, Brisbane, Queensland, Australia.
4
Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Victoria, Australia.
5
Healthscope and La Trobe Centre for Sport and Exercise Medicine Research, La Trobe University, Melbourne, Victoria, Australia.
6
Western Australian Centre for Health and Ageing, University of Western Australia, Royal Perth Hospital, Perth, Western Australia, Australia.
7
Malcom Randall VA Medical Center, Geriatric Research Education and Clinical Center, Gainesville, Florida.
8
College of Medicine, University of Florida, Gainesville, Florida.
9
Western Australian Centre for Health and Ageing, Centre for Medical Research, University of Western Australia, Perth, Western Australia, Australia.
10
Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia.
11
School of Occupational Therapy and Social Work, Faculty of Health Science, Curtin University, Perth, Western Australia, Australia.
12
School of Physiotherapy, Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia.
13
Department of Geriatric Rehabilitation, Armadale Health Service, Department of Health, Mount Nasura, Western Australia, Australia.
14
Department of Aged Care and Rehabilitation, St John of God Health Care, Midland, Western Australia, Australia.

Abstract

BACKGROUND:

Older adults recently discharged from the hospital are known to be at risk of functional decline and falls. This study evaluated the effect of a tailored education program provided in the hospital on older adult engagement in fall prevention strategies within 6 months after hospital discharge.

METHODS:

A process evaluation of a randomized controlled trial that aimed to improve older adult fall prevention behaviors after hospital discharge. Participants (n = 390) were aged 60 years and older with good cognitive function (greater than 7 of 10 Abbreviated Mental Test Score), discharged home from three hospital rehabilitation wards in Perth, Australia. The primary outcomes were engagement in fall prevention strategies, including assistance with daily activities, home modifications, and exercise. Data were analyzed using generalized linear modeling.

RESULTS:

There were 76.4% (n = 292) of participants who completed the final interview (n = 149 intervention, n = 143 control). There were no significant differences between groups in engagement in fall prevention strategies, including receiving instrumental activity of daily living (IADL) assistance (adjusted odds ratio [AOR] = 1.3 [95% confidence interval {CI} = 0.7-2.1]; P = .3), completion of home modifications (AOR = 1.2 [95% CI = 0.7-1.9]; P = .4), and exercise (AOR = 1.3 [95% CI = 0.7-2.2]; P = .3). There was a high proportion of unmet ADL needs within both groups, and levels of participant dependency remained higher at 6 months compared to baseline levels at admission. The proportion of all participants who engaged in exercise following hospital discharge increased by 30%; however, the mean duration of exercise reduced from 3 hours per week at baseline to 1 hour per week at 6-month follow-up (SD = 1.12 hours per week).

CONCLUSION:

Tailored education did not increase older adult engagement in fall prevention strategies after hospital discharge compared to usual care. Further research is required to evaluate older adults' capacity to change their behaviors once they return home from hospital, which may enable a safer recovery of their independence. J Am Geriatr Soc 67:2274-2281, 2019.

KEYWORDS:

evaluation studies; fall prevention; health behavior change; hospitalization; patient discharge

PMID:
31265139
DOI:
10.1111/jgs.16053

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