The relationship between the risk of falling and fear of falling among aged hospitalized patients
Background & Aim: Identifying older people with the risk of falls in hospitals is particularly essential for the prevention of falls. Review of literature revealed that the association of falls and fear of falls had not been investigated extensively in previous studies in Iran. This study aimed to determine the relationship between falling and fear of falling among elderly hospitalized patients.
Methods & Materials: In this descriptive-correlational study, 1123 subjects were recruited. Of all subjects, 385aged hospitalized patients, 60 years old and above, were conveniently selected based on inclusion criteria in Shahroud Imam Hossein hospital from March to December 2016. Johns Hopkins fall risk assessment tool (JHFRAT) was used to evaluate the risk of falls among older people and the Falling Efficiency Scale (FES) was applied to assess fear of falling. SPSS software version 19with the significance level of p<0.05. Chi-Square test and exact test of Fisher and logistic regression has been used for data analysis.
Results: All aged patients (n=1123) admitted in the emergency room were assessed for eligibility to inclusion in the study. Of all subjects, 385 patients were included in this study. The subjects' mean of age was 71.68±4.32 years, age range: 60-84. Of all samples (n=385) of study, 90 (23.4%), 151(39.2%), and 144 (37.4%) had low, middle, and high risk of falls, respectively. Of all participants of the study, 193(51%) subjects were male, and 192(49%) were female. One-third (36.4%) of the subjects had fear of falls and (33.8%) experienced fall in the last six months before admission. A statistically significant relationship was found between the incidence of falls and fear of falling (P<0.001).
Conclusion: This study found JHFRAT and FES as two applicable instruments for assessment of aged people. The result of this study concluded that evaluation of fear of falling and the risk of falls among hospitalized elderly patients are recommended as a routine procedure to predict the risk of falls. Nurses are in the best position to evaluate the fear of falls and risk of falls, so it is recommended considering the fear of falls as a potential risk factor for falls in the hospital.
Lucero RJ, Lindberg DS, Fehlberg EA, Bjarnadottir RI, Li Y, Cimiotti JP, Crane M, Prosperi M. A data-driven and practice-based approach to identify risk factors associated with hospital-acquired falls: Applying manual and semi-and fully-automated methods. International journal of medical informatics. 2019 Feb 1;122:63-9.
Hojati H, Dadgari A, Mirrezaie SM. Validity and Reliability of Persian Version of Johns Hopkins Fall Risk Assessment Tool among Aged People. Qom University of Medical Sciences Journal. 2018 Apr 15;12(2):45-53.
Dadgari A, Hamid TA, Hakim MN, Chaman R, Mousavi SA, Hin LP, Dadvar L. Randomized control trials on Otago exercise program (OEP) to reduce falls among elderly community dwellers in Shahroud, Iran. Iranian Red Crescent Medical Journal. 2016 May;18(5): e26340.
Ungar A, Mussi C, Ceccofiglio A, Bellelli G, Nicosia F, Bo M, Riccio D, Martone AM, Guadagno L, Noro G, Ghidoni G. Etiology of syncope and unexplained falls in elderly adults with dementia: syncope and dementia (SYD) study. Journal of the American Geriatrics Society. 2016 Aug;64(8):1567-73.
Jin Z, Cao L, Cheng Y, Liu Q, editors. Falls in old age: Research Review of Risk Identification and Intervention. IOP Conference Series: Materials Science and Engineering; 2018,439(3):032054.IOP Publishing.
Luk JK, Chan TY, Chan DK. Falls prevention in the elderly: translating evidence into practice. Hong Kong Med J. 2015 Apr 1;21(2):165-71.
Poe SS, Dawson PB, Cvach M, Burnett M, Kumble S, Lewis M, Thompson CB, Hill EE. The Johns Hopkins Fall Risk Assessment Tool. Journal of nursing care quality. 2018 Jan 1;33(1):10-9.
Sattar S, Spoelstra SL, Alibhai SM, Puts MT. Circumstances of falls and fear of falling in community-dwelling older adults with cancer: results from a mixed-methods study. Journal of geriatric oncology. 2019 Jan 1;10(1):105-11.
Hershkovitz L, Malcay O, Grinberg Y, Berkowitz S, Kalron A. The contribution of the instrumented Timed-Up-and-Go test to detect falls and fear of falling in people with multiple sclerosis. Multiple sclerosis and related disorders. 2019 Jan 1;27:226-31.
Choi NG, Marti CN, DiNitto DM, Kunik ME. Longitudinal associations of falls and depressive symptoms in older adults. The Gerontologist. 2019.
Dadgari A, Hamid TA, Mousavi SA, Hakim N, Hin LP, Dadvar L. Internal Consistency of Persian Version of Falls Efficacy Scale and Activity-Specific Balance Scale. International Journal of Health Studies. 2016;1(3): 29-32.
Klinkenberg WD, Potter P. Validity of the Johns Hopkins Fall Risk Assessment Tool for predicting falls on inpatient medicine services. Journal of nursing care quality. 2017;32(2):108-13.
Tinetti ME, Richman D, Powell L. Falls efficacy as a measure of fear of falling. Journal of gerontology. 1990;45(6):P239-P43.
ZHANG J-h, SU T-j, WANG H-j, YANG X-h. Correlation between Fall Risk and Psychological Efficiency in Elderly Inpatients [J]. Journal of Nursing. 2011;9:009.
Iranfar M, Eyni E, Soori H. Determining the epidemiology of falls in elderly of nursing home in Tehran. Iranian Journal of Aging. 2013;8(2):30-8.
Ash KL, MacLeod P, Clark L. A case control study of falls in the hospital setting. Journal of gerontological nursing. 1998;24(12):7-9.
Ghanbari A, Salehi Dehnavi N, Moslemiye Haghighi F, Torabi M. Prevalence and factors associated with falls in the elderly over 55 years of Shiraz. Iranian Journal of Aging. 2013;8(28):64-70.
Najafi Ghezlcheh T, Ariapour S, Jafari Oori M. Epidemiology and relationship of fall and fear of falling in the elderly residing at Kamrani nursing home, Tehran, Iran. Iranian Journal of Ageing. 2016;10(4):152-61.
Riemann BL, Lininger M, Kirkland MK, Petrizzo J. Age related changes in balance performance during self-selected and narrow stance testing. Archives of gerontology and geriatrics. 2018;75:65-9.
Chang H-T, Chen H-C, Chou P. Factors associated with fear of falling among community-dwelling older adults in the Shih-Pai study in Taiwan. PloS one. 2016;11(3):e0150612.
Stahl ST, Albert SM. Gender differences in physical activity patterns among older adults who fall. Preventive medicine. 2015;71:94-100.
Degens H. Human Ageing: Impact on Muscle Force and Power. Muscle and Exercise Physiology: Elsevier; 2019: 423-32.
Collado-Mateo D, Gallego-Diaz JM, Adsuar J, Domínguez-Muñoz FJ, Olivares P, Gusi N. Fear of falling in women with fibromyalgia and its relation with number of falls and balance performance. BioMed research international. 2015.
Lopes K, Costa D, Santos L, Castro D, Bastone A. Prevalence of fear of falling among a population of older adults and its correlation with mobility, dynamic balance, risk and history of falls. Brazilian Journal of Physical Therapy. 2009;13(3):223-9.
Borhaninejad V, Rashedi V, Tabe R, Delbari A, Ghasemzadeh H. Relationship between fear of falling and physical activity in older adults. medical journal of mashhad university of medical sciences. 2015;58(8):446-52.
Arfken CL, Lach HW, Birge SJ, Miller JP. The prevalence and correlates of fear of falling in elderly persons living in the community. American journal of public health. 1994;84(4):565-70.
Clemson L, Kendig H, Mackenzie L, Browning C. Predictors of injurious falls and fear of falling differ: an 11-year longitudinal study of incident events in older people. Journal of aging and health. 2015;27(2):239-56.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.