Department of Health Care and Nursing Science, Maastricht University, The Netherlands.
Aging Ment Health. 2011 Jan;15(1):68-77. doi: 10.1080/13607863.2010.501054.
Concerns about falling, or fear of falling, is highly common in old age and has adverse consequences. The development and understanding of interventions to reduce concerns about falling are therefore relevant. This study explored the mediating effects of psychosocial factors on trajectories of concerns about falling and daily activity in a multicomponent cognitive behavioral group intervention.
The study sample comprised 540 community-dwelling adults aged 70 years or older, with concerns about falling and associated activity avoidance, who participated in a randomized controlled trial evaluating this intervention. Control beliefs, self-efficacy beliefs, outcome expectations, and social interactions, as potential mediators, and concerns about falling and daily activity, as outcome variables, were assessed at baseline, and at two, eight, and 14 months. Data were analyzed with mixed-effects regression models.
Small to moderate statistically significant effects of the intervention on the potential mediators were found at nearly all follow-up assessments. Separate psychosocial factors showed modest mediating effects on the outcomes. When all mediators were taken into account simultaneously, 44-76% of the association between the intervention and the outcomes was explained.
This study showed that the multicomponent cognitive behavioral intervention improved control beliefs, self-efficacy, outcome expectations, and social interactions. These variables mediated the association between the intervention and concerns about falling or daily activity in community-dwelling older adults. This knowledge may facilitate further improvement and development of interventions to reduce concerns about falling and to increase daily activity.
对跌倒的担忧或恐惧在老年人中非常常见，且具有不良后果。因此，开发和理解减少对跌倒的担忧的干预措施是相关的。本研究探讨了多组分认知行为团体干预对跌倒相关担忧和日常活动轨迹的心理社会因素的中介作用。
该研究样本包括 540 名 70 岁或以上、对跌倒及其相关活动回避有担忧的社区居住成年人，他们参加了一项评估该干预措施的随机对照试验。控制信念、自我效能信念、结果期望和社会互动作为潜在的中介因素，以及对跌倒的担忧和日常活动作为结果变量，在基线以及 2、8 和 14 个月时进行评估。使用混合效应回归模型进行数据分析。
干预措施对几乎所有随访评估中的潜在中介因素均产生了小到中等程度的统计学显著影响。单独的心理社会因素对结果具有适度的中介作用。当同时考虑所有中介因素时，干预措施与结果之间的关联有 44%-76%得到了解释。
本研究表明，多组分认知行为干预可改善控制信念、自我效能、结果期望和社会互动。这些变量中介了干预措施与社区居住老年人对跌倒或日常活动的担忧之间的关联。这些知识可能有助于进一步改进和开发减少对跌倒的担忧和增加日常活动的干预措施。
