Department of Internal Medicine, Section of Geriatric Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Exp Gerontol. 2012 Apr;47(4):342-5. doi: 10.1016/j.exger.2012.01.006. Epub 2012 Jan 28.
BACKGROUND/OBJECTIVES: Falls are a major public health problem. Older persons are frequently underrepresented in trials, including falls prevention trials. Insight into possible reasons for non-participation could help to improve trial designs and participation rates among this age-group. The aim of this study was to explore reasons why older people refuse to participate in falls prevention trials.
A qualitative study.
Community-dwelling adults aged ≥65 years who attended the Emergency Department due to a fall and refused to participate in a falls prevention trial (IMPROveFALL-study).
A structured interview guide was used, and interview transcripts were subjected to an independent content analysis by two researchers.
15 interviews were conducted. A main reason to refuse trial participation was mobility impairment. In contrast, younger and more "active" and mobile seniors considered themselves "too healthy" to participate. Persons with multiple comorbidities mentioned that they attended a hospital too often, or experienced adequate follow-up by their own physicians already. Transport problems, including distance to the hospital, parking facilities, and travel expenses were another issue. During the interviews it was emphasized by the patients, that they knew the reason for their fall. However, they were not familiar with the positive effects of falls prevention programmes.
Older persons reported multiple reasons to refuse participation in a falls prevention study, such as health-related factors, several practical problems, and personal beliefs about the causes and preventability of falls. Anticipation of those issues might contribute to an improvement in participation rates of older fallers, shorter study duration, and a better generalizability of research findings.
背景/目的：跌倒 是一个主要的公共卫生问题。老年人在试验中经常代表性不足，包括跌倒预防试验。了解不参与的可能原因有助于改善该年龄段的试验设计和参与率。本研究旨在探讨老年人拒绝参与跌倒预防试验的原因。
定性研究。
因跌倒而到急诊科就诊且拒绝参与跌倒预防试验（IMPROveFALL 研究）的社区居住的 65 岁及以上成年人。
使用了结构化访谈指南，访谈记录由两位研究人员进行独立的内容分析。
进行了 15 次访谈。拒绝参与试验的主要原因是行动不便。相比之下，年轻且更“活跃”和行动自如的老年人认为自己“太健康”而无需参与。患有多种合并症的人提到，他们去医院的次数太多，或者已经得到了自己医生的充分随访。交通问题，包括到医院的距离、停车设施和旅行费用也是一个问题。在访谈中，患者强调他们知道跌倒的原因。然而，他们对跌倒预防计划的积极效果并不熟悉。
老年人报告了拒绝参与跌倒预防研究的多个原因，例如健康相关因素、多个实际问题以及个人对跌倒的原因和可预防的看法。预期这些问题可能有助于提高老年跌倒者的参与率、缩短研究持续时间和提高研究结果的推广性。
