a Department of Occupational Therapy , New York University, Steinhardt School of Culture, Education, and Human Development , New York , NY , USA.
Aging Ment Health. 2018 Jun;22(6):849-855. doi: 10.1080/13607863.2017.1309639. Epub 2017 Apr 10.
Using a theoretical model that combines an ecological perspective and Bandura's theory of self-efficacy as a guide, we sought to compare experiences and characteristics of community dwelling older adults with and without concern about falling outdoors.
A survey of randomly selected community dwelling older adults across NYC (N = 120) was conducted using the outdoor falls questionnaire. Descriptive quantitative analyses of participant characteristics were conducted for all participants and for those with and without concern about falling outside. Conventional content analysis using two coders was employed to examine outdoor fall experiences for each group. A mixed methods matrix was used to integrate qualitative and quantitative findings.
Some participant characteristics were more common among those with a concern about falling outside such as decreased functional status, female gender, and number of prior outdoor falls. As per descriptions of outdoor fall experiences, participants with concern were more likely to report a fall while climbing stairs or stepping up a curb, describe an intrinsic factor as a cause of their fall, use an injury prevention strategy during the fall, sustain a moderate to severe injury, seek medical attention, have had an ambulance called, require help to get up, and describe implementation of a behavioral change after the fall.
Differences exist in participant characteristics and outdoor fall experiences of those with and without concern about falling outside. The proposed model can be used to understand fear of falling outdoors and can help to inform the target population and content of intervention programs.
本研究旨在结合生态视角和班杜拉自我效能理论的理论模型，比较对户外跌倒有或无担忧的社区居住老年人的经历和特征。
采用户外跌倒问卷，对纽约市（N=120）的随机抽取的社区居住老年人进行调查。对所有参与者以及对户外跌倒有或无担忧的参与者的特征进行描述性定量分析。对每组的户外跌倒经历，采用两位编码员进行常规内容分析。采用混合方法矩阵整合定性和定量研究结果。
一些参与者的特征在对户外跌倒有担忧的人群中更为常见，例如功能状态下降、女性、以及既往户外跌倒次数。就户外跌倒经历的描述而言，有担忧的参与者更可能报告在爬楼梯或上台阶时跌倒、将内在因素描述为跌倒的原因、在跌倒时使用预防损伤策略、遭受中度至重度损伤、寻求医疗帮助、呼叫救护车、需要帮助才能站起来，并描述在跌倒后采取行为改变。
对户外跌倒有或无担忧的参与者的特征和户外跌倒经历存在差异。所提出的模型可用于理解对户外跌倒的恐惧，并有助于了解目标人群和干预计划的内容。
