School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.
School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.
Clin Interv Aging. 2018 Mar 26;13:485-495. doi: 10.2147/CIA.S162728. eCollection 2018.
Almost half of older people receiving community care fall each year and this rate has not improved in the last decade. Falls prevention programs targeted at this group are uncommon, and expensively delivered by university trained allied health professionals.
To investigate the feasibility of community care workers delivering a falls prevention exercise program to older clients, at low or medium risk of falling, as part of an existing service provision.
Community care workers from 10 community care organizations participated in the training for, and delivery to their clients of, an 8-week evidence-based falls prevention exercise program. Community care workers included assessment staff (responsible for identifying the need for community care services through completing an assessment) and support workers (responsible for providing support in the home). Clients were surveyed anonymously at the completion of the intervention and workers participated in a semi-structured interview.
Twenty-five community care workers participated in the study. The falls prevention program was delivered to 29 clients, with an average age of 82.7 (SD: 8.72) years and consisting of 65.5% female. The intervention was delivered safely with no adverse events recorded, and the eligibility and assessment tools were completed by the majority of community care workers (93.1%). Assessment staff found it difficult to find time to deliver the intervention. Support workers were able to complete the intervention within their current service delivery period, with the initial assessment taking a small amount of additional time. Support workers reported enjoying the additional responsibility afforded by delivering the falls prevention program and seeing changes in their clients. The majority of clients (82%) reported enjoying the exercises, with 59% reporting that they felt it made a positive change in their health. Clients completed the exercises on average 4.8 (SD: 2.2) days per week.
Community care workers who have completed appropriate training are able to deliver a falls prevention exercise program to their clients as part of their current services. Further research is required to determine whether the program reduces the rate of falls for community care clients and whether integration of a falls prevention program into an existing service is cost-effective.
每年有近一半接受社区护理的老年人跌倒,而这一比例在过去十年中并未改善。针对这一人群的跌倒预防计划很少见,而且由经过大学培训的联合健康专业人员提供的费用高昂。
调查社区护理工作者在现有服务提供的基础上,为低或中度跌倒风险的老年客户提供跌倒预防锻炼计划的可行性。
来自 10 个社区护理组织的社区护理工作者参加了为期 8 周的基于证据的跌倒预防锻炼计划的培训,并将其提供给客户。社区护理工作者包括评估人员(负责通过完成评估来确定社区护理服务的需求)和支持人员(负责在家中提供支持)。客户在干预结束时匿名接受调查,工作人员参加半结构化访谈。
共有 25 名社区护理工作者参与了这项研究。跌倒预防计划共为 29 名客户提供服务,平均年龄为 82.7(SD:8.72)岁,其中 65.5%为女性。干预措施安全实施,无不良事件记录,大多数社区护理工作者(93.1%)完成了资格和评估工具。评估人员发现很难找到时间实施干预措施。支持人员能够在其当前服务提供期间完成干预措施,最初的评估只需花费少量额外的时间。支持人员报告说,他们很享受通过提供跌倒预防计划所获得的额外责任,并看到了他们客户的变化。大多数客户(82%)喜欢锻炼,其中 59%的客户报告说这对他们的健康有积极的影响。客户平均每周完成锻炼 4.8(SD:2.2)天。
经过适当培训的社区护理工作者能够在其现有服务的基础上为其客户提供跌倒预防锻炼计划。需要进一步的研究来确定该计划是否能降低社区护理客户的跌倒率,以及将跌倒预防计划纳入现有服务是否具有成本效益。