Naseri Chiara, McPhail Steven M, Netto Julie, Haines Terrence P, Morris Meg E, Etherton-Beer Christopher, Flicker Leon, Lee Den-Ching A, Francis-Coad Jacqueline, Hill Anne-Marie
School of Physiotherapy and Exercise Sciences, Faculty of Health Science, Curtin University, Perth, Western Australia, Australia.
School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.
BMJ Open. 2018 Apr 20;8(4):e020726. doi: 10.1136/bmjopen-2017-020726.
Older adults recently discharged from hospital have greater incidence of adverse events, functional decline, falls and subsequent readmission. Providing education to hospitalised patients on how to prevent falls at home could reduce postdischarge falls. There has been limited research investigating how older adults respond to tailored falls prevention education provided at hospital discharge. The aim of this study is to evaluate how providing tailored falls prevention education to older patients at the point of, and immediately after hospital discharge in addition to usual care, affects engagement in falls prevention strategies in the 6-months postdischarge period, including their capability and motivation to engage in falls prevention strategies.
This prospective observational cohort study is a process evaluation of a randomised controlled trial, using an embedded mixed-method design. Participants (n=390) who have been enrolled in the trial are over the age of 60 years, scoring greater than 7/10 on the Abbreviated Mental Test Score. Participants are being discharged from hospital rehabilitation wards in Perth, Western Australia, and followed up for 6 months postdischarge. Primary outcome measures for the process evaluation are engagement in falls prevention strategies, including exercise, home modifications and receiving assistance with activities of daily living. Secondary outcomes will measure capability, motivation and opportunity to engage in falls prevention strategies, based on the constructs of the Capability Opportunity Motivation Behaviour system. Quantitative data are collected at baseline, then at 6 months postdischarge using structured phone interviews. Qualitative data are collected from a purposive sample of the cohort, using semistructured in-depth phone interviews. Quantitative data will be analysed using regression modelling and qualitative data will be analysed using interpretive phenomenological analysis.
Results will be presented in peer-reviewed journals and at conferences worldwide. This study is approved by hospital and university Human Research Ethics Committees.
近期出院的老年人发生不良事件、功能衰退、跌倒及随后再次入院的发生率更高。为住院患者提供有关如何在家预防跌倒的教育可减少出院后跌倒的发生。关于老年人对出院时提供的针对性跌倒预防教育如何反应的研究有限。本研究的目的是评估在出院时及出院后立即为老年患者提供针对性跌倒预防教育（除常规护理外）如何影响出院后6个月内参与跌倒预防策略的情况，包括他们参与跌倒预防策略的能力和动机。
这项前瞻性观察性队列研究是对一项随机对照试验的过程评估，采用嵌入式混合方法设计。已纳入该试验的参与者（n = 390）年龄在60岁以上，简易精神状态检查表得分大于7/10。参与者从西澳大利亚珀斯的医院康复病房出院，并在出院后随访6个月。过程评估的主要结局指标是参与跌倒预防策略，包括锻炼、家庭改造以及在日常生活活动中接受帮助。次要结局将根据能力-机会-动机-行为系统的结构来衡量参与跌倒预防策略的能力、动机和机会。在基线时收集定量数据，然后在出院后6个月使用结构化电话访谈收集。定性数据从该队列的一个有目的样本中收集，采用半结构化深度电话访谈。定量数据将使用回归模型进行分析，定性数据将使用解释性现象学分析进行分析。
研究结果将在同行评审期刊及全球会议上发表。本研究已获医院和大学人类研究伦理委员会批准。
