KITE, Toronto Rehab-University Health Network, Toronto, ON, Canada.
Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
PLoS One. 2020 Aug 28;15(8):e0238116. doi: 10.1371/journal.pone.0238116. eCollection 2020.
Wheelchair users with spinal cord injury are at a high risk of falls. However, the perspectives of wheelchair users with spinal cord injury on their fall circumstances and their preferences for fall prevention strategies/interventions remain understudied. Therefore, we aimed to: a) describe the circumstances of falls experienced by wheelchair users with spinal cord injury over a six-month period, b) explore their perspectives of why falls occurred in certain situations, and c) explore their perspectives on recommended content/structure of fall prevention strategies/interventions.
This sequential explanatory mixed methods study had two phases. Phase I involved tracking of falls experienced by wheelchair users with spinal cord injury over six months, in which participants completed a survey after experiencing a fall to track the number/circumstance of each fall. Data from the surveys were descriptively reported. Phase II involved a photovoice focus group discussion of the survey findings and their preferences for fall prevention strategies/interventions. Data from the focus group discussion were analyzed using a thematic analysis.
Thirty-two participants completed phase I. More than half of the participants fell at least once in six months. Falls commonly occurred in the afternoon during a transfer, or when participants were wheeling over uneven ground. One-third of the falls caused an injury. Eleven participants that fell during phase I participated in the focus group. Two main themes were identified from the discussion: 1) "circumstances surrounding the falls" (e.g. when falls occurred, the home is a 'safe space') and 2) "suggestions and preferences for fall prevention strategies/interventions" (e.g. fall prevention involves all, fall prevention training available as needed).
Fall prevention strategies/interventions should be an integral component of rehabilitation practices across the lifespan. Participants recommend customizing fall prevention strategies/interventions to their specific needs to guide the structure, content, and delivery of targeted fall prevention programs.
脊髓损伤的轮椅使用者有很高的跌倒风险。然而，对于脊髓损伤的轮椅使用者对他们跌倒情况的看法以及他们对预防跌倒策略/干预措施的偏好，研究仍不够充分。因此，我们的目的是：a）描述脊髓损伤的轮椅使用者在六个月内经历的跌倒情况，b）探讨他们对某些情况下跌倒原因的看法，以及 c）探讨他们对推荐的预防跌倒策略/干预措施的内容/结构的看法。
这是一项具有两个阶段的顺序解释性混合方法研究。第一阶段涉及对脊髓损伤的轮椅使用者在六个月内经历的跌倒进行跟踪，在此期间，参与者在经历跌倒后完成一项调查，以跟踪每次跌倒的次数/情况。调查数据以描述性报告呈现。第二阶段涉及对调查结果的摄影焦点小组讨论以及他们对预防跌倒策略/干预措施的偏好。使用主题分析对焦点小组讨论的数据进行分析。
32 名参与者完成了第一阶段。超过一半的参与者在六个月内至少跌倒一次。跌倒通常发生在下午转移期间，或参与者在不平坦的地面上行驶时。三分之一的跌倒导致受伤。在第一阶段跌倒的 11 名参与者参加了焦点小组。讨论中确定了两个主要主题：1）“跌倒的情况”（例如，何时跌倒，家是一个“安全的空间”）和 2）“预防跌倒策略/干预措施的建议和偏好”（例如，预防跌倒涉及所有人，按需提供预防跌倒培训）。
预防跌倒的策略/干预措施应成为整个生命周期康复实践的一个组成部分。参与者建议根据他们的特定需求定制预防跌倒策略/干预措施，以指导有针对性的预防跌倒计划的结构、内容和交付。
