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探索预防跌倒从业者如何评估和处理对跌倒的担忧。

Exploring how falls prevention practitioners assess and manage concerns about falling.

作者信息

Nicklen Bianca, Delbaere Kim, Ellmers Toby J

机构信息

Department of Brain Sciences, Centre for Vestibular Neurology, Charing Cross Hospital, Imperial College, London, W6 8RP, UK.

Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW, Australia.

出版信息

Eur Geriatr Med. 2025 Feb;16(1):219-227. doi: 10.1007/s41999-024-01127-2. Epub 2024 Dec 17.

Abstract

BACKGROUND

Concerns about falling (CaF) are common in older adults. They can lead to various negative outcomes, including an increased risk for future falls. The Worlds Falls Guidelines recently published recommendations for assessing and treating CaF. However, the extent to which these guidelines have been adopted into falls prevention practice (in addition to the barriers preventing implementation) are currently unknown.

METHODS

A cross-sectional survey was completed by 114 healthcare professionals working in falls prevention and rehabilitation services in the UK and Ireland. The survey explored their experiences and perceptions regarding the management and assessment of CaF.

RESULTS

Only 39% of respondents reported using the Falls Efficacy Scale-International (FES-I), a tool recommended by the World Falls Guidelines for assessing CaF. Healthcare professionals in hospital settings were significantly less likely to use the FES-I compared to those working in the community (X = 6.324, p = 0.043). While there was no significant difference between settings regarding the type of intervention used to manage CaF, only about 50% of participants adopted a holistic approach combining physical and psychological strategies as recommended by the World Falls Guidelines. The most commonly identified barriers to clinical management of CaF were a lack of both time and perceived effective interventions, particularly for those working within hospital settings (X = 6.209, p = 0.013 and X = 3.752, p = 0.053, respectively).

CONCLUSION

These findings indicate low levels of adoption of the World Falls Guidelines recommendations for assessing and managing CaF, especially in hospital settings. Future work should focus on addressing these barriers to maximise the clinical adoption of these recommendations.

摘要

背景

对跌倒的担忧(CaF)在老年人中很常见。它们会导致各种负面后果,包括未来跌倒风险增加。最近发布的《世界跌倒指南》对评估和治疗CaF提出了建议。然而,这些指南在跌倒预防实践中的采用程度(以及阻碍实施的因素)目前尚不清楚。

方法

114名在英国和爱尔兰从事跌倒预防与康复服务的医疗保健专业人员完成了一项横断面调查。该调查探讨了他们对CaF管理和评估的经验与看法。

结果

只有39%的受访者报告使用了国际跌倒效能量表(FES-I),这是《世界跌倒指南》推荐的用于评估CaF的工具。与社区工作人员相比,医院环境中的医疗保健专业人员使用FES-I的可能性显著更低(X = 6.324,p = 0.043)。虽然在用于管理CaF的干预类型方面,不同环境之间没有显著差异,但只有约50%的参与者采用了《世界跌倒指南》推荐的将身体和心理策略相结合的整体方法。CaF临床管理中最常被提及的障碍是缺乏时间和有效的干预措施,特别是对于医院环境中的工作人员(分别为X = 6.209,p = 0.013和X = 3.752,p = 0.053)。

结论

这些发现表明,《世界跌倒指南》中关于评估和管理CaF的建议采用率较低,尤其是在医院环境中。未来的工作应专注于克服这些障碍,以最大限度地在临床中采用这些建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cab/11850553/cb9978b64928/41999_2024_1127_Fig1_HTML.jpg

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