评估《世界跌倒指南》中用于识别挪威居家护理服务老年使用者跌倒情况的三个关键问题的内容效度和可行性。

Evaluation of content validity and feasibility of the World Falls Guidelines' three key questions to identify falls among older adult users of home care services in Norway.

作者信息

Solli Rune, Kvæl Linda Aimée Hartford, Olsen Nina Rydland, Brovold Therese

机构信息

Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Pilestredet 44, Oslo, 0167, Norway.

Norwegian Social Research (NOVA), OsloMet- Oslo Metropolitan University, Pilestredet 44, Oslo, 0167, Norway.

出版信息

BMC Health Serv Res. 2025 Mar 27;25(1):444. doi: 10.1186/s12913-025-12606-y.

DOI:10.1186/s12913-025-12606-y

PMID:40148859

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11948927/

Abstract

BACKGROUND

Falls among older adults (65 + years) is an important issue in municipal home care. Screening using the World Falls Guidelines' three key questions (3KQ) is recommended to identify older adults at increased fall risk, but the 3KQ has not been formally tested by healthcare practitioners (HCPs) working in Norwegian municipal home care. The aim of this study was to evaluate the content validity and the feasibility of the 3KQ among HCPs in home care services.

METHODS

Participants were 10 multidisciplinary HCPs working in home care and in low-threshold services of Oslo, Norway. We evaluated the content validity of the 3KQ through individual think-aloud interviews. Next, feasibility was evaluated as follows: We trained HCPs in how to use the 3KQ. HCPs then screened older adults using the 3KQ during a six-week test period, and took pocket-notes of older adults' answers. We conducted two focus groups to explore HCPs' experiences with using the 3KQ. We analysed interview data using reflexive thematic analysis.

RESULTS

Content validity evaluation revealed that HCPs found the 3KQ easy to understand, and potentially timesaving. They experienced the tool as applicable among home care users, and it was particularly useful among new users. Still, HCPs emphasised the necessity of their training on how to best ask the questions and determine appropriate actions based on users' responses. We identified three main themes from the feasibility evaluation: (1) Promoting awareness and action: using the 3KQ helps put falls on the agenda in municipal home care, (2) Obtaining reliable answers: integrating the 3KQ into daily practice is important, and (3) Unlocking insights: the 3KQ as a gateway to supplementary information from users. Most older adults had increased fall risk according to the 3KQ.

CONCLUSIONS

The 3KQ appears feasible for Norwegian municipal home care and may be of value for HCPs who screen new users and users of low-threshold services. Integrated use of the 3KQ may enhance awareness, promote reliable answers, and provide supplementary information useful for decision-making. The study findings may benefit HCPs and managers in home care services, and other stakeholders in implementing fall prevention guidelines in primary care.

TRIAL REGISTRATION

Open Science Framework Identifier https://doi.org/10.17605/OSF.IO/2JFHV . Registered: 11th January 2023.

摘要

背景

老年人（65岁及以上）跌倒在市政家庭护理中是一个重要问题。建议使用世界跌倒指南的三个关键问题（3KQ）进行筛查，以识别跌倒风险增加的老年人，但挪威市政家庭护理中的医护人员（HCPs）尚未对3KQ进行正式测试。本研究的目的是评估家庭护理服务中医护人员对3KQ的内容效度和可行性。

方法

参与者为10名在挪威奥斯陆从事家庭护理和低门槛服务的多学科医护人员。我们通过个人出声思考访谈评估了3KQ的内容效度。接下来，可行性评估如下：我们培训医护人员如何使用3KQ。然后，医护人员在为期六周的测试期内使用3KQ对老年人进行筛查，并记录老年人的回答。我们进行了两个焦点小组讨论，以探讨医护人员使用3KQ的经验。我们使用反思性主题分析法分析访谈数据。

结果

内容效度评估显示，医护人员发现3KQ易于理解，而且可能节省时间。他们认为该工具适用于家庭护理用户，在新用户中尤其有用。尽管如此，医护人员强调了他们接受关于如何最好地提出问题以及根据用户回答确定适当行动的培训的必要性。我们从可行性评估中确定了三个主要主题：（1）提高意识和采取行动：使用3KQ有助于将跌倒问题提上市政家庭护理的议程，（2）获得可靠答案：将3KQ纳入日常实践很重要，（3）挖掘见解：3KQ是获取用户补充信息的途径。根据3KQ，大多数老年人的跌倒风险增加。