背景:为老年患者提供参与个性化跌倒预防教育的机会,已被证明可以减少医院跌倒。然而,很少有研究探讨老年人对医院跌倒预防教育的看法。本研究旨在探讨老年人及其护理人员对预防医院跌倒的知识和意识。包括他们对住院时接受的教育的反思。
方法:定性,进行了焦点小组和半结构化访谈的探索性研究。参与者是在过去5年中住院的社区居住的老年人(65岁以上)和老年人的照顾者的有目的地选择的样本。使用演绎和归纳方法对数据进行主题分析,并应用能力-机会-动机-行为模型来了解实施住院老年人跌倒教育的关键决定因素。
结果:参与者[n=46(老年人n=37,年龄范围60-89岁),护理人员n=9]反馈确定了五个主题:如果参与者确实有医院跌倒或几乎跌倒,在医院需要什么行为的焦虑和不确定性,预防跌倒教育不足和不一致,沟通不足和年龄歧视的潜在态度。应用行为改变模型表明,老年人及其照顾者没有发展跌倒预防知识,从事跌倒预防行为的意识或动机。老年人在住院期间从事跌倒预防行为的机会也有限。
结论:我们研究中的老年人在入院期间接受了关于预防跌倒的零星教育,但没有提高他们对跌倒风险的认识和知识,也没有提高他们从事安全跌倒预防行为的能力。相互冲突的信息可能会导致老年人对在医院保持安全感到困惑和焦虑。
BACKGROUND: Providing older patients with an opportunity to participate in individualised falls preventive education, has been shown to reduce hospital falls. However, few studies have explored older peoples\' perspectives of hospital falls prevention education. This study aimed to explore older people and their caregivers\' knowledge and awareness about hospital falls prevention, including their reflections on the education they received when hospitalised.
METHODS: A qualitative, exploratory study with focus groups and semistructured interviews was conducted. Participants were a purposively selected sample of community-dwelling older people (65+ years) admitted to a hospital in the past 5 years and caregivers of older people. Data were thematically analysed using deductive and inductive approaches, and a capability-opportunity-motivation-behaviour model was applied to understand key determinants of implementing falls education for hospitalised older people.
RESULTS: Participants\' [n = 46 (older people n = 37, age range 60-89 years), caregivers n = 9] feedback identified five themes: distress and disempowerment if the participant did have a hospital fall or nearly fell, anxiety and uncertainty about what behaviour was required while in hospital, insufficient and inconsistent falls prevention education, inadequate communication and underlying attitudes of ageism. Applying a behaviour change model suggested that older people and their caregivers did not develop falls prevention knowledge, awareness or motivation to engage in falls prevention behaviour. Older people were also provided with limited opportunities to engage in falls preventive behaviour while in hospital.
CONCLUSIONS: Older people in our study received sporadic education about falls prevention during their hospital admissions which did not raise their awareness and knowledge about the risk of falls or their capability to engage in safe falls preventive behaviour. Conflicting messages may result in older people feeling confused and anxious about staying safe in hospital.