Citation

Naseri C, McPhail SM, Haines TP, Morris ME, Shorr R, Etherton-Beer C, Netto J, Flicker L, Bulsara M, Lee DA, Francis-Coad J, Waldron N, Boudville A, Hill AM. Health Soc. Care Community 2020; ePub(ePub): ePub.

Affiliation

School of Physiotherapy and Exercise Sciences, Faculty of Health Science, Curtin University, Perth, WA, Australia.

Copyright

(Copyright © 2020, John Wiley and Sons)

DOI

10.1111/hsc.12996

PMID

32337796

Abstract

Older adults recently discharged from hospital are at high risk of functional decline and falls. A tailored fall prevention education provided at hospital discharge aimed to improve the capacity of older adults to engage in falls prevention activities. What remains unknown are the factors affecting behaviour change after hospital discharge. This study identified the perceived barriers and enablers of older adults to engagement in fall prevention activities during the 6-month period post-discharge. An exploratory approach using interpretative phenomenological analysis focused on the lived experience of a purposive sample (n = 30) of participants. All were recruited as a part of an RCT (n = 390) that delivered a tailored fall prevention education program at three hospital rehabilitation wards in Perth, Australia. Data were collected at 6-month post-discharge using semi-structured telephone surveys. Personal stories confirmed that some older adults have difficulty recovering functional ability after hospital discharge. Reduced physical capability, such as experiences of fatigue, chronic pain and feeling unsteady when walking were barriers for participants to safely return to their normal daily activities. Participants who received the tailored fall education program reported positive effects on knowledge and motivation to engage in fall prevention. Participants who had opportunities to access therapy or social supports described more positive experiences of recovery compared to individuals who persevered without assistance. A lack of physical and social support was associated with apprehension and fear toward adverse events such as falls, injuries, and hospital readmission. The lived experience of participants following hospital discharge strongly suggested that they required more supports from both healthcare professionals and caregivers to ensure that their needs were met. Further research that evaluates how to assist this population to engage in programs that will mitigate the high risk of falls and hospital readmissions is required.

© 2020 John Wiley & Sons Ltd.

Language: en

Keywords

evaluation; fall prevention; falls; health behaviour change; hospitalization; patient discharge; physiotherapy