Effectiveness of autonomous home hazard reduction on fear of falling in community-dwelling older women

被引:3
作者
Schroeder, Ove [1 ]
Schroeder, Julia [2 ]
Fitschen-Oestern, Stefanie [1 ]
Besch, Lutz [1 ]
Seekamp, Andreas [1 ]
机构
[1] Univ Med Dept Ctr Schleswig Holstein, Dept Orthoped & Trauma Surg, Kiel, Germany
[2] Univ Kiel, Med Fac, Kiel, Germany
关键词
checklist; community-dwelling; fall prevention; fear of falling; home hazards; older women; RISK-FACTORS; PEOPLE; EFFICACY; ADULTS; POPULATION; PREVALENCE; VALIDATION; PREVENTION; INJURIES; CIRCUMSTANCES;
D O I
10.1111/jgs.17725
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Background Many falls in older people occur at home, and home hazards (HOHA) are often involved. Fear of falling (FOF) is a frequent and serious consequence of falls. This study aimed to analyze the effectiveness of an autonomous reduction of HOHA on FOF. Methods In this single-blinded, prospective cohort study design, the inclusion criteria were female sex, age >= 60 years, no known dementia, community-dwelling, and written informed consent. Using a 54-item room-by-room checklist, the participants identified and autonomously reduced as many HOHA as possible, within 14 days. The FOF was measured using a dichotomous scale (D-FOF) and the Falls Efficacy Scale International (FES-I). Logistic regression models were used to identify the predictors of a substantial reduction of HOHA (>= 50%) and FOF (>= 25%). Results A total of 782 women fulfilled the inclusion criteria, and 431 (60.5%) returned the complete checklist on time. The mean age was 72.5 [SD 7.1] years. 43.8% of participants reduced >= 50% of the HOHA. The D-FOF (odds ratio 22.4 [95% confidence interval 11.0-45.3]), age >= 75 years (14.1 [7.5-26.4]), polypharmacy (3.0 [1.4-6.5]), and assumed improvability of housing conditions (2.4 [1.3-4.3]) were identified as predictors for substantially reducing HOHA with an area under the curve of 0.91. The initial FES-I score decreased from 24.5 to 19.5. Prior to the intervention, 53.1% showed a high FOF (>22 FES-I scores). Of these, 70.7% participants reduced their high FOF to low FOF. 29.2% of all participants reduced FOF >= 25% postinterventionally, associated with a substantial reduction in HOHA (3.5 [2.2-5.7]) as the strongest independent factor in the multiple logistic regression analysis. Conclusion The use of a self-administered checklist led to a substantial reduction of HOHA and subsequently to a clinically relevant reduction of FOF in older community-dwelling women. Autonomous competence of older people should be considered when developing fall prevention strategies.
引用
收藏
页码:1754 / 1763
页数:10
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