A hybrid concept analysis of fall risk appraisal: Integration of older adults' perspectives with an integrative literature review

Aim This study aimed to define the concept of fall risk appraisal (FRA) and its measures by integrating the older adults' perspectives with an integrative literature review. Background Appraised fall risk is based mainly on either subjective or objective measures, which may result in inaccurate predictions of fall risk. Design This study was developed based on three phases of the hybrid concept analysis including a theoretical phase, a fieldwork phase, and an analytic phase. Eleven articles were selected to review in the theoretical phase. Qualitative data from in-depth interviews and focus groups in the fieldwork phase were used to compare and integrate into the analytic phase. Results FRA is a two-dimensional assessment of fall risk in older adults. Two independent dimensions were defined as (a) physiological fall risk dimension reflecting physical or body function, which may decline with age, and (b) perceived fall risk dimension reflecting the older adults' perception of their likelihood to fall. FRA consists of two categories including adaptive fall risk appraisal and maladaptive fall risk appraisal. Conclusion A practical definition of FRA and its measures could be extremely valuable for supporting the need for fall risk assessments and would be integral to nursing practice.