The Development of Practice Guideline for Preventing Fall Using 10 P’s Multifactorial Concepts among Older Adults in Community

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Panwarada Suwan
Napathtron Kanthanaphat
Jutharat Soawaphan
Supreeda Intarasongkor
Anchalee Uonkeaw
Supaphak Hankla

Abstract

          The aims of this developmental research were  1)To Develop multifactorial of 10 P’s principle of fall prevention guidelines in the older people in  community and 2) To study the effectiveness of the use of multifactorial of 10 P’s principle of fall prevention guidelines in the older people in community. This developed program separated into 3 phases 11 stages by applying conceptual framework from National health and medical research council by the practice development team which was conducted during March 2019 to January 2020. Samples were 2 groups of 42 older people and 21 VHVs. Purposive sampling was specified according to inclusion criteria. There were 2 types of instruments used in this study 1) Multifactorial Fall Prevention Guidelines were checked for content validity by 5 qualified practitioners in each issue, each with a content validity index of 0.8-1. [cvi] = 0.8-1, and 2) the data collection tools were the nursing team effectiveness questionnaire were checked for content validity by 5 qualified practitioners content validity index of 0.8-1 [cvi] = 0.8-1 and the reliability of Cronbach’s alpha of .88 .Data analysis was descriptive statistics, summary report and evaluation of the development of guidelines.


The Results was found as following; Multifactorial of 10 P’s principle of fall prevention guidelines in the older people in community proceeded 4 steps during 4 weeks. The 1st Week started (1) The workshop for 21 VHVs’ skill in knowledge using risk assessment tool among multifactorial of 10 P’s principle of fall prevention guidelines in the older people in community and assign the VHVs as a nursing team. (2) Assess the risk of falls in the older people in community and classify the older people according to the types of risk. (3) Knowledge Workshop for the older people for stimulate awareness of the risk of falls and activities prevention in the older people according to risk factors classified according to 10 P’s principle of fall prevention guidelines, providing fall prevention manual. And (4) 2nd week – 4th week home visit 4 times by a nursing team for healthy home environmental / avoid activities at risk locations, medication intake checking and drug advise , falls prevention knowledge reviewed by using fall prevention manual. The effectiveness of the nursing team regarding the accuracy of knowledge is at a good level (Mean= 20.71 ,SD. = 2.28 ),the respond speed is at very good level ( Mean= 23.23  ,SD. = 1.22 ), the creativity is at a good level ( Mean= 20.14  ,SD. =3.33 ) and the total topic is a good level ( Mean= 64.09  ,SD. = 5.04 ) Conclusion: Multifactorial of 10 P’s principle of fall prevention guidelines in the older people in community is the international standards and a nursing practice guideline applied effectively. In practice, the effectiveness of creative problems was found. The problem is a suitable healthy home environment requires proper budget and manpower, therefore the VHVs are unable to help and stimulate the older people and families at the aspect. Suggestion: The community participation guidelines in falls prevention of the older people in community in order to prevent falls and problems solving should be studied, monitored and evaluated in the long term.

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References

Prasartkul P. Situation of the Thai elderly 2018. [Internet]. [cited 2019 October 20]. Available from: https://thaitgri.org/?p=38670.pdf. (in Thai).

Srichang N, Kawee L. Forecast to fall and crash of elderly (age 60 and up) in Thailand. 2017-2021. Nonthaburi: Bureau of Non Communicable Diseases, Ministry of Public Health; 2016. (in Thai).

Thiamwong L, Thamarpirat J, Maneesriwongul W, Jitapunkul S. Thai falls risk assessment test (Thai-FRAT) developed for community-dwelling Thai elderly. Medical Journal of the Medical Association of Thailand 2008;91(12):1823-32. (in Thai).

Panyana T, Wiwatwanich S. Development of elderly falls prevention model for Thai community older people 2017. [Internet]. [cited 2019 October 20]. Available from: www.ckhospital.net/smf/index.php?action=dlattach;topic=106.0;attach=114. (in Thai).

Sorysang L, Khompraya J, Natetanasombut K. A study of fall prevention guideline in older adult living in Mitraphappatana community. Journal of The Royal Thai Army Nurses 2016;15(1):122-9. (in Thai).

Rongmuang D, Nakchattri C, Tongdee J, Sombutboon J. Incidence and factors associated with fall among the community-dwelling elderly, Suratthani. Journal of Phrapokklao Nursing College 2016;27(suppl.1):123-8. (in Thai).

Samgampang T, Nathapindhu G. Factors related to the accidental incidence of elderly in Kham Pom Sub-district, Prayuen District, Khon Kaen. The Office of Disease Prevention and Control 6 Khon Kaen 2011;18(1):61-9. (in Thai).

Panjathai S. Nursing care for the elderly. Chiangmai: Smart Coating & Service; 2017. (in Thai).

Kumkwan Y, Khumngeon A, Wanwilai U, Khatta N. Home-base fall prevention guideline in Thai contexts for elderly people. Nursing Journal of the Ministry of Public Health 2018;28(3):10-22. (in Thai).

Thiamwong L, Suwanno J. Risk factors related to balance impairment among rural community-dwelling older adults. Journal of the Police Nurse 2014;6(2):56-68. (in Thai).

Phumphid S, Sasat S. The effect of experiential health education on fall prevention behaviors in older people with Parkinson’s disease. Royal Thai Navy Medical Journal 2018;46(2):369-81. (in Thai).

Limpawattana P, Sutra S, Thavompitak Y, Chindaprasirt J, Mairieng P. Geriatric hospitalizations due to fall-related injuries. J Med Assoc Thai 2012;95(7):235-9. (in Thai).

Rawsky E. Review of the literature on falls among the elderly. Image: The Journal of Nursing Scholarship 1998;30(1):47-52.

Meiner SE. Safety. In: Meiner SE, editor. Gerontologic nursing. 4th ed. St. Lious: Mosby Elsevier; 2015.

Prommapong N. Factors related to fear of falling among older adult patient. [Master’s Thesis, Faculty of Nursing]. Burapha University; 2018. (in Thai).

World Health Organization. Violence and injury prevention: falls. [Internet]. [cited 2019 October 20]. Available from: http://www.who.int/violence_injury_prevention/other_injury/falls/en/.

Suputtitada A, Saguanrungsirikul S. Research report: the development of electrical cueing devices for gait improvement in Parkinson patient and gait and balance analysis in elderly. Bangkok: Chulalonkorn Uninversity; 2009.

National Health and Medical Research Council [NHMRC]. A Guideline to the Development, Implementation and Evaluation of Clinical Practice Guidelines. [cited 2019 October 20] Available from: http://www.nhmrc.gov.au.

Daniel WW, Cross CL. Biostatistics: a foundation of analysis in the health sciences. 11th ed. NJ: John Wiley & Sons; 2018.

Wayo W, Jitramontree N, Wirojratana V. The effect of multifactorial fall prevention program on fall prevention behavior among community–dwelling older adults. Journal of Nursing and Health Care 2017;35(2):25-33. (in Thai).

Jitaphankul S. Principles of geriatric medicine. 3rd ed. Bangkok: Chulalongkorn University Printing House; 2001.

Sarapun A, Sirisopon N, Kainaka P, Onsiri S, Outayanik B, Threrawachjareanchai S, Sukomol N. Factors related to a fall prevention behaviors of elderly. Journal of The Royal Thai Army Nurses 2017;19(suppl):215-22. (in Thai).

Ponguampai P. Hoontrakul S, Roojanavech S. The effects of family empowerment program on fall prevention capabilities of the elderly. Royal Thai Navy Medical Journal 2018;45(2):311-27. (in Thai).