A TAILORED INTERVENTION TO REDUCE FEAR OF FALLING AND IMPROVE FUNCTIONAL ABILITY AMONG OLDER ADULTS UNDERGOING HIP SURGERY:  A FEASIBILITY STUDY

Ladda  Senaphitak; Suparb Aree-ue; Phichpraorn  Youngcharoen; Paphon  Sa-Ngasoonsong

Authors

Ladda Senaphitak Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University
Suparb Aree-ue Ramathibodi School of NursingFaculty of Medicine Ramathibodi Hospital, Mahidol University.270 Rama 6 Road, Phayathai, Rachathewi, Bangkok, 10400, Thailand.
Phichpraorn Youngcharoen Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University
Paphon Sa-Ngasoonsong Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University

Keywords:

fear of falling, hip fracture, older adults

Abstract

Fear of falling after a hip surgery has drastically impacted on multi-dimensions of health. This study aimed to examine the feasibility of a tailored intervention program using the self-efficacy concept as a basis to reduce the fear of falling, decrease the incidence of re-falling, and improve functional abilities in older adults undergoing hip surgery. A quasi-experimental one-group pretest-posttest design was employed. Fifteen participants who met inclusion criteria were recruited to receive the tailored intervention, which included comprehensive discharge planning and rehabilitation program related to surgery approaches during their admission. Data were analyzed by using descriptive statistics, the Friedman test, and Wilcoxon signed rank test.

Results demonstrated high scores of the tailored intervention program feasibility for implementation in the clinic. Fears of falling at discharge and six weeks after the surgery were significantly decreased compared with the baseline (Z = -3.680, p =.002 and Z = -3.352, p =.001, respectively), but the fear of falling at discharge and six weeks after surgery were not significantly different ((Z =-1.633, p =.102). The functional ability at six weeks was significantly different from the baseline and the discharge day (Z = -3.424, p = .001 and Z = -3.190, p = .001, respectively). During the six weeks after the surgery, the participants had no incidence of re-falling. In conclusion, integrating self-efficacy theory-based intervention into a clinical practice emphasized the professional nursing role is vital to promote health, meliorate physical ability, and enhance the quality of care in older adults undergoing hip surgery.

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References

Agency for health care research and quality advancing excellence in health care. (2018). IDEA discharge planning (Tool 1). Retrieve from https://www. ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/engagingfamilies/strategy4/Strat4_Tool_1_IDEAL_chklst_508.pdf

Al-Maqbali, M. A. (2014). Nursing intervention in discharge planning for elderly patients with hip fractures. International Journal of Orthopaedic and Trauma Nursing, 18(2), 68-80.

Aree-Ue, S. (2004). Feasibility and acceptability of an osteoporosis prevention program for Thai older adult in Chiang Mai (A thesisthe degree of doctor of philosophy in nursing). Graduated School, Chiang Mai University, Chiang Mai.

Aree-Ue, S., & Youngcharoen, P. (2020). Six-item cognitive impairment test (6CIT) - kingshill version 2000 Thai version. Ramathibodi Nursing Journal, (inpress)

Bandura, A. (1997). Self-efficacy: The exercise of control. New York, NY: W. H. Freeman and company.

Bower, E. S., Wetherell, J. L., Petkus, A. J., Raivson, K. S., & Lenze, E. J. (2016). Fear of falling after hip fracture: Prevalence, course, and relationship with one-year functional recovery. American Journal of Geriatric Psychiatry, 24(12), 1228-1236.

Cauley, J. A., Cawthon, P. M., Peters, K. E., Cummings., S. R., Ensrud, K. E., Bauer, D. C., & Orwoll, E. S. (2016). Risk factors for hip fracture in older men: The Osteoporotic Fractures in Men Study (MrOS). Journal of Bone and Mineral Research, 31(10), 1810-1819. doi:10.1002/jbmr.2836

Cummings-Vaughn, L. A., & Gammack, J. K. (2011). Falls, osteoporosis, and hip fractures. Medical Clinics of North America, 95(3), 495-506.

Dattilo, J., Martire, L., Gottschall, J., & Weybright, E. (2014). A pilot study of an intervention designed to promote walking, balance, and self-efficacy in older adults with fear of falling. Educational Gerontology, 40(1), 26-39.

Dingova, M., & Kralova, E. (2017). Fear of falling among community dwelling older adults. Central European Journal of Nursing & Midwifery, 8(1), 580-587.

Goncalves-Bradley, D. C., Lannin, N.A., Clemson, L.M., Cameron, I.D., Shepperd, S. (2016). Discharge planning from hospital. Cochrane Database of Systematic Reviews, 1, 1-105.

Jaipiti, H., & Sasat, S. (2018). The effect of self-efficacy promoting program on fear of fall in postoperative total hip replacement older persons. Journal of The Royal Thai Army Nurses, 19, 109-117.

Jitapunkul, S., Kamolratanakul, P., & Ebrahim, S. (1994). The meaning of activities of daily living in a Thai elderly population: Development of a new index. Age & Ageing, 23(2), 97-101.

Leal, J., Gray, A. M., Prieto-Alhambra, D., Arden, N. K., Cooper, C., Javaid, M. K., . . . Judge, A. (2016). Impact of hip fracture on hospital care costs: A population-based study. Osteoporosis International, 27(2), 549-558.

Malina, P.G., & Marcos, S.E. (2015). Effected of strength and balance training on the mobility, fear of falling and grip strength of elderly female fallers. Journal of Bodywork and Movement Therapies, 19(4), 646-650.

Murphy, J., & Isaacs, B. (1982). The post-fall syndrome. Gerontology, 28(4), 265-270.

Nick, N., Petramfar, P., Ghodsbin, F., Keshavarzi, S., & Jahanbin, I. (2016). The effect of yoga on balance and fear of falling in older adults. The Journal of Injury, Function, and Rehabilitation, 8(2), 145-151.

Nilsson, M., Eriksson, J., Larsson, B., Odén, A., Johansson, H., & Lorentzon, M. (2016). Fall risk assessment predicts fall-related injury, hip fracture, and head injury in older adults. Journal of the American Geriatrics Society, 64(11), 2242-2250. doi:10.1111/jgs.14439

Tamsat, A., Aree-Ue, S., & Leelacharat, S. (2015). Fear of falling and functional ability in older adults undergoing hip surgery. Journal of The Police Nurse; 7(1), 64-82.

Thiamwong, L., & Suwanno, J. (2014). Effects of simple balance training on balance performance and fear of falling in rural older adults. International Journal of Gerontology, 8(3), 143-146.

Tinetti, M. E., Richman, D., & Powell, L. (1990). Falls efficacy as a measure of fear of falling. Journal of Gerontology, 45(6), 239-243.

Trombetti, A., Reid, K., Pasha, E., Phillips, E., Fielding, R., Hars, M., . . . Herrmann, F. (2016). Age-associated declines in muscle mass, strength, power, and physical performance: Impact on fear of falling and quality of life. Osteoporosis International, 27(2), 463-471.

Turunen, K., Salpakoski, A., Edgren, J., Tormakangas, T., Arkela, M., Kallinen, M., & Sipila, S. (2017). Physical activity after a hip fracture: Effected of a multicomponent home-based rehabilitation program-a secondary analysis of a randomized controlled trial. Archieves of Physical Medicine Rehabilitation, 98(5), 981-988.

Visschedijk, J., Van Balen, R., Hertogh, C., & Achterberg, W. (2013). Fear of falling in patients with hip fractures: Prevalence and related psychological factors. Journal of the American Medical Directors Association, 14(3), 218-220.

Wetherell, J. L., Johnson, K., Chang, D., Ward, S. R., Bower, E. S., Merz, C., . . . Petkus, A. J. (2016). Activity, balance, learning, and exposure (ABLE): A new intervention for fear of falling. International Journal of Geriatric Psychiatry, 31(7), 791-798.

Williem, E., Visschedijk, J., Balen, RV., & Achterberg, W. (2017). Physical activity, physical function and fear of falling after hip fracture. Journal of Orthopedic Research and Physiotherapy, 3(1), 031-036.

Winter, A., Bradman, H., Fraser, C., & Holt, G. (2016). The management of intracapsular hip fractures. Orthopaedics & Trauma, 30(2), 93-102.

Wirojyuti, S., Kengganpanich, T., Kengganpanich, M., & Tansakul, S. (2014). Effectiveness of post surgery rehabilitation program for elderly patients with hip fracture in Phramongkutklao hospital. Journal of the Royal Thai Army Nurses, 15(2), 187-194.

Wongngam W, Sucamvang K, & Nanasilp P. (2014). Effect of educative-supportive nursing on self-care behaviors of the elderly with hip fracture during recovery stage. Nursing Journal, 41(2), 72-82.