Family-Promoting Programme to Enhance Self-Management Ability in Older Persons with Knee Osteoarthritis and Its Impact on Fall Prevention
Objective: To study impacts that a family-promoting programme for self-management, designed for older persons with knee osteoarthritis, could have on fall prevention
Design: One-group quasi-experimental research with a pretest and a posttest
Methodology: This study was conducted on 23 purposively sampled participants and their family members. They participated in a seven-week family-promoting programme designed to enhance the self-management ability in older persons suffering from knee osteoarthritis. The programme comprised self-management education and skill-building activities, to promote thigh muscle exercise, practice in using walking sticks, and environment management. The instruments for data collection consisted of 1) a demographic questionnaire; 2) the Thai fall risk assessment test (Thai-FRAT); and 3) the ‘Time-Up-And-Go Test’ (TUGT). The data, collected from January to March 2020, were analysed using descriptive statistics, the McNemar test, and the Wilcoxon
matched pairs signed-ranks test.
Results: A comparison of the participants’ pre- and post-intervention risk of fall showed a signifcant decrease in their fall risk, with 23 identifed as facing risk of fall before the experiment versus three after the experiment (p < .001). Before the programme, 65.20% and 34.80% of the participants were found to have moderate and low balance and walking ability, respectively. After the programme, signifcant improvement was evident, with high balance and walking ability found in 56.52%, moderate ability in 39.13%, and low ability in only 4.35% of the participants. It could be concluded that the participants’ balance and walking ability improved signifcantly after the experiment (z = -4.47, p < .001).
Recommendations: This programme can be applied as a community-level guideline to
support older persons with knee osteoarthritis and their family members to improve their selfmanagement ability in prevention of falls.
National Institute of Emergency Medicine. Emergency medical statistics report. [Internet]. 2018 [cited 2019 Mar 15]; Available from: https://ws.niems.go.th/ITEMS_DWH/ (in Thai)
Bureau of Non-Communicable Diseases, Ministry of Public Health. Annual Report 2018. Nonthaburi: Aksorn grphic and design publishing; 2018. (in Thai)
Schooten KS, Pijnappels M, Rispens SM, Elders PJ, Lips P, Dieen JH. Ambulatory fall-risk assessment: amount and quality of daily-life gait predict falls in older adults. J Gerontol A Biol Sci Med Sci 2015;70(5):608-15.
Vásquez M, Castilloa ML, Altamirano LE, Torres S, Mellado J, Lópeza CO. Combining Russian stimulation with isometric exercise improves strength, balance, and mobility in older people with falls syndrome. Int J Rehabil Res 2019;42(1):41-5.
Lukaszyk C, Radford K, Delbaere K, Ivers R, Rogers K, Sherrington C, et al. Risk factors for falls among older Aboriginal and Torres Strait Islander people in urban and regional communities. Australas J Ageing 2018;37(2):113-19.
Vieira ER, Palmer RC, Chaves PH. Prevention of falls in older people living in the community. BMJ 2016;35 (i1419):1-13. doi:10.1136/bmj.i1419.
Anothaisintawee T, Thamakaison S, Srisuwan P. Systematic review of effectiveness of fall prevention program in elderly. [Internet]. 2014 [cited 2019 Mar 15]; Available from: http://thaitgri.org/?p=36704 (in Thai)
Levinger P, Nagano H, Downie C, Hayes A, Sanders KM, Cicuttini F, et al. Biomechanical balance response during induced falls under dual task condition in people with knee osteoarthritis. Gait
Boongird C. Falling in the Older Adults: Prevention and management in family medicine. Bangkok:
Sahamit Pattanakan; 2018. (in Thai)
Khalaj N, Osman NA, Mokhtar AH, Mehdikhani M, Abas WA. Balance and risk of fall in individuals with bilateral mild and moderate knee osteoarthritis. PLoS One 2014;9(3):1-7.
Hayashi K, Kako M, Suzuki K, Hattori K, Fukuyasu S, Sato K, et al. Gait speeds associated with anxiety responses to pain in osteoarthritis patients. Pain Med 2016;17:606-13.
Strategy and Planning Division, Ministry of Public Health. Health. [Internet]. 2015 [cited 2019 Mar 15]; Available from: http://wop.moph.go.th/ops/thp/thp/userfles/fle/Issue%2024_58. pdf (in Thai)
Lamphun Provincial SocialDevelopment and Human Security Offce. Social situation report in Lamphun
Province Budget year 2017. [Internet]. 2017[cited 2019 Apr 19]; Available from: www.dla.go.th>tempNews (in Thai)
Vannajak K, Taweekarnvannajak P. Falling in osteoporosis elderly: cause and exercise for prevention. The Public Heath Journal of Burapha University 2018;13(2):141-50. (in Thai)
Somtrakul K. Self-care experiences in preventing recurrent fall among older persons. [Dissertation]. Bangkok: Chulalongkorn University; 2019. (in Thai)
Foundation of Thai Gerontology Research and Development Institute. Situation of the Thai elderly 2017. Bangkok: TGRI; 2017. (in Thai)
Creer LT. Self-management of chronic illness. California: Academic; 2000.
Kongpibarn S. The effect of self-management program on eating behaviors of patients with heart failure. Thai Journal of Cardio-Thoracic Nursing 2017;28(2):82-96. (in Thai)
Narin R. Comparison of the two different nursing interventions for knee osteoarthritis patients in the community in northern Thailand. [Doctoral dissertation]. Norwich: University of East Anglia; 2012.
Department of Health, Ministry of Public Health. Oxford Knee Score. [Internet]. 2013 [cited 2019 Apr 19]; Available from: https://www.chiangmaihealth.go.th/cmpho_web /document/ (in Thai)
Intarasombat P. Health assessment in the elderly. Ramathibodi Nursing Journal 1996;2(3):44-56.(in Thai)
Thiamwong L, Thamarpirat J, Maneesriwongul W, Jitapunkul S. Thai Falls Risk Assessment Test (Thai-FRAT)developed for community-dwelling thai elderly. Journal of the Medical Association of Thailand 2008;91(12): 1823-32. (in Thai)
Gulsatitporn S. Physical therapy in the elderly. 2nd ed. Bangkok: Offset Place; 2006. (in Thai)
Gadudom P, Apinyalungkon K, Janjaroen K, Wae N. Family Roles to increase quality of life of older persons in a changing situation. The Southern College Network Journal of Nursing and Public Health 2018;5(3):300-10. (in Thai)
Sakanashi S, Fujita K. Empowerment of family caregivers of adults and elderly persons: A concept analysis. Int J Nurs Pract 2017;23(e12573):1-9.doi:10.1111/ijn.12573.
Answer S, Alghadir A. Effect of isometric quadriceps exercise on muscle strength, pain, and function in patients with knee osteoarthritis: a randomized controlled study. J PHYS THER SCI 2014;26(5):745-48.
Leem SH, Kim JH, Lee BH. Effects of Otago exercise combined with action observation training on balance and gait in old people. JER 2019;15(6):848-54.
Punlomso S. Effects of health belief model with exercising program on fall prevention among the elderly in Khok Klang Subdistrict, Nonsaad District, Udonthani Province. [Dissertation]. Mahasarakham: Mahasarakham University; 2019. (in Thai)
Poncumhak P. Assistive Walking Devices. Srinagarind Medical Journal 2013;28(4):583-88. (in Thai)
Copyright (c) 2020 Thai Journal of Nursing Council
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.