Health Promotion Education for Elderly Patients by Using Structured Self-Health Records to Enhance Knowledge and Attitudes Toward Fall Prevention

Main Article Content

Siriporn Khongrang
Chitima Boongird
Soontraporn Phiphadthakusolkul
Krongtong Putthipokin


Background: Health promotion education in elderly is the most important key to successful implementation of fall prevention program in primary care practice. The Ministry of Public Health in Thailand has encouraged the hospital in community to use the self-health records which were found to enhance healthy behaviors.

Objective: To compare the knowledge and attitudes on fall prevention among elderly patients and their caregivers before and after the education program that employed using self-health records and receiving the counseling from nurses and pharmacists.

Methods: This embedded mixed methods study was designed by using the structured questionnaires including demographic data and measuring the knowledge and attitude on fall prevention for quantitative arm (143 elderly patients and 42 caregivers). The open-ended questions about the advantages and disadvantages of self-health records were used in qualitative part among 106 elderly patients and 29 caregivers after 6 months of using their records.

Results: Knowledge and attitude scores were statistically higher in all parts, including appropriate use of the medications, following vaccination schedule, and getting information about fall prevention from their primary care physicians. All participants in qualitative study required to have their self-health records to improve their understanding about their medications and health information.

Conclusions: Self-health records and receiving the counseling from nurses and pharmacists not only enhances the knowledge and attitude toward fall prevention program in older adults but also helps patients to communicate with the specialists about their health information.

Article Details

How to Cite
Khongrang, S., Boongird, C., Phiphadthakusolkul, S., & Putthipokin, K. (2019). Health Promotion Education for Elderly Patients by Using Structured Self-Health Records to Enhance Knowledge and Attitudes Toward Fall Prevention. Ramathibodi Medical Journal, 42(1), 19–28.
Original Articles


Close J, Ellis M, Hooper R, Glucksman E, Jackson S, Swift C. Prevention of falls in the elderly trial (PROFET): a randomised controlled trial. Lancet. 1999;353(9147):93-97. doi:10.1016/S0140-6736(98)06119-4.

Rubenstein LZ, Josephson KR. The epidemiology of falls and syncope. Clin Geriatr Med. 2002;18(2):141-158. doi:10.1016/S0749-0690(02)00002-2.

Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988;319(26):1701-1707. doi:10.1056/NEJM198812293192604.

Matsuda S. Health promotion policy in Japan. Asian Pacific Journal of Disease Management. 2007;1(1):11-17.

Clemson L, Cumming RG, Kendig H, Swann M, Heard R, Taylor K. The effectiveness of a community-based program for reducing the incidence of falls in the elderly: a randomized trial. J Am Geriatr Soc. 2004;52(9):1487-1494. doi:10.1111/j.1532-5415.2004.52411.x.

Sze PC, Lam PS, Chan J, Leung KS. A primary falls prevention programme for older people in Hong Kong. Br J Community Nurs. 2005;10(4):166-171. doi:10.12968/bjcn.2005.10.4.17956.

Healy TC, Peng C, Haynes MS, McMahone EM, Botler JL, Gross L. The feasibility and effectiveness of translating a matter of balance into a volunteer lay leader model. J Appl Gerontol. 2008;27(1):34-51. doi:10.1177/0733464807308620.

Somton W, Rawiworrakul T, Amnatsatsue K. Effect of fall prevention program in older adults. Journal of Public Health Nursing. 2013;27(3):59-70.

Boongird C, Suthatvoravut U, Suksabai P, Ramarong K, Gaensan T, Ross R. Raising communities’ positive attitude and awareness toward fall prevention in elderly population: an embedded mixed methods study. Journal of Health Systems Research. 2015;9:1-12.

Boongird C, Thamakaison S, Krairit O. Impact of a geriatric assessment clinic on organizational interventions in primary health-care facilities at a university hospital. Geriatr Gerontol Int. 2011;11(2):204-210. doi:10.1111/j.1447-0594.2010.00671.x.

Bureau of Elderly Health. Elderly Health Notebook. Department of Health, Ministry of Public Health; 2014. Accessed June 18, 2018.

HITAP. Survey report of health in Thai elderly 2013 under the policy for health promotion in elderly and disabled people. Department of Health, Ministry of Public Health; 2013. Accessed June 18, 2018.

Phelan EA, Mahoney JE, Voit JC, Stevens J. Assessment and management of fall risk in primary care settings. Med Clin North Am. 2015;99(2):281-293. doi:10.1016/j.mcna.2014.11.004.