The Effect of an Adjusted Health Belief Program on Fall Prevention Behaviors among Hospitalized Older Patients

Authors

  • Manita Raksree Student of Master of Nursing Science Program in Gerontological Nursing, Faculty of Nursing Mahidol University
  • Narirat Jitramontree Faculty of Nursing Mahidol University
  • Saovaluck JIirathummakoon Faculty of Nursing, HRH Princess chulabhorn College of Medical Science Rangsit University

Keywords:

the adjusted health belief program, fall prevention behaviors, hospitalized older patients, health belief model

Abstract

        This was a quasi-experimental research with a two groups post-test design to study the effects of an adjusted health belief program on fall prevention behaviors among hospitalized older patients in the surgical wards of King Chulalongkorn Memorial Hospital. The subjects were 62 older patients selected by inclusion criteria and divided into 31 subjects in the control group and 31 subjects in the experimental group. The control group received normal nursing, the experimental group received an adjusted health belief program developed under the concept of the Health Belief Model. The program includes an assessment of the risk factors and the risk of falls, education using multimedia communications; demonstrations and training and warning signs. The tools for data collection included: a demographic data form, fall prevention assessment of  hospitalized older patients. Data were analyzed using descriptive statistics and Chi-square test. The difference in the average fall prevention behavior score of elderly patients was compared using independent t-test.

        The results revealed that the experimental group who received the adjusted health belief program had a significantly higher average score of fall prevention behavior than those of the control group ( t = 10.42, p < .000 ). This study shows that elderly patients who underwent the program had better fall prevention behaviors than those who did not undergo the program. It is, therefore, recommended that the surgical wards apply this program to prevent falls among older patients.

References

1. Bureau of Nursing. Nursing quality indicators [Internet]. 2015 [cited 2015 oct 3].Available from: http://www.nursing.go.th/? page_id=2489. (in Thai)

2. Spoelstra SL, Given BA, Given CW. Fall prevention in hospitals: an integrative review. Clin Nurs Res 2012;21(1):92-112.

3. Choi YS, Lawler E, Boenecke CA, Ponatoski ER, Zimring CM. Developing a multi-systemic fall prevention model, incorporating the physical environment, the care process and technology: a systematic review. J Adv Nurs 2011;67(12):2501-24.

4. The Institute of Medicine and the Elderly Department of Medicine The Ministry of Public Health. Patterns of falling prevention in the elderly [Internet]. 2012 [cited 2015 jan 15]. Available from: www.agingthai.org. (in Thai)

5. Haines TP, Hill AM, Hill KD, McPhail S, Oliver D, Brauer S, et al. Patient education to prevent falls among older hospital inpatients a randomized controlled trial. Arch Intern Med 2011;171(6):516-24.

6. Ungar A, Rafanelli M, Iacomelli I, Brunetti MA, Ceccofiglio A, Tesi F, et al. Fall prevention in the elderly. Clin Cases Miner Bone Metab 2013;10(2):91-5.

7. Tzeng HM, Yin CY. Toileting-related inpatient falls in adult acute care settings. Medsurg Nurs 2012;21(6):372-7.

8. The Institute of Medicine and the Elderly Department of Medicine, The Ministry of Public Health. Medical practice guidelines prevention / assessment falls in the elderly [Internet]. 2008 [cited 2014 Dec 12]. Available from: http://agingthai.dms.moph.go.th/agingthai/download/book

9. Hong HJ, Kim NC, Jin Y, Piao J, Lee SM. Trigger factors and outcomes of falls among Korean hospitalized patients: analysis of electronic medical records. Clin Nurs Res 2015;24(1):51-72.

10. Tasuwanin T, Tappakit K. Effects of a falling prevention program for elderly. Journal of Nursing and Health Care 2017;35(3):186-95. (in Thai)

11. Nassar N, Helou N, Madi C. Predicting falls using two instruments (the Hendrich Fall Risk Model and the Morse Fall Scale) in an acute care setting in Lebanon. J Clin Nurs 2014;23(11-12):1620-9.

12. Rowe RJ. Preventing patient falls: what are the factors in hospital settings that help reduce and prevent inpatient falls? 2012. Home Health Care Manag Pract 2013;25(3)3:98-103.

13. Sheth HS, Faust-Smith K, Sanders JL, Palmer RM. Screening for injurious falls in acute care hospitals. J Patient Saf 2013;9(1):24-8.

14. Trepanier S, Hilsenbeck J. A hospital system approach at decreasing falls with injuries and cost. Nurs Econ 2014;32(3):135-41.

15. Cahill S, Stancliffe RJ, Clemson L, Durvasula S. Reconstructing the fall: individual, behavioural and contextual factors associated with falls in individuals with intellectual disability. J Intellect Disabil Res 2014;58(4):321-32.

16. Yau S. Analysis on the high risk factors for elderly fall in hospital settings [Internet]. 2017 [cited 2018 May 28]. Available from: http://www3.ha.org.hk/haconvention/hac2017/proceedings/downloads/F8.7.pdf2017.

17. Cameron ID, Gillespie LD, Robertson MC, Murray GR, Hill KD, Cumming RG, Kerse N. Interventions for preventing falls in older people in care facilities and hospitals. Cochrane Database Syst Rev 2012;12:CD005465.

18. Hempel S, Newberry S, Wang Z, Booth M, Shanman R, Johnsen B, et al. Hospital fall prevention: a systematic review of implementation, components, adherence, and effectiveness. J Am Geriatr Soc 2013;61(4):483-94.

19. Muangsiri M, Maharachpong N, Rodjarkpai Y. Factors relating the behavior of fall prevention among elderly in Chonburi province. Naresuan University Journal: Science and Technology. 2017;4(25):23-33. (in Thai)

20. Pongpaew S. Predictive factors of fall prevention behaviors among older adults, Nontaburi province [dissertation]. Bangkok: Mahidol University; 2013. (in Thai)

21. Maipimai W. The relationships between perceived susceptibility, perceived severity, fear of falling, and fall preventive behaviors in older fallers [dissertation]. Bangkok: Mahidol University; 2013. (in Thai)

22. Sarapun A, Sirisopon N, Kainaka P, Onsiri S, Outayanik B, Threrawachjareanchai S, Sukomol N. Factors ralated to a fall prevention behaviors of elderly. Journal of The Royal Thai Army Nurses 2017;18:215-22. (in Thai)

23. Rosenstock IM, Strecher VJ, Becker MH. Social learning theory and the Health Belief Model. Health Educ Q 1988;15(2):175-83.

24. Thiya N. Fall prevention related behavior among elder patients seeking treatment at female trauma ward of Pramongkutkloa hospital [dissertation]. Bangkok: Kasetsart University; 2008.
(in Thai)

25. CDC. Talking about fall prevention with your patients [Internet]. 2017 [cited 2018 Jun 15]. Available from: https://www.cdc.gov/steadi/pdf/Talking_about_Fall_Prevention_with_Your_Patients-print.pdf.

26. Wayo W. The effect of multifactorial fall prevention program on fall prevention behavior among community-dwelling older adults [dissertation]. Bangkok: Mahidol University; 2016.

27. Lee DC, McDermott F, Hoffmann T, Haines TP. 'They will tell me if there is a problem': limited discussion between health professionals, older adults and their caregivers on falls prevention during and after hospitalization. Health Educ Res 2013;28(6):1051-66.

28. Hill AM, McPhail SM, Francis-Coad J, Waldron N, Etherton-Beer C, Flicker L, et al. Educators' perspectives about how older hospital patients can engage in a falls prevention education programme: a qualitative process evaluation. BMJ Open 2015;5(12):e009780.

29. Hill AM, Waldron N, Francis-Coad J, Haines T, Etherton-Beer C, Flicker L, et al. 'It promoted a positive culture around falls prevention': staff response to a patient education programme-a qualitative evaluation. BMJ Open 2016;6(12):e013414.

30. Moura LA, Araújo JNdM, Fernandes APNdL, Araújo MGd, Silva ABd, Olímpio JdA, et al. Fall prevention behavior among hospitalized elderly patients. Int Arch Med 2016;9(57):1-9.

31. Masawang S, Chanthapasa K. Patient rights: meaning in lay’s perspective under local culture context. Isan Journal of Pharmaceutical Sciences 2014;9(Suppl):122-6. (in Thai)

Downloads

Published

2020-02-24

Issue

Section

บทความวิจัย (Research Report)