The development and pilot testing of a fall prevention education intervention for older persons at high risk of falls in a Malaysian primary care setting / Annaletchumy Loganathan
The aim of this study was to develop and pilot test a fall prevention education intervention for older persons with a high risk of falls in a primary care setting. There were three phases in this study. In the needs assessment study, the needs of community-dwelling older persons with a high risk...
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| Format: | Thesis |
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2018
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| Online Access: | http://studentsrepo.um.edu.my/9223/ http://studentsrepo.um.edu.my/9223/7/annaletchumy.pdf |
| Summary: | The aim of this study was to develop and pilot test a fall prevention education
intervention for older persons with a high risk of falls in a primary care setting.
There were three phases in this study. In the needs assessment study, the needs of
community-dwelling older persons with a high risk of falls and healthcare professionals
(HCPs) who managed falls were explored using qualitative interviews. The study was
conducted at University Malaya Medical Centre (UMMC), Kuala Lumpur from July
2012 to April 2013. Semi-structured topical guides were developed to facilitate the
interviews. The transcribed interview data were analysed thematically using Weft QDA.
A systematic literature review was conducted to determine the effectiveness of FPEIs.
The intervention was developed based on the evidence from the findings of the needs
assessment, systematic review, theories and clinical practice guidelines. The
Multifaceted Fall Education by Interprofessional Team (MuFE_IT) intervention consists
of presentations by inter-professional team and a fall prevention education booklet. The
MuFE_IT was then pilot-tested in three group sessions and revised based on the
feedback from the participants. The study participants’ knowledge and behavioural
changes were evaluated using questionnaires and focus-group discussions immediately,
one-month, and three-month post-intervention. The data were analysed using SPSS and
Weft QDA.
In the needs assessment study, both the HCPs and older persons highlighted the need
for educational materials on fall prevention. HCPs perceived their roles as the
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coordinator of care and provider of advice on fall prevention to older persons. HCPs
were aware that they needed to consider older persons’ views, beliefs and behaviours
when offering fall prevention advice. A systematic literature review of 21 RCTs found
that FPEIs which involved HCPs in providing fall advice, educational pamphlets, small
group sessions, video and multimedia presentations were effective. In the qualitative
evaluation of the MuFE_IT, four themes emerged: change of attitude towards fall
prevention, actions taken related to fall prevention, barriers in MuFE_IT
implementation, and reasons to take action to prevent falls. The participants were more
‘careful’, ‘compliant’ and ‘motivated’ to prevent falls. The participants found the
following components of the MUFE_IT intervention useful: professional advice from
the presentation on proper shoe wear, medication review and home interior
modification; information from the education booklet on fall prevention activities such
as exercises; small discussion groups that eased interaction and allowed information to
be shared among the participants. However, a few participants perceived that the advice
given at the MuFE_IT intervention was ‘common sense’ and ‘not practical’, as these
participants were already practising fall prevention activities. In addition, there was no
improvement in their knowledge after attending the MuFE_IT intervention sessions.
This study confirms the feasibility of developing an FPEI for older persons based on
needs, evidence and theories using mixed research methods. The MuFE_IT warrants
further study to evaluate its effectiveness in preventing falls in the Malaysian primary
care setting. |
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