The effect of intervention on fear of falling among elderly adults in a Long-term Care Institute

• Main Authors: Meng Ling Chung, 鍾孟玲
• Other Authors: T. T. Huang
• Format: Others
• Published: 2009
• Online Access: http://ndltd.ncl.edu.tw/handle/69337899974810784288

碩士 === 長庚大學 === 護理學研究所 === 97 === In the long-term care institutes, approximately 40% to 70% of elderly people have fear of fall. Fear of fall will lead the elders to the restriction of self-activities and the decrease of social interaction. Because of reduced activities, the situation will cause a gradual decline of their physical function, loss of independent function, resulting in depression and even affect adversely the quality of life. Fear of fall is also a risk factor of fall. Fall not only causes physical injuries, but also carries psychological influences. For those elderly adults who have never experienced fall, they would have this kind of feeling as well. The purpose of this study is to develop the Group Health Education Program (GHEP) as well as the Exercise Intervention Strategy (EIS), which aim to decrease fear of fall among elder adults in nursing homes, and to examine the various effects. This study utilizes a quasi-experimental design. This study involved a sample of 36 elder adults aged 65 and older living in a nursing home affiliated to a medical center in northern Taiwan. In the experiment, group 1 (n=13) received GHEP and EIS, group 2 (n=12) received an individual health education program, and the comparison group (n=11) only received usual care. The tracking began right after the start of the measurement and lasted for 3 months. Measurements employed: demographical data, Fall Efficacy Scale (FES), Geriatric Fear of Falling Measure (GFFM), Taiwanese Depression Questionnaire (TDQ), Tinetti mobility scale, extremities muscle strength and fall times record. The results of this study are: 1.Based on the Pearson product-moment correlation coefficient, there was a significant positive relationship among fear of fall, age and the number of diagnosis. (respectively r＝.397, p＜.05; r＝.374, p＜.05) There was a negative relationship among fear of fall, falls self-efficacy, balance and gait function. (respectively r=-.481, p＜.01; r=-.407, p＜.05). In addition, there was a significant positive relationship between falls self-efficacy and balance and gait function. (r=-.487, p＜.01) There was a negative relationship between falls self-efficacy and depression. (r=-.374, p＜.05). 2. By using ANCOVA to control pre-intervention, data showed, at post test 1, falls self-efficacy (F=7.89, p＜.05), fear of falling (F=7.31, p＜.05), depression (F=15.61, p＜.001), balance and gait function (F=14.35, p＜.001), and extremities muscle strength (respectively F=3.87, F=4.26, F=4.67, F=4.04, all p＜.05) were significantly different, while at post test 2, except fear of falling (F=1.97, p＞.05), and extremities muscle strength (respectively F=0.14, F=0.60, F=1.80, F=1.23, all p＞.05) were not significantly different. The other variables were still significantly different. 3.At the end of the 3 months observation period, falling times (χ2 =7.219, p＜.05) were significantly different from the beginning of the period. According to the results of the study, we could find that by providing the health education for reducing fear of fall, infusing and strengthening the relative knowledge, and increasing regular exercise, the elder people are able not only to postpone the physical function decline accompanied by aging, but also to gain confidence and lower the chances of being injured due to fear of falling. This study could serve as a reference for further clinical experiments in nursing, which could in turn help curb fear of falling among elderly adults.