Predictive factors for fear of falling after hip fracture (original) (raw)
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Cureus, 2022
Background In this study, we determined that among patients who had been operated upon for hip fractures at our hospital, prognostic factors for mortality and functional recovery in the preoperative period were indicated via laboratory parameters using the International Falls Efficacy Scale (FES-I) and Berg Balance Scale (BBS) scores. Methodology Between January 2020 and January 2021, the results of 64 patients who had been surgically treated for a hip fracture and 57 patients who had scheduled elective surgery were compared retrospectively. The groups' demographic data and blood parameters were compared. We used the FES-I and BBS scores to determine patients' physical functional status and fear of falling. Results The case group's statistically significant FES-I score was high, and its BBS score was low (p = 0.001/0.001). As expected, the case group's D-dimer measurement was higher than the control group's (p = 0.001). In addition, hemoglobin, platelet, lymphocyte, albumin, total protein, and calcium levels were lower in the case group (p = 0.001 for all levels). No significant difference was found for other parameters. Conclusions The scales are used by physical therapy, neurology, and orthopedics professionals to evaluate the geriatric population's physical functional status and fear of falling. We believe prevention and cost-effective treatments for hip fractures can be achieved by determining geriatric patients' hemoglobin, platelet, lymphocyte, albumin, total protein, and calcium levels upon hospital admission and by directing these patients to relevant clinics using the fear-of-falling and balance scales.
Fear of Falling in Patients With Hip Fractures: Prevalence and Related Psychological Factors
Journal of the American Medical Directors Association, 2013
Hip fractures rehabilitation fear of falling falls efficacy a b s t r a c t Objective: To determine the prevalence of fear of falling (FoF) in patients after a hip fracture, to investigate the relation with time after fracture, and to assess associations between FoF and other psychological factors. Design: Cross-sectional study performed between September 2010 and March 2011 in elderly patients after a hip fracture. Setting: Ten postacute geriatric rehabilitation wards in Dutch nursing homes. Participants: A total of 100 patients aged 65 years with a hip fracture admitted to a geriatric rehabilitation ward. Measurements: FoF and related concepts such as falls-related self-efficacy, depression, and anxiety were measured by means of self-assessment instruments. Results: Of all patients, 36% had a little FoF and 27% had quite a bit or very much FoF. Scores on the Falls Efficacy Scale-International were 30.6 in the first 4 weeks after hip fracture, 35.6 in the second 4 weeks, and 29.4 in the period 8 weeks after fracture. In these 3 periods, the prevalence rates of FoF were 62%, 68%, and 59%, respectively. Significant correlations were found between FoF and anxiety (P < .001), and self-efficacy (P < .001). Conclusion: In these patients with a hip fracture, FoF is common and is correlated with anxiety and falls-related self-efficacy. During rehabilitation, FoF is greatest in the second 4 weeks after hip fracture. More studies are needed to explore the determinants of FoF and develop interventions to reduce FoF and improve outcome after rehabilitation.
2013
Objective: To identify factors that explain differences in patients with high and low levels of fear of falling after a hip fracture. Design: Cross-sectional study in 10 skilled nursing facilities in the Netherlands. Patients: A total of 100 patients aged ≥ 65 years admitted to a skilled nursing facility after a hip fracture. Methods: Participants were divided into 2 groups; low and high level of fear of falling, based on median Falls Efficacy Score -International. Data relating to factors that might explain fear of falling were collected, including demographic variables, aspects of functioning, psychological factors, and comorbidities. For every factor a univariate logistic regression was conducted. For the multivariate regression model a backward procedure was used in which variables with p < 0.05 were included. Results: Walking ability and activities of daily living before fracture, number of complications, activities of daily living after fracture, anxiety and self-efficacy were significantly associated univariately with fear of falling. Multivariate analysis showed that walking ability before fracture (odds ratio (OR) 0.34, 95% confidence interval (CI) 0.14-0.83), activities of daily living after fracture (OR 0.89, 95% CI 0.80-0.99), and anxiety (OR 1.22, 95% CI 1.05-1.42) were independently associated with fear of falling. Conclusion: Impaired walking ability before fracture, impaired activities of daily living after fracture, and increased anxiety help distinguish between older persons with high and low levels of fear of falling after hip fracture. Because the last 2 factors are modifiable, this information enables the development of specific interventions for older persons with a high level of fear of falling.
Fear of falling, falls efficacy, and health outcomes in older people following hip fracture
Disability and Rehabilitation, 2002
This study sought to determine whether fear of falling and falls efficacy independently contribute to the prediction of health outcomes after a fall, controlling for length of stay in hospital, prefall activity problems, and history of falls. Method: Eighty-two older people (565 years) admitted to hospital as a result of a fall, with proximal femoral fracture, were interviewed to assess variables of interest. At two months after initial interview, participants (n=57) were re-interviewed in their own home, and their functional limitation and further fall events were assessed. Regression analyses were carried out to determine the ability of the variables assessed in hospital to predict functional limitation and further falls post discharge. Results: Perceived risk of falling and falls efficacy did not explain variance in functional limitation when added to a model containing biomedical factors. In the prediction of further falls, addition of falls efficacy and worry over further falls to a model containing biomedical factors resulted in a statistically reliable improvement, although falls efficacy was not independently associated with outcome. Conclusions: Assessing worry over further falls in hospital may help to identify older people with hip fracture at risk of poor health outcomes.
Aging Clinical and Experimental Research, 2022
Background Hip fracture causes not only physical injury but also psychological trauma. Fear of falling (FoF) is related to poor recovery, loss of mobility and mortality. There is limited data on the clinical factors affecting post-hip fracture FoF and its consequences. Objective To investigate the factors associated with and 1-year outcomes of post-hip fracture FoF. Methods An observational prospective cohort study. Data were collected on hospital admission, at a geriatric outpatient assessment 4-6 months post-hip fracture and by telephone interviews 1 year after the index fracture. FoF was assessed with a dichotomous single-item question. Logistic regression analyses were conducted to examine the age, gender and multivariableadjusted association between baseline and the geriatric assessment domains with FoF. Follow-up outcomes included changes in mobility, living arrangements and mortality. Results Of the 916 patients included, 425 (49%) had FoF at the time of their geriatric assessment. These patients were predominantly female and were living alone in their own homes with supportive home care. They scored lower on tests of physical performance. Less FoF was documented in patients with diagnosed cognitive disorders before the index fracture and in those with Clinical Dementia Rating ≥ 1. After adjusting for age and gender, no association was observed between FoF and any of the 1-year follow-up outcomes. Conclusion Post-hip fracture FoF is common and associated with female gender, polypharmacy, poor daily functioning, poor physical performance and depressive mood. Patients with cognitive disorders have less FoF than those without. FoF appears to have no impact on the follow-up outcomes.
Disability and Rehabilitation, 2012
The aims of the study were to assess self-reported fear of falling (FOF) and functional ability among communitydwelling elderly people 3-6 months post hospital discharge after a hip fracture, to investigate the association between FOF and functional ability, and to explore the lived experience of FOF and disability when recovering from a hip fracture. Method: A sequential explanatory mixed method design was used in a "face-to-face" survey assessing FOF (Falls Efficacy Scale-International, FES-I), avoidance of activities (Modified survey of Activities and Fear of Falling, mSAFFE), functional ability (Functional Recovery Score, FRS), and mobility (New Mobility Score, NMS) followed by in-depth interviews of four participants. Interviews were analyzed using systematic text condensation. Results: Among the 33 participants 58% had a high degree of FOF and avoided more activities, needed more assistance in activities of daily living, and were less mobile than participants who had a low degree of FOF (p < 0.0001). According to the informants FOF reduced their functional ability and seriously altered their lives. Conclusions: FOF was common and significantly associated with activity avoidance, disability, and affected the lives of elderly recovering from a hip fracture. Some patients were physically incapacitated by FOF.
British medical …, 2000
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Journal of Clinical Nursing, 2017
Predictors of postoperative falls in the first and second postoperative years among older people hip fracture patients Aim and objectives. To explore risk factors for a single fall and multiple falls in the first and second postoperative years among older people hip fracture patients. Background. Older people hip fracture patients have a high probability of falling again after a fall incident. Risk factors for postoperative falls among older people hip fracture patients in Taiwan remain to be confirmed. Design. Secondary analysis. Methods. Data collected from control groups of two clinical trials conducted during 2001-2004 and during 2005-2009 were selected. Overall, 181 older adults who underwent hip fracture surgery were assessed at predischarge and postdischarge. Participant data were collected through home visits. Results. Decline in unaffected limb quadriceps muscle endurance was a crucial predictor of a single fall in the first postoperative year for older people hip fracture patients. Advanced age and more severe depressive symptoms were the crucial predictor for multiple falls. Engagement in activities of daily living was the crucial predictor for falls during the first to second postoperative years among older people hip fracture patients. Conclusion. In Taiwan, postoperative falls that occur within 1-2 years of a hip fracture are associated with a high incidence of single and multiple falls in older people. The crucial predictors of falls in the first and second year after a hip fracture include unaffected limb quadriceps endurance, age, depression status and postdischarge ADLs in older people. Relevance to clinical practice. The identified factors associated with subsequent falls within 1 and 2 years of a hip fracture should be incorporated into clinical strategies and taught in nursing courses. Early postoperative lower extremity muscular endurance rehabilitation must be provided. Furthermore, as part of the healthcare plan before hospital discharge, it must be ensured that the Accepted Article This article is protected by copyright. All rights reserved. community where the older adults live has nutritional education, cognitive screening, and psychological support.