Effects of a Health Education Program on Fall Risk Prevention among the Urban Elderly: A Quasi-Experimental Study
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Abstract
Background: Elderly falls increase dramatically with age and are a leading cause of injury, carrying a risk of loss of independence and death. We studied the effects of a health education program on fall-risk prevention among urban elderly persons in the municipality of Khon Kaen, Thailand.
Methods: A quasi-experimental study was conducted in 2 communities. The calculated sample size was 216 individuals: 108 for intervention and 108 for control, all of whom were 60 or older, and registered at the Samlium Primary Care Unit (SPCU). The educational intervention was a fall risk intervention program by an elderly buddy. A structured questionnaire that incorporated questions from the Thai Fall Risk Assessment Tool (Thai-FRAT) was used to collect general and specific information. Data were analyzed using the independent sample t-test and c2, with P<0.05 being statistically significant.
Results: The response rate was 94.4%. More than half of the respondents were at risk of a fall. The prevalence of risk of a fall among the intervention group was slightly less than that for those within the control group [Intervention group=52.9% (95%CI: 42.85, 62.81, P<0.001); Control group=60.8% (95%CI: 50.59, 70.15, P=0.016)]. After 6 months of intervention, the balance impairment, medicine usage, and overall proportion with risk of fall were decreased. The difference between the intervention and control groups was statistically significant (P<0.05).
Conclusion: The provision of a health education program designed for fall risk prevention among the elderly would be a useful public health initiative.
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7. Kuhirunyaratn P, Prasomrak P, Jindawong B (2013). Factors related to falls among community dwelling elderly. Southeast Asian J Trop Med Public Health, 44(5): 906-15.
8. Janz NK, Becker MH (1984). The Health Belief Model: a decade later. Health Educ Q, 11(1): 1-47.
9. Yazachew M, Alem Y (2004). Introduction ot Health education. Ethiopia Public Health Training Initiative, the Carter Center, the Ethiopia Ministry of Health and the Ethiopia Misnistry of Education, Ethiopia.
10. Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, Lamb SE (2012). Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev, 12(9): CD007146.
11. National Statistical Office [NSO] (2010). Thai population migration survey report. National Statistics Office, Bangkok.
12. Tabloski PA (2010). Challenges of Aging and Cornerstones of Excellence in Nursing Care. In: Gerontological Nursing. 2nd Ed. New Jersy , USA: Pearson Education, pp. 87-343.
13. Kececi A, Bulduk S (2012). Health Education for the Elderly. In: Geriatrics, Craig S. Atwood. Shanghai, China. : InTech, pp. 153-177.
14. Larson L, Bergmann TF (2008). Taking on the fall: The etiology and prevention of falls in the elderly. Clin Chiropr, 11(3): 148-154.
15. Pynoos J, Steinman BA, Nguyen AQ (2010). Environmental Assessment and Modification as Fall-Prevention Strategies for Older Adults. Clin Geriatr Med, 26(4): 633-44.
16. Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VO (1982-1983). Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res, 17(1): 37-49.
17. Thiamwong L, Thamarpirat J, Maneesriwongul W, Jitapunkul S (2008). Thai falls risk assessment test (Thai-FRAT) developed for community-dwelling Thai elderly. J Med Assoc Thai, 91(12): 1823-31.
18. Stevens JA, Sogolow ED (2005). Gender differences for non-fatal unintentional fall related injuries among older adults. Inj Prev, 11(2): 115-9.
19. Pattaramongkolrit S, Sindhu S, Thosigha O, Somboontanot W (2013). Fall-related Factors among Older, Visually-Impaired Thais. Pacific Rim Int J Nurs Res, 17(2): 181-196.
20. Lord SR (2006). Visual risk factors for falls in older people. Age Ageing, 35 Suppl 2:ii42-ii45.
21. Kuang TM, Tsai SY, Hsu WM, Cheng CY, Liu JH, Chou P (2008). Visual impairment and falls in the elderly: the Shihpai Eye Study. J Chin Med Assoc, 71(9): 467-72.
22. Lord SR, Dayhew J (2001). Visual risk factors for falls in older people. J Am Geriatr Soc, 49(5): 508-15.
23. Somtom W, Rawiworrakul T, Amnatsatsue K (2013). Effects of fall prevention program for Thai older adults. Journal of Public Health Nursing 27:58-70.
24. Salzman B (2010). Gait and balance disorders in older adults. Am Fam Physician, 82(1): 61-8.
25. Fong KNK, Siu AMH, Yeung KA, Cheung SWS, Chan CCH (2011). Falls Among the Community-living Elderly People in Hong Kong: A Retrospective Study. Hong Kong Journal of Occupational Therapy, 21(1): 33-40.
26. Baranzini F, Diurni M, Ceccon F et al (2009). Fall-related injuries in a nursing home setting: is polypharmacy a risk factor? BMC Health Serv Res, 9: 228.
27. Tromp AM, Pluijm SM, Smit JH, Deeg DJ, Bouter LM, Lips P (2001). Fall-risk screening test: a prospective study on predictors for falls in community-dwelling elderly. J Clin Epidemiol, 54(8): 837-44.
28. Chu LW, Chi I, Chiu AY (2005). Incidence and predictors of falls in the chinese elderly. Ann Acad Med Singapore, 34(1): 60-72.
29. Stalenhoef PA, Diederiks JP, Knottnerus JA, Kester AD, Crebolder HF (2002). A risk model for the prediction of recurrent falls in community-dwelling elderly: a prospective cohort study. J Clin Epidemiol, 55(11): 1088-94.
30. Jacobs JV.(2016) A review of stairway falls and stair negotiation: Lessons learned and future needs to reduce injury. Gait & Posture, 49:159-67
31. Verghese J, Wang C, Xue X, Holtzer R (2008). Self-reported difficulty in climbing up or down stairs in nondisabled elderly. Arch Phys Med Rehabil, 89(1): 100-4.
32. Hanlin ER, Delgado-Rendon A, Lerner EB, Hargarten S, Farias R (2013). Fall risk and prevention needs assessment in an older adult Latino population: a model community global health partnership. Prog Community Health Partnersh, 7(2): 191-9.
33. Lookkabaugh-Deur H, Esdale A (2005). Comprehensive Fall Prevention for Community-Dwelling Older Adults. Michigan Department of Community Health, State of Michigan.
34. Adab P, Macfarlane DJ (1998). Exercise and health---new imperatives for public health policy in Hong Kong. Hong Kong Med J, 4(4): 389-394.
35. Sohng KY, Moon JS, Song HH, Lee KS, Kim YS (2003). Fall prevention exercise program for fall risk factor reduction of the community-dwelling elderly in Korea. Yonsei Med J, 44(5): 883-91.
36. Silverman P, Hecht L, McMillin JD (2000). Modeling life satisfaction among the aged: a comparison of Chinese and Americans. Journal of Cross-Cultural Gerontology, 15(4): 289-305.
37. Chen SF (2013). Intervention to prevent falls through health education for elderly in Taiwan. Pak J Statist, 29(5): 535-546.
2. Fuller GF (2000). Falls in the elderly. Am Fam Physician, 61(7): 2159-68, 2173-4.
3. American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention (2001). Guideline for the Prevention of Falls in Older Persons. J Am Geriatr Soc, 49(5): 664-672.
4. Anders J, Dapp U, Laub S, von Renteln-Kruse W (2007). [Impact of fall risk and fear of falling on mobility of independently living senior citizens transitioning to frailty: screening results concerning fall prevention in the community]. Z Gerontol Geriatr, 40(4): 255-67.
5. Mizukami S, Arima K, Abe Y, Kanagae M, Kusano Y, Niino N, Aoyagi K (2013). Falls are associated with stroke, arthritis and multiple medications among community-dwelling elderly persons in Japan. Tohoku J Exp Med, 231(4): 299-303.
6. Assantachai P, Praditsuwan R, Chatthanawaree W, Pisalsarakij D, Thamlikitkul V (2003). Risk factors for falls in the Thai elderly in an urban community. J Med Assoc Thai, 86(2): 124-30.
7. Kuhirunyaratn P, Prasomrak P, Jindawong B (2013). Factors related to falls among community dwelling elderly. Southeast Asian J Trop Med Public Health, 44(5): 906-15.
8. Janz NK, Becker MH (1984). The Health Belief Model: a decade later. Health Educ Q, 11(1): 1-47.
9. Yazachew M, Alem Y (2004). Introduction ot Health education. Ethiopia Public Health Training Initiative, the Carter Center, the Ethiopia Ministry of Health and the Ethiopia Misnistry of Education, Ethiopia.
10. Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, Lamb SE (2012). Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev, 12(9): CD007146.
11. National Statistical Office [NSO] (2010). Thai population migration survey report. National Statistics Office, Bangkok.
12. Tabloski PA (2010). Challenges of Aging and Cornerstones of Excellence in Nursing Care. In: Gerontological Nursing. 2nd Ed. New Jersy , USA: Pearson Education, pp. 87-343.
13. Kececi A, Bulduk S (2012). Health Education for the Elderly. In: Geriatrics, Craig S. Atwood. Shanghai, China. : InTech, pp. 153-177.
14. Larson L, Bergmann TF (2008). Taking on the fall: The etiology and prevention of falls in the elderly. Clin Chiropr, 11(3): 148-154.
15. Pynoos J, Steinman BA, Nguyen AQ (2010). Environmental Assessment and Modification as Fall-Prevention Strategies for Older Adults. Clin Geriatr Med, 26(4): 633-44.
16. Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VO (1982-1983). Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res, 17(1): 37-49.
17. Thiamwong L, Thamarpirat J, Maneesriwongul W, Jitapunkul S (2008). Thai falls risk assessment test (Thai-FRAT) developed for community-dwelling Thai elderly. J Med Assoc Thai, 91(12): 1823-31.
18. Stevens JA, Sogolow ED (2005). Gender differences for non-fatal unintentional fall related injuries among older adults. Inj Prev, 11(2): 115-9.
19. Pattaramongkolrit S, Sindhu S, Thosigha O, Somboontanot W (2013). Fall-related Factors among Older, Visually-Impaired Thais. Pacific Rim Int J Nurs Res, 17(2): 181-196.
20. Lord SR (2006). Visual risk factors for falls in older people. Age Ageing, 35 Suppl 2:ii42-ii45.
21. Kuang TM, Tsai SY, Hsu WM, Cheng CY, Liu JH, Chou P (2008). Visual impairment and falls in the elderly: the Shihpai Eye Study. J Chin Med Assoc, 71(9): 467-72.
22. Lord SR, Dayhew J (2001). Visual risk factors for falls in older people. J Am Geriatr Soc, 49(5): 508-15.
23. Somtom W, Rawiworrakul T, Amnatsatsue K (2013). Effects of fall prevention program for Thai older adults. Journal of Public Health Nursing 27:58-70.
24. Salzman B (2010). Gait and balance disorders in older adults. Am Fam Physician, 82(1): 61-8.
25. Fong KNK, Siu AMH, Yeung KA, Cheung SWS, Chan CCH (2011). Falls Among the Community-living Elderly People in Hong Kong: A Retrospective Study. Hong Kong Journal of Occupational Therapy, 21(1): 33-40.
26. Baranzini F, Diurni M, Ceccon F et al (2009). Fall-related injuries in a nursing home setting: is polypharmacy a risk factor? BMC Health Serv Res, 9: 228.
27. Tromp AM, Pluijm SM, Smit JH, Deeg DJ, Bouter LM, Lips P (2001). Fall-risk screening test: a prospective study on predictors for falls in community-dwelling elderly. J Clin Epidemiol, 54(8): 837-44.
28. Chu LW, Chi I, Chiu AY (2005). Incidence and predictors of falls in the chinese elderly. Ann Acad Med Singapore, 34(1): 60-72.
29. Stalenhoef PA, Diederiks JP, Knottnerus JA, Kester AD, Crebolder HF (2002). A risk model for the prediction of recurrent falls in community-dwelling elderly: a prospective cohort study. J Clin Epidemiol, 55(11): 1088-94.
30. Jacobs JV.(2016) A review of stairway falls and stair negotiation: Lessons learned and future needs to reduce injury. Gait & Posture, 49:159-67
31. Verghese J, Wang C, Xue X, Holtzer R (2008). Self-reported difficulty in climbing up or down stairs in nondisabled elderly. Arch Phys Med Rehabil, 89(1): 100-4.
32. Hanlin ER, Delgado-Rendon A, Lerner EB, Hargarten S, Farias R (2013). Fall risk and prevention needs assessment in an older adult Latino population: a model community global health partnership. Prog Community Health Partnersh, 7(2): 191-9.
33. Lookkabaugh-Deur H, Esdale A (2005). Comprehensive Fall Prevention for Community-Dwelling Older Adults. Michigan Department of Community Health, State of Michigan.
34. Adab P, Macfarlane DJ (1998). Exercise and health---new imperatives for public health policy in Hong Kong. Hong Kong Med J, 4(4): 389-394.
35. Sohng KY, Moon JS, Song HH, Lee KS, Kim YS (2003). Fall prevention exercise program for fall risk factor reduction of the community-dwelling elderly in Korea. Yonsei Med J, 44(5): 883-91.
36. Silverman P, Hecht L, McMillin JD (2000). Modeling life satisfaction among the aged: a comparison of Chinese and Americans. Journal of Cross-Cultural Gerontology, 15(4): 289-305.
37. Chen SF (2013). Intervention to prevent falls through health education for elderly in Taiwan. Pak J Statist, 29(5): 535-546.
| Files | ||
| Issue | Vol 48 No 1 (2019) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v48i1.788 | |
| Keywords | ||
| Health education Fall risk prevention Elderly | ||
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How to Cite
1.
KUHIRUNYARATN P, PRASOMRAK P, JINDAWONG B. Effects of a Health Education Program on Fall Risk Prevention among the Urban Elderly: A Quasi-Experimental Study. Iran J Public Health. 2019;48(1):103-111.
