Fall Risk Awareness and Experiences Among Adult Users of Opioids in Denmark: A Community Pharmacy-Based Questionnaire Pilot Study.

Background and ObjectivesFalls, the leading cause of death and disability among older adults, occur in daily life when the demands of daily activities surpass the ability to maintain balance. An estimated 30% of older adults misestimate their physical function, placing them at greater risk of falling. This study examined how experiences of physical function are linked to awareness of fall risk in daily life.Research Design and MethodsFor 30 consecutive days following a fall-risk assessment, 41 older adults (observations = 1,135; 56% women; age: 65–91) self-assessed objective and subjective fall risk using a custom smartphone application. Alignment of objective and subjective fall risk was indexed as awareness of fall risk. Postural sway was measured by the application. Physical and mobility symptoms and fear of falling were reported daily.ResultsAt baseline, 49% of participants misestimated their fall risk. Awareness of fall risk varied from day to day and fall risk was misestimated on 40% of days. Multilevel multinomial models showed individual differences in the level of daily symptoms to increase the tendency to misestimate fall risk. Daily symptoms and fear of falling increased awareness of high fall risk, but daily symptoms threatened awareness of low fall risk.Discussion and ImplicationsFindings suggest that misestimation of fall risk is common in older adulthood and informed by appraisals of physical function. Fall prevention strategies could support older adults in understanding their everyday physical function and provide tools to adjust the demands of activities in daily life.

The overarching aim of this study was to explore patients' falls risk awareness in hospitals using section A of the validated Self Awareness of Falls Risk Measure (SAFRM). Descriptive cross-sectional study design. Three rural/regional hospitals in the State of Victoria, Australia. Using a purposive sampling strategy, patients were eligible to participate if aged ≥ 40 years, English-speaking, and have ambulatory capacity prior to hospital admission. Participants were excluded from the study if they returned a Standardised Mini-Mental State Examination (SMMSE) score < 18. Falls risk awareness data was collected from both patient and health professionals using section A of the SAFRM. Patient demographic data was collected from patient medical records. A total of 77 patients (72.9 years ±11.2) and 58 health professionals were recruited. Patients had a significant difference in falls risk awareness when compared to their clinician (z = -2.08, p = 0.038). Regression analyses showed that patients were more likely to overestimate their falls risk if they used anticoagulant medication and if their highest education level was less than or equal year 11. An exploratory factor analysis (EFA) revealed a three-factor solution from section A of the SAFRM, which were labelled Physical Activity Awareness, Cognitive Awareness and Balance Awareness. There was a significant difference in patients' falls risk awareness compared to a health professional. The independent associations of variables with falls risk awareness, such as age, education level and medication use, further our understanding of the differences in falls risk awareness. The findings also establish that the 15-item section A SAFRM is a reliable and feasible falls risk perception measure for use in hospitals, with future research recommended to evaluate the proposed three-factor model with the addition of tailored hospital falls education. The findings from this study establish a significant difference in patients' falls risk awareness compared to their health professional. Section A of the SAFRM is a reliable tool for nurses and other health professionals to establish the presence of a falls risk disparity. The ability to empirically measure this disparity and to determine an under- or overestimation of falls risk is a useful addition to clinical practice. The SAFRM facilitates a person-centred approach to falls prevention by providing opportunities for the clinician to collaborate with the patient and tailor fall prevention strategies. Problem: Inpatient falls in hospital settings. There was a significant difference in patients' falls risk awareness compared to a health professional. Section A of the Self-Awareness of Falls Risk measure is a reliable and feasible tool to identify under- or overestimation of falls risk perception in hospitals. Patients were more likely to overestimate their falls risk if they used anticoagulant medication and if their highest education level was less than year 11. The findings for a three factor-model Physical Activity Awareness, Cognitive Awareness and Balance Awareness could inform future hospital falls education. Registered nurses, health professionals, inpatients. Reporting Method: STROBE checklist for cross-sectional studies. Patient or Public Contribution: This study involved the collection of data from patient participants and registered nurses.

The aim of the present study was to clarify the factorial structure influencing risk awareness by focusing on how fall risk awareness affects activities and behavior in the daily lives of middle-aged and elderly women who often experience falls both indoors and outdoors. A &apos;fall risk awareness&apos; checklist created by the authors in 2013 was used to assess risk awareness. The subject sample comprised 120 women (mean age 61.19 years) who underwent a regional health check in Y Hokkaido. The subject were divided into two groups according to the degree of risk awareness (a high risk awareness group and low risk awareness group) and examined using t-test to assess cognitive function, mobility, physical condition and degree of fall risk awareness. The relationship between fall risk awareness and each measurement item was analysed using Pearson&apos;s correlation coefficient. Furthermore, the interrelationship between fall risk awareness and physical condition, cognitive function, mobility and falls was found by covariance structure analysis. Pain associated with motor function affected reduced cognitive function and mobility. The results showed that reduced cognitive function affected by pain led to heightened awareness of risks. Higher risk awareness influenced by these factors increased the number of falls and decreased the frequency of outings. Even if subject had no problems with activities of daily living, encouraging the prevention of reduced cognitive function in the high risk awareness, while managing pain and preventing reduced mobility in the event of locomotor apparatus pain, can prevent falls and enable the maintenance of social activities such as outings.

Does functional capacity, fall risk awareness and physical activity level predict falls in older adults in different age groups?

To identify clinical correlates of person-centered fall risk awareness and their validity for predicting falls. Prospective cohort study. Community. Ambulatory community-dwelling older adults without dementia (N = 316; mean age 78, 55% female). Fall risk awareness was assessed using a two-item questionnaire that asked participants about overall likelihood of someone in their age group having a fall and their own personal risk of falling over the next 12 months. Incident falls were recorded over study follow-up. Fifty-three participants (16.8%) responded positively to the first fall risk awareness question about being likely to have a fall in the next 12 months, and 100 (31.6%) reported being at personal risk of falling over the next 12 months. There was only fair correlation (κ = 0.370) between responses on the two questions. Prior falls and depressive symptoms were associated with positive responses on both fall risk awareness questions. Age and other established fall risk factors were not associated with responses on either fall risk awareness question. The fall risk awareness questionnaire did not predict incident falls or injurious falls. Fall risk awareness is low in older adults. Although person-centered fall risk awareness is not predictive of falls, subjective risk perceptions should be considered when designing fall preventive strategies because they may influence participation and behaviors.

ABSTRACTIntroduction: This study examined whether participation in a modified version of the “Stepping On” program was effective in increasing fall self-efficacy, static and dynamic balance, and awareness of fall risks in older adults. Design: A mixed methods, one-group, nonexperimental, pretest-posttest design. Participants: Nineteen women aged 65 and older residing in a senior living facility. Intervention: Participants attended a 7-week fall prevention education program focused on group exercises, home hazards, community safety and footwear, and vision and medication management. The program met for 2 h weekly for 7 weeks. Participants were assessed pre- and postintervention using the Modified Falls-Efficacy Scale, Get Up and Go Test, and Romberg Balance Test. In addition, a focus group was facilitated postintervention to determine participants’ awareness of fall risks. Results: While the Modified Falls-Efficacy Scale (MFES) postintervention results were not statistically significant, they did indicate a decreased level of confidence in participants’ ability to avoid a fall postintervention. “Get Up and Go” completion time also increased postintervention, but was not statistically significant. No change in static balance was noted in Romberg Balance Test results. Participants did report an overall increase in awareness of fall risks postintervention. Conclusion: Although results did not support the hypotheses regarding increased fall self-efficacy and static and dynamic balance, participation in the modified “Stepping On” program did lead to an overall increase in awareness of fall risks. Modifying the evidence-based program made it feasible to test in a new community and may have empowered older adults with the knowledge to prevent future falls.

This study examined the relationship between the behavioral activation system (BAS) and fall risk awareness among Korean older adults, focusing on the mediating roles of optimistic bias and risk-taking. Data from 280 participants aged 60-84 were collected via an online survey. Using PROCESS Macro 3.5 Model 6, results showed that BAS positively correlated with optimistic bias, risk-taking, and fall risk awareness. However, optimistic bias and risk-taking were not directly correlated with fall risk awareness. A double mediation effect was observed, where optimistic bias and risk-taking sequentially mediated the BAS-fall risk awareness link. While BAS generally increased fall risk awareness, its influence became negative when mediated through optimistic bias and risk-taking. These findings suggest BAS affects fall risk awareness in complex ways, sometimes leading to lower awareness due to overconfidence and risk-taking behaviors.

ABSTRACTAims: To determine if a two-visit, personalized falls prevention educational intervention affected awareness of fall risk in community-dwelling older adults in Belize. Secondary aim: to assess new learning in a cross-cultural context and willingness to make lifestyle changes to reduce fall risk. Methods: A US-based team completed fall risk assessments (Short FES-I, mCTSIB, TUG, and 30-s Chair Stand Test), pre- and postintervention questionnaires, and an original postintervention semi-structured interview with eighteen participants. Investigators employed the Fall Risk Awareness Questionnaire (FRAQ) to assess awareness of fall risk. Intervention consisted of an educational class regarding fall risks that took place in a day centre, and a home visit. Questionnaire results were analyzed for statistical significance. Investigators completed thematic analysis of interviews. Results: Mean scores of the FRAQ rose slightly at posttest, but results were not statistically significant. Qualitative analyses revealed themes regarding specific fall risk awareness, barriers to change, and willingness to change. Conclusions: Participants in this sample demonstrated an increase in falls risk awareness after a brief falls prevention program. The sample size and prepost design limited generalizability of the results. Therapists should be aware of cultural competence, health literacy, and personal narrative of participants.

IntroductionDaily life requires frequent estimations of the risk of falling and the ability to avoid a fall. The objective of this study was to explore older women’s and men’s understanding of fall risk and their experiences with safety precautions taken to prevent falls.MethodsA qualitative study with focus group discussions was conducted. Eighteen community-dwelling people [10 women and 8 men] with and without a history of falls were purposively recruited. Participants were divided into two groups, and each group met four times. A participatory and appreciative action and reflection approach was used to guide the discussions. All discussions were audio recorded and transcribed verbatim. Data were analysed by qualitative content analysis, and categories were determined inductively.FindingsThree categories describing the process of becoming aware of fall risks in everyday life were identified: 1] Facing various feelings, 2] Recognizing one’s fall risk, and 3] Taking precautions. Each category comprised several subcategories. The comprehensive theme derived from the categories was “Safety precautions through fall risk awareness”. Three strategies of ignoring [continuing a risky activity], gaining insight [realizing the danger in a certain situation], and anticipating [thinking ahead and acting in advance] were related to all choices of actions and could fluctuate in the same person in different contexts.ConclusionsThe fall risk awareness process might be initiated for various reasons and can involve different feelings and precautions as well as different strategies. This finding highlights that there are many possible channels to reach older people with information about fall risk and fall prevention, including the media and their peers. The findings offer a deeper understanding of older peoples’ conceptualizations about fall risk awareness and make an important contribution to the development and implementation of fall prevention programmes.

Falls are life-changing events in older adulthood. With an accurate understanding of balance, older adults can adapt to age-related changes in physical ability without prematurely restricting physical activity. The Daily Balance Project examines the implications of older adults’ awareness of fall risk in daily life. For 30-consecutive days, following a fall-risk assessment, 40 older adults used a smartphone to report balance confidence and then perform four balance assessment and a 30-second sit-to-stand task to measure postural sway and fall-risk. Measures of postural sway showed greater intraindividual variability than balance confidence and fall risk. Multilevel models showed that awareness of balance fluctuated during the study and varied across individual differences in baseline fall-risk. Baseline fall risk also differentiated how balance confidence and postural sway were linked to subsequent momentary fall risk assessments. The findings are discussed within the framework of action-perspectives of adult development and awareness of aging.

BackgroundMany older people (care recipients) experience long-term psychological distress due to the fear of falling again. Falls can affect carers due to concerns about their care recipients falling. Understanding carers’ fall concern is crucial to determine if carers are coping with the provision of care or have adequate knowledge and support in preventing their care recipients from falling at home.MethodsA descriptive qualitative study was conducted to explore carers’ concern about their care recipients being at risk of falling and their management of fall risk at home. Twenty-two carers were recruited from two research registers and a large tertiary hospital in a regional centre of Australia. Carers were interviewed face-to-face, or by telephone using a semi-structured interview guide about their fall concern. The data was analysed using an inductive content analysis method.ResultsEight major themes emerged from the interviews. Four themes described key factors influencing carers’ fall concern which include: 1) carers’ perception of fall and fall risk, 2) care recipients’ behaviour and attitude towards fall risk, 3) care recipients’ health and function, and 4) care recipients’ living environment. Another four themes described the management of care recipients’ fall risk which include: 5) fall prevention strategies used, 6) risk of preventing falls, 7) support from family and friends, and 8) support from healthcare professionals.ConclusionsThe findings from this qualitative study provide an insight into the carers’ awareness of fall risk, knowledge, and the availability of support in preventing their care recipients from falling at home. Healthcare professionals are encouraged to include carers and address their fall concern to improve fall prevention programmes for care recipients at risk of falling at home.

Falls and their consequences are perhaps the greatest moderators of quality of life (QoL) among older adults with hypertension. However, limited studies have been conducted to identify associations between fall risk and awareness, anthropometric, balance, and QoL among older women with different blood pressure patterns within the Pakistani population. This cross-sectional study examined the relationship between anthropometric measurements, postural balance (PB), fear of falling, fall risk awareness, and QoL in older females with hypersensitive status in Lahore, Pakistan. A total of 114 females aged 65 to 83 years from Bajwa hospital participated in the study. Anthropometric measurements, including height, weight, body mass index (BMI), and waist-to-height ratio, were calculated. Time up and go test, Berg balance scale (BBS), fall efficacy scale international (FES-I), and fall risk awareness questionnaire were used. QoL was measured through SF-36. Independent t-tests, Pearson correlation, and multiple regression analysis were conducted. Comparison of hypertensive and normotensive participants showed statistically significant differences in BMI (P = .006), waist-to-height ratio (P < .001), and balance measured by BBS (P = .013). Compromised mobility was observed among hypertensive and obese women. Multiple regression models showed that the domains of emotional well-being and role limitations due to physical health could be predicted by PB, fear of falling, and fall risk awareness. These results revealed obesity and fear of falling as key factors to predict QoL. The waist-to-height ratio (an indicator of central obesity) was associated more closely with poor PB in comparison to the BMI (R = 0.75 vs R = 0.36), and the fear of falling positively correlated with poor acute awareness of fall risk (R = 0.28, P < .05). The variables related to QoL differ based on hypertensive status. Among elderly hypertensive females, obesity, reduced balance, and fear of fall represent the key determinants of decreased emotional well-being and role limitation due to physical health. Strategies to prevent falls need to be individualized and multifactorial.

Purpose: To determine effects of a fall risk educational program on fall risk awareness. Methods: Twenty-five community-dwelling older adults 65 years and older attended a single-session intervention. Investigators held focus groups 1 month post-intervention. Investigators administered the Short Falls Efficacy Scale-International (S-FES-I) pre- and post-intervention. Results: Raw S-FES-I scores trended toward reduced fear of falling. Older adults reported heightened awareness of fall risks and reinforcement of fall prevention behaviors. Social support and narrative storytelling helped motivate participants. Conclusion: A single-session educational program reinforced existing fall risk reduction knowledge and behaviors but was limited in its ability to prompt behavioral change.

Background: Elderly people with uncontrolled diabetes mellitus (DM) are at risk of falls, which can lead to injury and disability. Not much is known of informal caregivers’ awareness of falls in elderly patients with DM. Objective: This study aims to identify an association between caregiver’s awareness and falls in elderly patients with DM. Methods: A total of 136 pairs of DM patients and their respective family caregivers were recruited from a clinical service center at Chiang Mai University, Thailand. The questionnaire regarding the caregiver’s awareness of the risk of falls in elderly patients was given via a face-to-face interview. Each elderly patient was asked about their history of falls in the prior year, and the risk of falls was assessed by Time Up &amp; Go (TUG) test. Logistic regression analysis was performed to determine association. Results: The mean age of the DM patients was 65.7 years. Sixty-two patients (45.6%) had fallen at least once in the prior year. The mean TUG test result was 12.67±1.83 second. Most caregivers demonstrated a high level of awareness regarding the risk of falls in elderly patients. The results of the multivariable analysis showed that three variables – balance problems, risk of falls assessed by TUG test, and scores of caregiver’s awareness of risk of falls – were significantly related to falls in the previous year among elderly patients with DM (p-value&lt;0.05). Conclusion: The caregivers’ awareness of fall risk may influence fall occurrence among older adults with DM. An intervention program to improve awareness among informal caregivers should be considered for fall prevention in elderly people.

This thesis project was created to help promote fall risk awareness in older adults who are living in the community with a serious mental illness. This project consisted of a 3-part multifactorial intervention plan that focused on increasing fall risk awareness and promoting participation in healthy lifestyles. Environmental modifications were made to the facility to create a safe environment and minimize the risk of falls. An exercise video was created and piloted with the residents of a facility for people with serious mental illness. The video included strength and balance exercises which minimize the risks of falling. An inservice was provided to educate and inform the staff on effective ways to promote healthy aging and fall risk awareness. The residents and staff were given surveys to evaluate the exercise video and inservice. Approximately 90 percent of the responses generated from the surveys were positive. Despite positive reviews, project developers were unable to determine if the exercise video, fall prevention materials provided, and completion of environmental modifications will be adhered to. The population of older adults is on the rise; therefore, healthy aging and wellness are areas of concern for society and occupational therapists. iv