Abstract
BackgroundFear of falling and associated avoidance of activity are common among older people and may have negative consequences in terms of functional decline, quality of life and institutionalisation. We evaluated the effects of a cognitive behavioural group intervention to reduce fear of falling and associated avoidance of activity among older persons. This intervention showed favourable effects on fear of falling, avoidance of activity, daily activity, and several secondary outcomes. The aim of the present study is to assess the feasibility of this cognitive behavioural group intervention for participants and facilitators.MethodsThe intervention consisted of eight weekly group sessions lasting two hours each and a booster session after six months. Self-administered questionnaires, registration forms and interviews were used to collect data from participants (n = 168) and facilitators (n = 6) on the extent to which the intervention was performed according to protocol, participant attendance, participant adherence, and participants' and facilitators' opinion of the intervention. Quantitative data from the questionnaires and registration forms were analysed by means of descriptive statistics. Qualitative data were categorised based on matching contents of the answers.ResultsFacilitators reported no major protocol deviations. Twenty-six percent of the participants withdrew before the start of the programme. Of the persons who started the programme, 84% actually completed it. The participants reported their adherence as good, but facilitators had a less favourable opinion of this. The majority of participants still reported substantial benefits from the programme after six and twelve months of follow-up (71% and 61% respectively). Both participants and facilitators provided suggestions for improvement of the intervention.ConclusionResults of this study show that the current cognitive behavioural group intervention is feasible for both participants and facilitators and fits in well with regular care. Minor refinement of the intervention, however, is warranted to further improve intervention effectiveness and efficiency. Based on these positive findings, we recommend implementing a refined version of this effective and feasible intervention in regular care.Trial registrationISRCTN43792817
Highlights
Tennstedt and colleagues developed a cognitive behavioural group intervention primarily aimed at reducing fear of falling and avoidance of activity [12,13]
We carried out a randomised controlled trial (n = 540) to assess both short-term and longterm effects of "A Matter of Balance" in the Netherlands (ISRCTN43792817) [15,16]. Results of this trial showed that the intervention had favourable effects on all primary outcomes: fear of falling, avoidance of activity, and daily activity
We think that some aspects of the intervention could be refined, the results of the present study show that this effective intervention is feasible for both participants and facilitators and fits in well with regular care
Summary
Fear of falling and associated avoidance of activity may have negative consequences in terms of functional decline, decreased quality of life and institutionalisation [2,10,11] For this reason, Tennstedt and colleagues developed a cognitive behavioural group intervention primarily aimed at reducing fear of falling and avoidance of activity [12,13]. Favourable effects were observed on several of the secondary outcomes [Zijlstra GAR, van Haastregt JCM, Ambergen T, van Rossum E, van Eijk JThM, Tennstedt SL, Kempen GIJM: Effectiveness of a cognitive behavioural group intervention on fear of falling and associated avoidance of activity in community-living older people: a randomised controlled trial.
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