Abstract
BackgroundIn light of the multifactorial etiology of fall-related hip fracture, knowledge of fall circumstances may be especially valuable when placed in the context of the health of the person who falls. We aimed to investigate the circumstances surrounding fall-related hip fractures and to describe fall circumstances in relation to participants’ health and functional characteristics.MethodsThe fall circumstances of 125 individuals (age ≥ 50 years) with hip fracture were investigated using semi-structured interviews. Data concerning participants’ health (comorbidities and medications) and function (self-reported performance of mobility, balance, personal activities of daily living and physical activity, previous falls and hand grip strength) were collected via medical records, questionnaires and dynamometry. Using a mixed methods design, both data sets were analysed separately and then merged in order to provide a comprehensive description of fall events and identify eventual patterns in the data.ResultsFall circumstances were described as i) Activity at the time of the fall: Positional change (n = 24, 19%); Standing (n = 16, 13%); Walking (n = 71, 57%); Balance challenging (n = 14, 11%) and ii) Nature of the fall: Environmental (n = 32, 26%); Physiological (n = 35, 28%); Activity-related indoor (n = 8, 6%) and outdoor (n = 8, 6%); Trips and slips on snow (n = 20, 16%) and in snow-free conditions (n = 12, 10%) and Unknown (n = 10, 8%). We observed the following patterns regarding fall circumstances and participants’ health: those who fell i) during positional change had the poorest functional status; ii) due to environmental reasons (indoors) had moderate physical function, but high levels of comorbidity and fall risk increasing medications; iii) in snow-free environments (outdoors) appeared to have a poorer health and functional status than other outdoor groups.ConclusionsOur findings indicate that patterns exist in relation to the falls circumstances and health characteristics of people with hip fracture which build upon that previously reported. These patterns, when verified, can provide useful information as to the ways in which fall prevention strategies can be tailored to individuals of varying levels of health and function who are at risk for falls and hip fracture.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-015-0036-x) contains supplementary material, which is available to authorized users.
Highlights
In light of the multifactorial etiology of fall-related hip fracture, knowledge of fall circumstances may be especially valuable when placed in the context of the health of the person who falls
Based on qualitative content analysis, categories were created and we aimed to explore whether health and functional characteristics varied across these categories and whether there were identifiable patterns in the data
Being descriptive in nature, the present study aimed to identify patterns between fall descriptions and health characteristics of 125 cognitively unimpaired people with hip fracture, who were included from a population-based sample of patients admitted during a 10-month period
Summary
In light of the multifactorial etiology of fall-related hip fracture, knowledge of fall circumstances may be especially valuable when placed in the context of the health of the person who falls. Third party observations of falls in residential care settings provide valuable insights into fall mechanisms, they do not account for subjectively experienced factors such as dizziness or pain, or provide contextual health details of the person who fell [9,13]. These studies are not generalizable to all patients with hip fracture since the majority of hip fractures occur unobserved in community settings [14]. Explorative studies rarely place these perceptions in the context of the health of the faller [17,19,20,21], which may explain these reported diversities in fall perceptions [22]
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