Introduction
The chosen study studies patients’ experiences after a fall and their views on fall prevention strategies in hospitals. The research used a qualitative methodology, with patient interviews as the main source of data. The analysis of the interview results suggested some common themes and attitudes, such as self-blame, reluctance to call for aid, and negative feelings towards nurses (Lim et al., 2018). The study has important implications for nursing practice, as it offers valuable insight into patients’ perceptions of fall prevention.
Problem, Purpose, and the Hypothesis
The researchers provide a clear problem statement based on prior studies in the area. Lim et al. (2018) explain the problem of fall prevention, stating that patient falls were the most common type of injury in Singapore in 2013. The problem of falls is essential in all countries. For example, in the United States, patient falls are of critical importance to hospitals and care facilities (Nuckols et al., 2017). The purpose of the study is clearly defined and appropriate to the chosen research problem. However, the authors did not provide a clear hypothesis for the study. In addition, Lim et al. (2018) did not define and explain key terms, including patient falls, risk factors, and patient attitudes. The dependent and independent variables are also not identified and refined.
Review of the Literature
The literature review is efficient in summarizing the key knowledge in the area of patient fall prevention. For instance, the authors mention that knowledge of the risk factors appears to have a beneficial influence on patient engagement in fall prevention programs. Pohl et al. (2015) support this suggestion In their study. The vast majority of the sources included by the authors are less than five years old. Finally, the information presented in this section appears to be unbiased and is relevant to the topic studied.
Methods
The study used a qualitative research methodology, which is consistent with its purpose. According to Sorrell (2013), qualitative methods enable the researchers to gain more insight into the participants’ views, feelings, and opinions. However, the qualitative design also has some weaknesses, including small sample sizes and low reliability.
Sampling
The authors clearly defined the inclusion and exclusion criteria. In particular, the sample included “100 patients who experienced a fall in the inpatient wards, and who were medically stable and cognitively intact after the fall incident” (Lim et al., 2018, p. 48). The size of the sample is sufficient for qualitative research and is representative of the target population. The sampling procedures were also ethical because the authors obtained informed consent from each of the participants, as well as ethical approval from the SingHealth Centralized Institutional Review Board (Lim et al., 2018).
Variable Control
The authors do not discuss the variables or strategies for controlling them. However, this is justified by the focus of the study.
Content Quality and Validity
The researchers took appropriate steps to ensure the high quality and validity of content obtained from the interviews. All interviews were transcribed verbatim by a separate member of the research team (Lim et al., 2018). The validity and quality of responses were assured by investigator triangulation. Therefore, the content quality and validity of the study are rather high.
Statistical Procedures, Test Value, Validity, and Reliability
The study did not use any statistical procedures, as it utilized a qualitative methodology. Similarly, the test value and level of significance were not measured. As the study did not use any quantitative measurement tools, validity and reliability information was not provided by the authors.
Data Analysis and Presentation
The qualitative data obtained from the interviews were analyzed using an inductive content analysis, which is appropriate for qualitative studies. The findings fulfilled the aims of the study, as they identified key attitudes and feelings associated with falls. The authors did not describe the weaknesses or gaps in their findings.
Other Research Findings
The results presented in the study are consistent with other research findings. For example, a study by Haines et al. (2013) also supports the authors’ conclusions about the ineffectiveness of patient education in fall prevention. However, patient attitudes to falls were not extensively examined in previous research. Only two recently published study of the patients’ perceptions of falls and fall prevention was found. Shuman et al. (2016) report that patients can be apathetic towards falls or exhibit self-blaming behaviors, which supports the results of the present research. Hill et al. (2016), on the other hand, highlight the patients’ unwillingness to alert the nurses and their negative feelings towards nurses.
Limitations
Despite the overall high quality of the study, it had some limitations. First, the write-up was incomplete, as the authors did not discuss the key terms and variables. Secondly, the study focused on a single hospital in Singapore and thus had a narrow scope. Finally, the study did not consider the influence of age on patients’ attitudes towards falls, thus missing an opportunity to map a vital connection.
Implications for Practice
The results of the study can be used to develop potentially effective fall prevention programs, as they highlight some critical barriers to fall prevention. Also, the research shows the need for improved patient education regarding fall prevention. Finally, the study underlined the necessity for psychological assistance after a patient falls, as it could assist in improving patient attitudes and preventing self-blaming behaviors. The feasibility of this option could be addressed in further research.
Assessment
Overall, this is a high-quality qualitative study that provides a valuable assessment of patient experiences with falls. The article would be useful in my practice, as it shows how patient behaviors impact their experiences after falls. In particular, I would use the article to provide support to patients after a fall, as well as to improve patient education efforts in my facility.
References
Haines, T. P., Hill, A. M., Hill, K. D., Brauer, S. G., Hoffmann, T., Etherton-Beer, C., & McPhail, S. M. (2013). Cost-effectiveness of patient education for the prevention of falls in hospital: Economic evaluation from a randomized controlled trial. BMC Medicine, 11(1), 135.
Hill, A. M., Francis-Coad, J., Haines, T. P., Waldron, N., Etherton-Beer, C., Flicker, L.,… McPhail, S. M. (2016). ‘My independent streak may get in the way’: How older adults respond to falls prevention education in hospital. BMJ Open, 6(7), 1-11.
Lim, M. L., Ang, S. G. M., Teo, K. Y., Wee, Y. H. C., Yee, S. P., Lim, S. H., & Ang, S. Y. (2018). Patients’ experience after a fall and their perceptions of fall prevention. Journal of Nursing Care Quality, 33(1), 46-52.
Nuckols, T. K., Needleman, J., Grogan, T. R., Liang, L. J., Worobel-Luk, P., Anderson, L.,… Walsh, C. M. (2017). Clinical effectiveness and cost of a hospital-based fall prevention intervention: The importance of time nurses spend on the front line of implementation. Journal of Nursing Administration, 47(11), 571-580.
Shuman, C., Liu, J., Montie, M., Galinato, J. G., Todd, M. A., Hegstad, M., & Titler, M. (2016). Patient perceptions and experiences with falls during hospitalization and after discharge. Applied Nursing Research, 31(1), 79-85.
Sorrell, J. M. (2013). Qualitative research in clinical nurse specialist practice. Clinical Nurse Specialist, 27(4), 175-178.