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Fall Prevention Issues: Strategies and Key Concepts

Falls, especially in older adults, is a significant problem, the solutions to which are still being researched. In this paper, a synthesis of the literature that is relevant to education-based fall prevention is presented (see Appendices A and B). Since recent articles that consider fall education in isolation is not very numerous, some of them review similar or adjacent topics. The synthesis of their key concepts demonstrates that high-quality studies have been dedicated to the topic, but their limitations imply that a new project could cover multiple research gaps.

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Concept 1: The Problem of Falls

The topic of fall prevention is naturally connected to the concept of falls, which, in the reviewed literature, is typically problematized. It is mentioned or directly addressed in every of the thirty reviewed articles, including quantitative ones. The first subtheme in this literature review is the issue of falls and their consequences. While few of the studies pose a research question about the consequences of falls, all of them justify their attention to the topic by pointing out the dangers of falls.

As an illustration, the study by Gazibara et al. (2017) incorporated an epidemiological question about injuries after falls in older persons in Serbia; for that sample, almost 50% of the falls led to injuries. The sample was sufficient for the setting, which was one center (n=354), but not for more direct generalizations. However, the authors pointed out the similarities in their findings with other studies, and future research may consider other, understudied populations.

Furthermore, some studies incorporate outcome measures (fall-related injuries) in their research questions. An example is an article by Hill et al. (2015), which is a multi-site randomized controlled trial (RCT) with a large sample (3,606 inpatients in two groups). Its findings may be specific to Australia and inpatients from rehabilitation units, which is a limitation. Also, the results are only applicable to a particular intervention, and other interventions may need more research. Still, the fact that the consequences of falls make them important to address is a common theme in the literature.

As is required for determining appropriate solutions for a problem, a second subtheme is the causes of falls. An article by Haines, Lee, O’Connell, McDermott and Hoffmann (2015) proposed a question about the reasons for falls with a focus on risky behaviors. It is a qualitative study with interview data from 16 inpatients (older adults), eight caregivers, and 33 staff members. Other qualitative studies have also demonstrated that some of the potential causes for falls (or fall-prone behaviors) include overconfidence, the lack of knowledge about fall prevention, and difficulties with performing fall prevention activities (Lim et al., 2018; Mamani et al., 2019).

All these articles suffer from sample size issues; their findings may not apply to populations that are different from their samples. Still, the findings indicate that the motivations for taking risks vary, and they include the lack of information.

Quantitative articles that cover this subtheme also exist. Their questions are generally concerned with the epidemiology of risk factors in different populations. For example, Yoo, Kim, Yim, and Jeon (2016) conducted a quantitative assessment to determine the factors that may be more important in rural and urban areas (with a sample of 534 South Korean people). Similarly, Gale, Cooper, and Sayer (2016), with a sample of 4,301 people, demonstrate that fall risks for women and men tend to differ. The additional investigation of this topic is justified since both studies have sample-related limitations and do not cover all conceivable subgroups in patient populations. Still, the literature demonstrates that attention is paid to the causes of falls, one of which is the lack of knowledge.

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The importance of addressing falls, which is the third subtheme, appears to be the rationale of most presented articles. Some articles pose questions about the perspectives of patients and caregivers, as well as staff members (Haines et al., 2015; Hill et al., 2016; Lim et al., 2018; Mamani et al., 2019; Meyer, Dow, Hill, Tinney, & Hill, 2016; Radecki, Reynolds, & Kara, 2018; Schoberer, Breimaier, Mandl, Halfens, & Lohrmann, 2016; Xu et al., 2017).

Such articles are typically qualitative, which affects the size of their samples and means that generalizing their findings is impossible, which is a limitation. An exception is an article by Mamani et al. (2019), in which the authors determined the prevalence of good knowledge and helpful attitudes in participants. The authors focused on elderly caregivers, and with a small sample of 97 people, their findings are not supposed to be generalized, but they demonstrate that most caregivers understand the significance of falls.

Regarding the rest of the studies in this subtheme, they are qualitative because they attempt to produce insights into participants’ views. They may involve patients and caregivers (Meyer et al., 2016; Schoberer et al., 2016; Xu et al., 2017), as well as staff members (Haines et al., 2015; Hill et al., 2016). The articles indicate the studied populations’ interest in solutions to fall problems, including those that are achieved through education. Therefore, this finding, which is reflected in different studies, can be considered relatively well-established, even though the attitudes toward specific interventions may require individual research.

To summarize, the concept of falls is made to incorporate the subthemes of the negative features of falls, their risks, and the importance of addressing them. Based on these studies, falls are connected, among other things, to the lack of knowledge, and addressing falls is important, partially because of their consequences and the perspectives of falls-prone people.

Concept 2: Factors to Consider in Prevention Intervention Development

Many of the studied articles consider the development of interventions that are supposed to prevent falls. They are predominantly quantitative; they discuss the process of an intervention’s creation and test or pilot it with quantitative outcomes as the common measurements (Hill et al., 2019; Ueda et al., 2017). However, qualitative studies are also present for patient-focused interventions (Hill et al., 2016; Meyer et al., 2016). A primary subtheme to this concept is the consideration of the opinions and perspectives of the people who are targeted by an intervention. Multiple qualitative studies pose the questions or state goals and purposes that require investigating such views (Hill et al., 2016; Lim et al., 2018; Meyer et al., 2016; Radecki et al., 2018; Schoberer et al., 2016; Xu et al., 2017).

Such articles have small samples, and they are typically concerned with fall-prone patients (Hill et al., 2016; Lim et al., 2018; Radecki et al., 2018), informal caregivers (Meyer et al., 2016; Xu et al., 2017), and formal caregivers (that is, hospital staff) (Hill et al., 2016). Qualitative methodology implies limitations for the findings’ application outside of a specific population that the sample represents. However, they show that the feedback of the people who are targeted by the interventions is valuable and needs to be researched for each intervention.

The second subtheme is customization; some articles set questions about testing tailored (customized) programs, including the articles by Hill et al. (2015) and Ueda et al. (2017). Certain studies, for example, those by Carlucci et al. (2018) and Jie and Deng (2019), mention that their trials incorporated customized elements, but they do not focus on this topic.

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Three RCTs (Hill et al., 2015; Jie & Deng, 2019; Ueda et al., 2017), as well as a pre-test post-test study (Carlucci et al., 2018), use reliable methods, but only one of them has a sample that can be considered large (Hill et al., 2015). As a result, most of these articles have limited generalizability, especially since each of them investigates a specific intervention. These studies imply that customized programs could be effective, but more research on individual interventions, especially that by Ueda et al. (2017), is needed.

The final subtheme is concerned with involving specialists in the process of intervention development. Many studies state research questions about the effectiveness of interventions that are developed by physicians, nurses, or other experts (Lohman et al., 2017; Nakagami-Yamaguchi et al., 2016; Vonnes & Wolf, 2017). Each of those articles has its intervention and approach to studying it, but they tend to have relatively large sample sizes (269 people and more). Their quantitative methodologies, while not free of limitations (for example, those associated with pre-test post-test design), produce reliable findings. The results suggest that professional-developed interventions are effective. To summarize, the reviewed literature suggests that intervention development should be patient-centered, customized, and performed by professionals.

Concept 3: Different Approaches to Prevention Interventions

The approaches to fall prevention are rarely limited to education, but the first subtheme to be considered is education and educational elements in fall prevention. Some of the reviewed articles consider more comprehensive interventions, which incorporate education as their part (Casey et al., 2017; Johnston et al., 2018; Lohman et al., 2017; Szewieczek, Mazur, & Wilczyński, 2016). However, many of the reviewed studies ask questions about the effectiveness and outcomes of specifically education-related interventions. The main limitation of these studies is that they are most often dedicated to a specific program that is not investigated again; the only exception is a series of articles by Hill et al. (2016), in which one educational project was studied from multiple perspectives in several sites.

Regarding samples, inpatients (Perrot, Ayad, Gernigon, & Maillot, 2019), as well as outpatients (Carlucci et al., 2018; Hill et al., 2019; Jie & Deng, 2019; Kuhirunyaratn, Prasomrak, & Jindawong, 2019; Lyons & Hall, 2016; Ott, 2018; Ueda et al., 2017), are involved in such studies. Typically, older patients are a part of the sample (Nakagami-Yamaguchi et al., 2016; Perrot et al., 2019; Uymaz & Nahcivan, 2016). In addition, caregivers are occasionally considered (Vonnes & Wolf, 2017).

The limitations can be connected to the specifics of the methodology, including, for example, the lack of a comparison group (Perrot et al., 2019; Uymaz & Nahcivan, 2016) or randomization (Kuhirunyaratn et al., 2019), but the most common issue is a small sample. As an example, Perrot et al. (2019) involved only 30 people during the pre-intervention period, and in the study by Ott (2018), only eight people were subjected to the intervention. Large samples can also be encountered with the maximum number amounting to over 3,000 people (Hill et al., 2015). Still, small or specific (non-generalizable) samples remain an issue for these studies, which warrants individual research for specific interventions.

The target of the interventions varies across the literature, and it is the second subtheme of this concept. Thus, several studies posed research questions that required determining the effectiveness of an intervention that was aimed directly at patients (inpatients and outpatients) (Johnston et al., 2018; Uymaz & Nahcivan, 2016). However, some of the interventions were targeting caregivers and patients (Nakagami-Yamaguchi et al., 2016; Vonnes & Wolf, 2017), as well as staff (Hill et al., 2015).

The primary limitations of such studies are connected to their sample sizes; mostly, they are relatively small. In addition, not all studies are RCTs (Uymaz & Nahcivan, 2016; Vonnes & Wolf, 2017). Most studies demonstrate different positive outcomes associated with their interventions, although they consider individual interventions that can benefit from additional research.

As a third theme, the different new approaches to the modes of education can be noted. Such studies ask a question about the effectiveness of unusual interventions, for example, educational movies, floor plans, or robotic coaches (Maneeprom, Taneepanichskul, Panza, & Suputtitada, 2019; Nakagami-Yamaguchi et al., 2016; Ueda et al., 2017).

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Outpatients (Maneeprom et al., 2019; Ueda et al., 2017), as well as inpatients (Nakagami-Yamaguchi et al., 2016), have been involved, and the methodologies included an RCT by Ueda et al. (2017) and quasi-experiments. All the studies demonstrated the effectiveness of the novel interventions with older patients, but with the limited amount of data for each of those interventions, which were mostly studied with small samples, more research for each of them should be recommended. To summarize, the approaches to interventions incorporate novel and older ones, including education, which may target different groups.

Concept 4: Studying Prevention Interventions

Few articles are directly dedicated to the methods of studying and evaluating the interventions. However, they are important since they can direct future studies (Hill et al., 2019; Meyer et al., 2016). First, the subtheme and research question of investigating the effectiveness was found (Carlucci et al., 2018; Hill et al., 2019; Jie & Deng, 2019; Kuhirunyaratn et al., 2019; Lyons & Hall, 2016; Ott, 2018; Perrot et al., 2019; Ueda et al., 2017).

As mentioned, the populations are typically older adults who are in or outpatients; the samples are rather small and typically restricted to one facility with few exceptions (Hill et al., 2015). The findings usually suggest effectiveness in some respect; it is rather rare for a study to find no effect at all. Out of the reviewed literature, only an article by Hill et al. (2019) reports that an RCT with 382 discharged patients did not demonstrate any positive effects of their education as related to fall rates. Therefore, individual programs require individual studies to prove or disprove their effectiveness. Also, with pilot studies and small samples (Ueda et al., 2017), additional research may be required.

The subtheme of gathering feedback from participants is represented rather extensively. Some articles dedicate their inquiry to the questions related to the perspectives of patients, caregivers, and staff (Carlucci et al., 2018; Hill et al., 2016; Meyer et al., 2016; Schoberer et al., 2016; Xu et al., 2017). Such articles focused on qualitative methodologies, and their findings should be applied to a relatively small population. However, new populations can be studied in future research.

An underrepresented theme is the tools that can be used to study the interventions. An article by Lohman et al. (2017) is unique in its research question, which requires determining how effective a STEADI tool is at predicting falls. Similarly, there exists a study of a risk assessment algorithm, which would be useful in reviewing fall prevention (Gomez, Wu, Auais, Vafaei, & Zunzunegui, 2017).

These articles have very large samples of older adults, and their limitations are mostly individual issues, for example, the impossibility of assessing the accuracy of the patients’ self-reports. Still, their results demonstrate that workable tools, which might benefit from some additional investigation, exist and can be used for researching falls. To summarize, the presented literature shows how to investigate a fall prevention program with attention paid to its outcomes, clients’ feedback, and well-researched methods of performing that activity. Despite the limitations, the cited literature also implies that fall prevention can be assessed and tends to have positive effects, although there are some exceptions.

Concept 5: The Effectiveness of Education

Since education is the primary focus of the proposed study, the effectiveness of education is the final concept. It has been evaluated from different perspectives, especially quantitative ones (Carlucci et al., 2018; Hill et al., 2019). The first subtheme is the reduction in fall ratios (Hill et al., 2019; Nakagami-Yamaguchi et al., 2016), falls (Perrot et al., 2019), near-falls (Ueda et al., 2017), injurious falls (Vonnes & Wolf, 2017), and fallers (Hill et al., 2015), which becomes the research question of the cited sources. These studies are quantitative, and some of them have large samples (Hill et al., 2015), although other ones have very small ones (Perrot et al., 2019).

Inpatients and outpatients can be studied (Hill et al., 2019), as well as staff and informal caregivers (Hill et al., 2015). The limitations are mostly the sample and location; also, the interventions are not always tested against a control group or groups. Since each of these articles is about a specific intervention, future ones will need additional research.

As a second subtheme, the reduction in risks of falls is noteworthy. The studies that ask the question of the effectiveness of their intervention at achieving this outcome are quantitative (Carlucci et al., 2018; Jie & Deng, 2019; Kuhirunyaratn et al., 2019; Maneeprom et al., 2019; Perrot et al., 2019; Uymaz & Nahcivan, 2016), but a qualitative study can ask what fall risks are affected by the educational program (Hill et al., 2016). With small and large samples of in- and outpatients (from 43 at post-test to 757), these articles have the limitations of specific samples (for example, only rehabilitation units) and individual interventions.

The articles prove that education can improve knowledge (Maneeprom et al., 2019), reduce the fear of falls (Perrot et al., 2019; Uymaz & Nahcivan, 2016), and enhance awareness and confidence (Hill et al., 2016), as well as balance (Kuhirunyaratn et al., 2019). However, risk factors are more numerous, and their additional research in the areas in which these articles found no statistically significant differences could be helpful.

As a third subtheme, the approval of the target audience can be noted. These articles and their findings are not as generalizable since they are mostly qualitative (Carlucci et al., 2018; Hill et al., 2016; Meyer et al., 2016). Their samples are on the smaller side, which is a limitation, and they also focus on older patients and people who provide them with care. The articles demonstrate the fact that educational interventions can be of importance to target audiences, but to support this thesis for different populations, additional research may be required. To summarize, this concept demonstrates that educational interventions can be effective from different perspectives (from fall reductions to risk factors improvements), and they can also have no effects, which is why investigating new ones is a requirement.

Conclusion

The presented synthesis demonstrates that the articles cover different aspects of fall-related issues, and the topics of older people and educational interventions are represented. Most articles are limited by their samples and by studying individual interventions. Educational interventions are proven to be effective, which may be attributable to them targeting one of the causes of falls. Furthermore, the literature demonstrates that fall prevention interventions need to be studied to ensure their effectiveness, and the presented articles can be used to design or choose an intervention, research it, and justify researching it.

References

Carlucci, C., Kardachi, J., Bradley, S., Prager, J., Wyka, K., & Jayasinghe, N. (2018). Evaluation of a community-based program that integrates joyful movement into fall prevention for older adults. Gerontology and Geriatric Medicine, 4, 233372141877678. Web.

Casey, C., Parker, E., Winkler, G., Liu, X., Lambert, G., & Eckstrom, E. (2017). Lessons learned from implementing CDC’s STEADI falls prevention algorithm in primary care. The Gerontologist, 57(4), 787–796. Web.

Gale, C., Cooper, C., & Sayer, A. (2016). Prevalence and risk factors for falls in older men and women: The English Longitudinal Study of Ageing. Age and Ageing, 45(6), 789-794. Web.

Gazibara, T., Kurtagic, I., Kisic-Tepavcevic, D., Nurkovic, S., Kovacevic, N., Gazibara, T., & Pekmezovic, T. (2017). Falls, risk factors and fear of falling among persons older than 65 years of age. Psychogeriatrics, 17(4), 215-223. Web.

Gomez, F., Wu, Y., Auais, M., Vafaei, A., & Zunzunegui, M. (2017). A simple algorithm to predict falls in primary care patients aged 65 to 74 years: The international mobility in aging study. Journal of the American Medical Directors Association, 18(9), 774-779. Web.

Haines, T. P., Lee, D. C. A., O’Connell, B., McDermott, F., & Hoffmann, T. (2015). Why do hospitalized older adults take risks that may lead to falls? Health Expectations, 18(2), 233-249. Web.

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), e012363. Web.

Hill, A. M., McPhail, S. M., Haines, T. P., Morris, M. E., Etherton-Beer, C., Shorr, R.,… Francis-Coad, J. (2019). Falls after hospital discharge: A randomized clinical trial of individualized multimodal falls prevention education. The Journals of Gerontology: Series A, 74(9), 1511-1517. Web.

Hill, A. M., McPhail, S. M., Waldron, N., Etherton-Beer, C., Ingram, K., Flicker, L.,… Haines, T. P. (2015). Fall rates in hospital rehabilitation units after individualised patient and staff education programmes: A pragmatic, stepped-wedge, cluster-randomised controlled trial. The Lancet, 385(9987), 2592-2599. Web.

Hill, A. M., Waldron, N., Francis-Coad, J., Haines, T., Etherton-Beer, C., Flicker, L.,… McPhail, S. M. (2016). ‘It promoted a positive culture around falls prevention’: Staff response to a patient education programme—a qualitative evaluation. BMJ Open, 6(12), e013414. Web.

Jie, E., & Deng, J. (2019). Fall prevention education reduces the falling rate on the osteoporosis patients treated with zoledronic acid. Case Reports in Clinical Medicine, 08(08), 222-230. Web.

Johnston, Y. A., Bergen, G., Bauer, M., Parker, E. M., Wentworth, L., McFadden, M.,… Garnett, M. (2018). Implementation of the Stopping Elderly Accidents, Deaths, and Injuries Initiative in primary care: An outcome evaluation. The Gerontologist, XX(XX), 1-10. Web.

Kuhirunyaratn, P., Prasomrak, P., & Jindawong, B. (2019). Effects of a health education program on fall risk prevention among the urban elderly: A quasi-experimental study. Iranian Journal of Public Health, 48(1), 103–111. Web.

Lim, M., Ang, S., Teo, K., Wee, Y., Yee, S., Lim, S., & Ang, S. (2018). Patientsʼ experience after a fall and their perceptions of fall prevention. Journal of Nursing Care Quality, 33(1), 46-52. Web.

Lohman, M., Crow, R., DiMilia, P., Nicklett, E., Bruce, M., & Batsis, J. (2017). Operationalisation and validation of the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) fall risk algorithm in a nationally representative sample. Journal of Epidemiology and Community Health, 71(12), 1191–1197. Web.

Lyons, B., & Hall, R. (2016). Outcomes of a falls prevention education program among older adults in Grenada. Journal of Community Health, 41(5), 1021-1026. Web.

Mamani, A., Reiners, A., Azevedo, R., Vechia, A., Segri, N., & Cardoso, J. (2019). Elderly caregiver: Knowledge, attitudes and practices about falls and its prevention. Revista Brasileira De Enfermagem, 72(suppl 2), 119-126. Web.

Maneeprom, N., Taneepanichskul, S., Panza, A., & Suputtitada, A. (2019). Effectiveness of robotics fall prevention program among elderly in senior housings, Bangkok, Thailand: A quasi-experimental study. Clinical Interventions in Aging, 14, 335-346. Web.

Meyer, C., Dow, B., Hill, K., Tinney, J., & Hill, S. (2016). “The right way at the right time”: Insights on the uptake of falls prevention strategies from people with dementia and their caregivers. Frontiers in Public Health, 4, 1-10. Web.

Nakagami-Yamaguchi, E., Fujinaga, K., Batard, A., Baba, N., Nakamura, K., Miyazaki, K.,… Nakatani, T. (2016). The effect of an animation movie for inpatient fall prevention: A pilot study in an acute hospital. Safety in Health, 2(1), 1-10. Web.

Ott, L. (2018). The impact of implementing a fall prevention educational session for community-dwelling physical therapy patients. Nursing Open, 5(4), 567-574. Web.

Perrot, A., Ayad, A., Gernigon, M., & Maillot, P. (2019). The impact of therapeutic patient education and physical activity programs on the fall risk of elderly people. Movement & Sport Sciences – Science & Motricité, 2019, 1-8. Web.

Radecki, B., Reynolds, S., & Kara, A. (2018). Inpatient fall prevention from the patient’s perspective: A qualitative study. Applied Nursing Research, 43, 114-119. Web.

Schoberer, D., Breimaier, H., Mandl, M., Halfens, R., & Lohrmann, C. (2016). Involving the consumers: An exploration of users’ and caregivers’ needs and expectations on a fall prevention brochure: A qualitative study. Geriatric Nursing, 37(3), 207-214. Web.

Szewieczek, J., Mazur, K., & Wilczyński, K. (2016). Geriatric falls in the context of a hospital fall prevention program: Delirium, low body mass index, and other risk factors. Clinical Interventions in Aging, 11, 1253-1261. Web.

Ueda, T., Higuchi, Y., Imaoka, M., Todo, E., Kitagawa, T., & Ando, S. (2017). Tailored education program using home floor plans for falls prevention in discharged older patients: A pilot randomized controlled trial. Archives of Gerontology and Geriatrics, 71, 9-13. Web.

Uymaz, P., & Nahcivan, N. (2016). Evaluation of a nurse-led fall prevention education program in Turkish nursing home residents. Educational Gerontology, 42(5), 299-309. Web.

Vonnes, C., & Wolf, D. (2017). Fall risk and prevention agreement: Engaging patients and families with a partnership for patient safety. BMJ Open Quality, 6(2), e000038. Web.

Xu, T., O’Loughlin, K., Clemson, L., Lannin, N., Dean, C., & Koh, G. (2017). Developing a falls prevention program for community-dwelling stroke survivors in Singapore: Client and caregiver perspectives. Disability and Rehabilitation, 1-11. Web.

Yoo, J., Kim, C., Yim, J., & Jeon, M. (2016). Factors influencing falls in the frail elderly individuals in urban and rural areas. Aging Clinical and Experimental Research, 28(4), 687-697. Web.

Appendix A

The Summary of First Articles.

Criteria and Defining Characteristics Article 1: Article 2: Article 3:
Abstract
After reading the abstract what do you expect to learn from the article?
Haines, Lee, O’Connell, McDermott, and Hoffmann (2015) explore the motivations of older patients who take risks of falling in the clinical setting. It is expected that older patients’ desire to be independent is one of the factors contributing to their taking risks. After reading the abstract of the article by Szewieczek, Mazur, and Wilczyński (2016), it is expected to learn about some factors that contribute to the increase in fall rates after the implementation of fall prevention interventions. Xu et al. (2017) examine the perspectives of older patients (stroke survivors) and their caregivers regarding fall risk factors and fall prevention.
Introduction: Summarize the following in paragraph form.
  • What is the purpose of the study?
  • What is the scope of the study?
  • What is the rational for the study?
  • What is the hypothesis or research question?
  • What key concepts and terms are noted?
  • Is a review of the literature provided?
The purpose of the study is the identification of the factors contributing to older patients’ risk taking that may lead to a fall in the clinical environment and after their discharge. Haines et al. (2015) provide a brief review of the current literature on the matter and state that the concept of risk taking has been researched and defined. However, the exact reasons for risk taking have not been explored so far. The authors provide several definitions of risk taking as well. Although the research questions are not specified they can be easily formulated: What are the reasons behind such risk taking? The purpose of this study is to examine the factors contributing to the falls after the implementation of fall prevention intervention. The authors put their research in a larger context mentioning the adverse effects of falls. Szewieczek et al. (2016) note that a prevention program has been implemented, but its effectiveness has not been evaluated. Although the researchers do not formulate research questions, they are on the surface and can be reconstructed: What factors are associated with falls after the implementation of falls prevention intervention. The article does not include a separate literature review section, but all claims and data used are well-supported by current literature. No specific concepts or definitions are included, but the falls prevention intervention is described in detail. The purpose of the study is to investigate the views of older patients and their caregivers concerning the central challenges associated with falls and fall prevention methods they employ. Xu et al. (2017) emphasize that older survivors of stroke are often confined to their homes due to the focus on prevention, which has a negative effect on their overall health. No specific terms or concepts are defined. The authors do not include a specific hypothesis or research question, although the latter can be formulated as follows: What perceived factors contribute to falls? The researchers refer to numerous sources to support their claims.
Methods: Summarize the following in paragraph form.
  • What is the population being sampled?
  • What data collection procedure is presented?
  • What other procedures are described?
Sixteen patients aged 65 an older, eight caregivers, and 33 healthcare practitioners took part in the research. It is noteworthy that the sample size is not large, but it is quite sufficient for a qualitative study. The participants were interviewed twice, in the clinical setting and after patients’ discharge. Haines et al. (2015) also provide a detailed description of the recruitment and data analysis processes. 788 patients aged between 60 and 100 years took part in the study. The sample size is relatively large and appropriate for a quantitative study. The researchers analyzed some physical examinations results (including BMI) and used several fall risk estimation instruments including Modified Get-Up and Go Test, Tinetti Performance-Oriented Mobility Assessment, and Mini Mental State Examination, and Geriatric Depression Scale. Nine stroke survivors, four family members, and four maids took part in the study. The sample size is appropriate for a qualitative study. The participants were asked open-ended questions regarding the matter. The textual data were analyzed with the help of the corresponding statistical software. The authors provide quite a detailed description of the recruitment process, which validates the findings of this study. No other procedures are described.
Results: Summarize the following in paragraph form.
  • What are the given findings?
  • How was data collected?
  • Are the findings supported by graphs and charts?
  • What does the analysis of data state?
The primary reasons behind patients’ risk-taking were older people’s willingness to test their abilities, their readiness to ask for help, their risk compensation capacity, and communication failure between patients and their caregivers. The results are well-supported by graphs and charts, which makes them comprehensible. The textual analysis of the results of the interviews was implemented with the help of computer-based tools. Szewieczek et al. (2016) report that primary risk factors include age, delirium, BMI, confidence interval, and history of falls. The information was collected in different ways. Clinical data were obtained during physical examinations. Risk factors were calculated with the help of tests that have been used in many studies and have proved to be credible. The collected data were analyzed with the help of computer-based statistical tools. The results are provided in charts and graphs, which helps readers to perceive the information. For patients, the primary challenges associated with falls include independent living, social connectedness, and community participation. Patients’ caregivers are more concerned about patients’ safety. The results are presented in the form of charts and graphs. This kind of presentation of findings is beneficial as it helps to perceive the data easier. It is stated that the existing fall prevention interventions lack the focus on patients’ peculiarities and their needs.
Conclusion: Summarize in paragraph form.
  • What is the summary of the study?
  • What is the conclusion of the hypothesis?
  • What are the questions for future research?
This study sheds light on older patients’ reasons for taking risks that result in falls. Haines et al. (2015) note that the major factors contributing to risk taking among older patients include their perceived capacity, their readiness to ask for help, and communication failures. It is concluded that caregivers and healthcare professionals effectively mitigate risks. The authors also note that further research may focus on the perspectives of healthcare staff and caregivers with a specific focus on their cultural backgrounds. It is added that a larger sample size can be involved. Szewieczek et al. (2016) examined the central factors contributing to older patients’ falls after the implementation of a fall prevention intervention. Age, mental health, BMI, and the history of falls are associated with an increased rate of falls. It is mentioned that the findings are consistent with the previous research on the matter. The authors also note that higher BMI is linked to improved protection against falls. The researchers add that further studies should evaluate and develop interventions based on the provided findings. They emphasize that the use of a patient-centered approach is critical, and interventions should be developed on the basis of older patients’ needs. This research unveiled the perspectives of older patients and their caregivers regarding the barriers to patients’ inclusion in the community life after stroke. Xu et al. (2017) conclude that patients need more patient-centered fall prevention interventions. The authors also note that caregivers focus on patients’ safety, but often display over-protective behaviors that can be rather harmful. It is stated that the involvement of a larger sample with diverse cultural and socioeconomic backgrounds is needed. A larger sample size should be utilized in further studies.
References
  • What are the total number of references used in the study?
  • List two of the references used.
The total number of the utilized references is 25.
Hill, A. M., Hoffmann, T., McPhail, S., Beer, C., Hill, K. D., Oliver, D., … Haines, T. P. (2011). Evaluation of the sustained effect of inpatient falls prevention education and predictors of falls after hospital discharge–follow-up to a randomized controlled trial. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 66A(9), 1001-1012. doi:10.1093/gerona/glr085
Haines, T. P., Hill, A. M., Hill, K. D., McPhail, S., Oliver, D., Brauer, S.,… Beer, C. (2011). Patient Education to Prevent Falls Among Older Hospital Inpatients. Archives of Internal Medicine, 171(6). doi:10.1001/archinternmed.2010.444
The total number of references is 53.
Basic, D., & Hartwell, T. J. (2015). Falls in hospital and new placement in a nursing home among older people hospitalized with acute illness. Clinical Interventions in Aging, 10, 1637-1643. doi:10.2147/cia.s90296
Quigley, P. A., Barnett, S. D., Bulat, T., & Friedman, Y. (2016). Reducing falls and fall-related injuries in medical-surgical units. Journal of Nursing Care Quality, 31(2), 139-145. doi:10.1097/ncq.0000000000000151
The total number of references is 61.
Ayerbe, L., Ayis, S., Wolfe, C. D., & Rudd, A. G. (2013). Natural history, predictors and outcomes of depression after stroke: systematic review and meta-analysis. British Journal of Psychiatry, 202(1), 14-21. doi:10.1192/bjp.bp.111.107664
Olayiwola, J. N., Shih, J. A., Shiow, S., & Wee, H. (2015). Could values and social structures in Singapore facilitate attainment of patient-focused, cultural, and linguistic competency standards in a patient-centered medical home pilot? Journal of Patient Experience, 2(2), 37-42. doi:10.1177/2374373515615975
Criteria and Defining Characteristics Article 4: Article 5: Article 6:
Abstract
After reading the abstract what do you expect to learn from the article?
The abstract by Casey et al. (2017) describes an article about the implementation of STEADI. The abstract by Hill et al. (2016) shows that the article reports the results of a qualitative survey. The abstract states that Hill et al. (2015) report an RCT of an education program meant for staff and patients.
Introduction: Summarize the following in paragraph form.
  • What is the purpose of the study?
  • What is the scope of the study?
  • What is the rational for the study?
  • What is the hypothesis or research question?
  • What key concepts and terms are noted?
  • Is a review of the literature provided?
The purpose of the study is to describe the implementation of STEADI, and its scope is limited to the process and Kotter framework. The literature review provides the rationale for the study (falls are common, and fall prevention methods require implementation). With no hypothesis or direct research question, the article focuses on the concepts of falls, fall prevention, intervention implementation, and Kottler framework. With a modest literature review, the authors show the rationale for the study and its concepts (the importance of falls and fall preventions; the lack of research on the patients’ perspectives). The purpose of the study was to determine barriers to improved behaviors and the program’s ability to improve behaviors. The scope consisted of patients providing their feedback on the matter, and no hypothesis or research question was stated. The literature review is extremely short; the authors use it to rationalize the study (the importance of falls and the feasibility of educational prevention programs). They do not offer hypotheses, but they state the purpose of investigating the program’s effectiveness, which they do with the help of an RCT in Australian hospitals (scope). The key concepts are falls, fall prevention, and education.
Methods: Summarize the following in paragraph form.
  • What is the population being sampled?
  • What data collection procedure is presented?
  • What other procedures are described?
The Oregon Health & Science University (OHSU) Internal Medicine and Geriatrics Clinic was used as the site; its healthcare providers (26 people) were the participants. The authors discuss the process of choosing the framework, and they describe clinical reports, Facilitators and Barriers survey, and chart reviews as data collection methods. A total of 757 older patients from 8 Australian rehabilitation wards took fall prevention education and completed face-to-face qualitative surveys. Eight Australian general hospitals (specifically, their rehabilitation units) were involved for 50 weeks in testing a program through RCT. The authors gathered data about falls, including injurious ones, by auditing hospital reports and patient notes.
Results: Summarize the following in paragraph form.
  • What are the given findings?
  • How was data collected?
  • Are the findings supported by graphs and charts?
  • What does the analysis of data state?
The results are presented as a narrative, in which implementation activities are described with Kotter’s framework. No graphs or charts are presented, but certain STEADI tools are included as the study materials. The stated data collection mechanisms and thematic and statistical analysis suggest that STEADI was implemented; process facilitators included technology and staff buy-in, and barriers were costs and feasibility. With the help of a content analysis of the survey, the authors determined that the education improved the understanding and awareness of preventative strategies, but individual feelings and misconceptions about one’s abilities were barriers that could result in risky behaviors. The findings were summarized into tables, and the results of the analysis were organized into charts. A statistical analysis of the data shows that with 1623 and 1983 people in the trial and control groups, the former showed fewer falls, including injurious ones. Charts summarize these data and support the analysis-based statement that the program was effective.
Conclusion: Summarize in paragraph form.
  • What is the summary of the study?
  • What is the conclusion of the hypothesis?
  • What are the questions for future research?
The authors point out the key aspects of implementation (champions, customization, communication, support). With no hypothesis, the authors suggest that continued STEADI implementation is warranted. In conclusion, the authors reiterated their methods and findings of the causes of risky behaviors and the benefits of education. With no hypothesis, they recommended improving communication between patients and staff and conducting additional research on providing fall prevention education. In the conclusion paragraph, the authors restate their assessment of the program’s effectiveness. With no hypothesis, the authors do not make suggestions for future research, but they make a point to restrict their findings to rehabilitation units with particular features, which implies that other units may require additional research.
References
  • What are the total number of references used in the study?
  • List two of the references used.
The study has 24 sources.
Jones, T., Ghosh, T., Horn, K., Smith, J., & Vogt, R. (2011). Primary care physicians perceptions and practices regarding fall prevention in adult’s 65 years and over. Accident Analysis & Prevention, 43(5), 1605-1609. doi: 10.1016/j.aap.2011.03.013
Stevens, J., & Phelan, E. (2012). Development of STEADI. Health Promotion Practice, 14(5), 706-714. doi: 10.1177/1524839912463576
The study has 34 sources.
Hill, A. M., McPhail, S., Hoffmann, T., Hill, K., Oliver, D., Beer, C.,… Haines, T. P. (2009). A randomized trial comparing digital video disc with written delivery of falls prevention education for older patients in hospital. Journal of the American Geriatrics Society, 57(8), 1458-1463. doi: 10.1111/j.1532-5415.2009.02346.x
Krauss, M. J., Nguyen, S. L., Dunagan, W. C., Birge, S., Costantinou, E., Johnson, S.,… Fraser, V. J. (2007). Circumstances of patient falls and injuries in 9 hospitals in a midwestern healthcare system. Infection Control & Hospital Epidemiology, 28(05), 544-550. doi: 10.1086/513725
The study has 37 sources.
Ang, E., Mordiffi, S., & Wong, H. (2011). Evaluating the use of a targeted multiple intervention strategy in reducing patient falls in an acute care hospital: A randomized controlled trial. Journal of Advanced Nursing, 67(9), 1984-1992. doi: 10.1111/j.1365-2648.2011.05646.x
Haines, T., Lee, D., O’Connell, B., McDermott, F., & Hoffmann, T. (2015). Why do hospitalized older adults take risks that may lead to falls? Health Expectations, 18(2), 233-249. doi: 10.1111/hex.12026
Criteria and Defining Characteristics Article 7: Article 8: Article 9:
Abstract
After reading the abstract what do you expect to learn from the article?
Hill et al. (2016) report in the abstract that a qualitative focus-group-based study will be described in their article. Johnston et al. (2018) state in the abstract that they report a cohort study meant to assess the effectiveness of STEADI. The abstract shows that the article by Lohman et al. (2017) studies the Fall Risk Algorithm (FRA) of STEADI.
Introduction: Summarize the following in paragraph form.
  • What is the purpose of the study?
  • What is the scope of the study?
  • What is the rational for the study?
  • What is the hypothesis or research question?
  • What key concepts and terms are noted?
  • Is a review of the literature provided?
To justify the article’s rationale (the importance of fall prevention) and report its concepts (fall, prevention, education), the authors offer a short literature review. The qualitative study has no hypothesis or research question, but its purpose is to investigate staff responses to a fall prevention program. From the perspective of scope, the authors made their conclusions based on five focus group interviews. The literature review explains the need for the study (rationale) by discussing falls, their consequences, and (in detail) STEADI, as well as the ability of the Broome County Health Department and United Health Services to test it. The purpose of the study is to assess STEADI outcomes in the named institution (purpose and scope); the hypothesis is that it reduces medically treated falls. The key concepts are falls and fall prevention. The literature review in the paper’s introduction explains the dangers of falls and the purpose of STEADI, as well as the lack of FRA research, justifying the study (rationale). The aims and purposes consisted of operationalizing and determining the predictive validity of FRA with the hypothesis that it is a valid tool (scope). The concepts include operationalization, validity, risk algorithm, and falls.
Methods: Summarize the following in paragraph form.
  • What is the population being sampled?
  • What data collection procedure is presented?
  • What other procedures are described?
Thirty staff members from multiple sites took part in five audiotaped focus groups (roughly 70 minutes), which took place after the implementation of an education program. The authors used the RE-AIM Framework for evaluating STEADI. Inpatient EHR was utilized to determine the organization’s fall-related health service use in older adults (11,080 people in groups with a plan of care, with no plan of care, and with no risk of falls). In addition, the official data for the institution’s country were extracted for the period from 2007 to 2015. The National Health and Aging Trends Study was used to obtain survey data for non-hospitalized older adults. The final sample had 7,392, which the authors estimated to be nationally representative. The study’s variables included STEADI fall risks, demographics, health and impairment status, and frailty.
Results: Summarize the following in paragraph form.
  • What are the given findings?
  • How was data collected?
  • Are the findings supported by graphs and charts?
  • What does the analysis of data state?
With the help of thematic analysis, the authors identified themes in the responses from the focus groups, and the results were summarized in a chart. The program was deemed useful for patients and staff since it improved their awareness and knowledge and advanced a fall prevention culture. With the help of uni- and multivariate analyses, the authors determined that in the group with a plan of care, the likelihood of hospitalizations that would be related to falls was significantly decreased. No such findings were discovered for fall-related visits. The authors used the analysis, tables, and charts to show that the findings prove the effectiveness of the program. Logistic regressions were used to analyze the survey data, which showed (with the help of tables and figures) that STEADI could predict fall risks with FRA-defined moderate risks 2.62 times higher than low risks, and high risks 4.76 times higher than low risks.
Conclusion: Summarize in paragraph form.
  • What is the summary of the study?
  • What is the conclusion of the hypothesis?
  • What are the questions for future research?
In conclusion, the authors reiterated the positive effects of the program on staff and patients. Without a hypothesis, they recommended investigating the cost-effectiveness of similar programs and educators. The authors summarize the study by stating that STEADI can reduce fall-related hospitalizations, which supports the hypothesis. Future research can implement STEADI in a more complete form. In the concluding paragraph, the authors reiterate that STEADI’s FRA is valid and can predict fall risks, which means that the hypothesis is supported. Future research should focus on standardizing risk assessments and screening.
References
  • What are the total number of references used in the study?
  • List two of the references used.
The study has 34 sources.
Dykes, P., Carroll, D., Hurley, A., Benoit, A., & Middleton, B. (2009). Why do patients in acute care hospitals fall? Can falls be prevented? JONA: The Journal of Nursing Administration, 39(6), 299-304. Web.
Haines, T., Lee, D., O’Connell, B., McDermott, F., & Hoffmann, T. (2015). Why do hospitalized older adults take risks that may lead to falls? Health Expectations, 18(2), 233-249. Web.
The study has 33 sources.
Palvanen, M., Kannus, P., Piirtola, M., Niemi, S., Parkkari, J., & Järvinen, M. (2014). Effectiveness of the Chaos Falls Clinic in preventing falls and injuries of home-dwelling older adults: A randomised controlled trial. Injury, 45(1), 265-271. Web.
Stevens, J., & Phelan, E. (2012). Development of STEADI. Health Promotion Practice, 14(5), 706-714. Web.
The study has 40 sources.
Bandeen-Roche, K., Seplaki, C. L., Huang, J., Buta, B., Kalyani, R. R., Varadhan, R.,… Kasper, J. D. (2015). Frailty in older adults: A nationally representative profile in the United States. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 70(11), 1427-1434. Web.
Sanders, K., Stuart, A., Scott, D., Kotowicz, M., & Nicholson, G. (2015). Validity of 12-month falls recall in community-dwelling older women participating in a clinical trial. International Journal of Endocrinology, 2015, 1-6. Web.
Criteria and Defining Characteristics Article 10: Article 11: Article 12:
Abstract
After reading the abstract what do you expect to learn from the article?
The abstract states that the article by Meyer, Dow, Hill, Tinney, and Hill (2016) reports a qualitative research (series of studies) dedicated to fall prevention in people with dementia, as well as the strategies that are employed by their caregivers. Nakagami-Yamaguchi et al. (2016) report their pre- and post-intervention study, which uses a survey to determine the effectiveness of an animation movie developed for fall prevention. Perrot, Ayad, Gernigon, and Maillot (2019) state in their abstract that their article is about an RCT of a combined fall prevention program (education and physical activity).
Introduction: Summarize the following in paragraph form.
  • What is the purpose of the study?
  • What is the scope of the study?
  • What is the rational for the study?
  • What is the hypothesis or research question?
  • What key concepts and terms are noted?
  • Is a review of the literature provided?
With no hypothesis, the aim (purpose) of this study is to explore the views of people with dementia and their caregivers on a specific educational fall prevention program. The study only involved a few people who had been engaged in a specific, individualized program (scope), and it is justified (rationale) with a short literature review that explains the issue of falls in people with dementia and patient-centered solutions to it. The purpose of the study is to develop and test the effectiveness of a novel educational effort, which is a video. The scope includes the development of the video and evaluation of its effectiveness. The rationale is that multimedia options are a potent tool in education. The hypothesis or research question is not stated directly. The authors mostly focus on the concepts of falls, fall prevention, and fall prevention education, and they include a very short literature review to justify their study. The authors use the literature review to justify their study, demonstrating that it covers a research gap and is dedicated to an important issue. The purpose of the article is to review the effectiveness of the program in reducing the fall risk factors in the elderly with the hypothesis that it is effective. The paper focuses on the key concepts of fall risks (footwear, environment, body knowledge, lifestyle), which determine its scope.
Methods: Summarize the following in paragraph form.
  • What is the population being sampled?
  • What data collection procedure is presented?
  • What other procedures are described?
The study involved 25 caregivers and 25 patients at the beginning of the study, with 24 and 16 of them retained by the end (six months). The patients were older people with dementia; most caregivers were also older people. They participated in the educational program for the duration of the period, and they also had two semi-structured interviews. The study took place in one medical center and focused on its inpatients, including younger and older ones (304 pre-intervention; 269 post-intervention). A survey questionnaire for movie evaluation (Likert scale) was administered for data collection. The authors commented on the involvement of specialists in the development of the movie. A total of thirty older rehabilitation inpatients were randomized to form a group that focused on physical activity only and a group that also had an education intervention. By the end of the study (10 weeks), the former group had 12 people, and the latter one had 13 people. Tests included a dynamic balance test, a test for balance and gait, and the Falls Efficacy Scale International.
Results: Summarize the following in paragraph form.
  • What are the given findings?
  • How was data collected?
  • Are the findings supported by graphs and charts?
  • What does the analysis of data state?
The results of the interviews, which were subjected to thematic analysis, were narrated (not put in tables). The authors determined that the participants viewed falls as unpredictable and felt a need for relevant information, but they also believed that they also could contribute to fall management. The authors discussed the findings in terms of recommendations, highlighting the need for shared decision-making and good communication. Based on the survey, the fall frequency and likelihood decreased, especially in the older participants. The authors reported a favorable assessment of the video, differences in the patients’ understanding of the instructions, and some reasons that could be contributing to patient falls. The article uses charts, and ANOVA was the data analysis method. Using tables, the authors report the patients’ scores, and with the help of ANOVA, they demonstrate that post-test results in the education group differed significantly with respect to a specific risk factor (fear of falling). Still, both groups were good at reducing risk factors.
Conclusion: Summarize in paragraph form.
  • What is the summary of the study?
  • What is the conclusion of the hypothesis?
  • What are the questions for future research?
In conclusion, the authors highlight the individual nature of the participants’ needs, knowledge, and preferences, repeating recommendations for appropriate knowledge-focused interventions with shared decision-making. The authors had no hypothesis and did not directly recommend future questions, but they pointed out the limited generalizability of their qualitative inquiry. The authors state that their findings indicate the potential usefulness of multimedia education in fall prevention. They also recommend exploring different approaches to educational multimedia creation. In the concluding paragraph, the authors note that their findings imply the benefits of education, which supports their hypothesis. Future research is supposed to focus on the cognitive abilities of patients and their interaction with education.
References
  • What are the total number of references used in the study?
  • List two of the references used.
The study has 37 sources.
Laybourne, A., Biggs, S., & Martin, F. (2008). Falls exercise interventions and reduced falls rate: Always in the patient’s interest? Age and Ageing, 37(1), 10-13. Web.
Yardley, L., Donovan-Hall, M., Francis, K., & Todd, C. (2007). Attitudes and beliefs that predict older people’s intention to undertake strength and balance training. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 62(2), P119-P125. Web.
The study has 43 sources.
Hempel, S., Newberry, S., Wang, Z., Booth, M., Shanman, R., Johnsen, B.,… Ganz, D. A. (2013). Hospital fall prevention: A systematic review of implementation, components, adherence, and effectiveness. Journal of the American Geriatrics Society, 61(4), 483-494. Web.
Hignett, S., Sands, G., & Griffiths, P. (2013). In-patient falls: What can we learn from incident reports? Age and Ageing, 42(4), 527-531. Web.
The study has 41 sources.
Brouwer, B., Musselman, K., & Culham, E. (2004). Physical function and health status among seniors with and without a fear of falling. Gerontology, 50(3), 135-141. Web.
El-Khoury, F., Cassou, B., Charles, M., & Dargent-Molina, P. (2013). The effect of fall prevention exercise programmes on fall induced injuries in community dwelling older adults. British Journal of Sports Medicine, 49(20), 1348-1348. Web.
Criteria and Defining Characteristics Article 13: Article 14: Article 15:
Abstract
After reading the abstract what do you expect to learn from the article?
Based on the abstract, Schoberer, Breimaier, Mandl, Halfens, and Lohrmann (2016) report a qualitative interview-based study of the perspectives of patients, caregivers, and staff members on fall prevention education materials. The abstract by Ueda et al. (2017) shows that the article is about a piloted RCT dedicated to fall prevention education program testing. The abstract of the article by Uymaz and Nahcivan (2016) shows that the paper is dedicated to the study of a nurse-led education program with no control group.
Introduction: Summarize the following in paragraph form.
  • What is the purpose of the study?
  • What is the scope of the study?
  • What is the rational for the study?
  • What is the hypothesis or research question?
  • What key concepts and terms are noted?
  • Is a review of the literature provided?
The study’s purpose is to examine the expectations of varied stakeholders regarding educational brochures. The scope consists of reporting the findings of the interviews with those stakeholders. The rationale is that to develop brochures, it is important to take stakeholder perspectives into account, and the hypothesis (or research question) is not stated directly. The key concepts are fall prevention, education, and brochures. The introduction incorporates a detailed literature review. With multiple sources, the literature review explains the importance of preventing falls and the validity of education-based fall prevention (rationale). The authors intended to test the effectiveness of a specific program that incorporated floor plans (purpose), and they hypothesized that it would be effective. The project is a pilot (scope), and its key terms and concepts are fall prevention, education, and floor plans. There is little research review in the paper, but it shows that the rationale for the project is connected to the importance of fall prevention, which is the primary concept of the work along with education and nurse-led program. The purpose is to test the intervention, and the hypotheses are that the program can reduce falls and fear of falling and improve fall-related knowledge and behaviors. From the perspective of the scope, the article describes a quasi-experiment with 60 participants.
Methods: Summarize the following in paragraph form.
  • What is the population being sampled?
  • What data collection procedure is presented?
  • What other procedures are described?
The authors sampled patients, caregivers, and nurses from three Austrian nursing homes. The consenting participants (eventual number 51) made up nine focus groups, which were the data collection mechanism. Older outpatients from one center (final sample of 51 people with 25 in the trial group) were randomly assigned to undergo or not undergo education. Both groups were assessed at the baseline and followed for one month. Medical record reviews and interviews were the data collection mechanisms. Older people from a Turkish nursing home (pre-test 46, post-test 43) were subjected to a multifaceted educational program delivered by nurses. Interviews, observations, and record reviews were used to collect data.
Results: Summarize the following in paragraph form.
  • What are the given findings?
  • How was data collected?
  • Are the findings supported by graphs and charts?
  • What does the analysis of data state?
Using focus groups, the researchers collected qualitative data and analyzed them through concept-coding. The coding frame was presented in a table, and a chart with recommendations was shown. The analysis of the data was used to make more refined recommendations than those in the findings section. The authors specified certain areas important to include in a brochure (fall risks, motivation, preventative methods, and so on). Statistical analyses (t-test and chi-square) and modeling showed that the control group had more falls and near-falls (based on record reviews, interviews, and health assessments). These findings were shown using tables and a graph of the model. The analysis suggested that the program was effective, but the authors pointed out multiple limitations. Fall rates were determined by record review and reported in percentages; the knowledge and fear were measured with the help of specific questionnaires, and scores in the Fall Behavior Scale were reported as well. The baseline and posttest data were statistically analyzed. Tables reported all the important findings. The analysis and findings indicate that six months after the program, fall rates, knowledge, and protective fall behaviors improved, but fear remained the same.
Conclusion: Summarize in paragraph form.
  • What is the summary of the study?
  • What is the conclusion of the hypothesis?
  • What are the questions for future research?
The summary of the study suggests that educational brochures are valuable, and so is a user-centric approach to their development. The authors highlighted the interest of caregivers in information and the need for patient- and caregiver-intended brochures. With no hypothesis and no direct recommendations for future research, the authors reported limitations, which included a convenience sample. The authors reiterated their conclusion that the program could reduce falls, which supports the hypothesis. As a pilot study, the article implies that a non-pilot RCT is to be conducted. The authors reiterated the findings, indicating that there were positive effects after the intervention. Thus, the hypotheses were partially supported. The authors suggested using future research for developing and testing similar interventions that are tailored to particular needs.
References
  • What are the total number of references used in the study?
  • List two of the references used.
The study has 47 sources.
Dilles, A., Heymans, V., Martin, S., Droogné, W., Denhaerynck, K., & De Geest, S. (2011). Comparison of a computer assisted learning program to standard education tools in hospitalized heart failure patients. European Journal of Cardiovascular Nursing, 10(3), 187-193. Web.
Lins, S., Icks, A., & Meyer, G. (2011). Understanding, comprehensibility and acceptance of an evidence-based consumer information brochure on fall prevention in old age: a focus group study. BMC Geriatrics, 11(26), 1-9. Web.
The study has 34 sources.
Dinh, A., Shi, Y., Teng, D., Ralhan, A., Chen, L., Dal Bello-Haas, V.,… McCrowsky, C. (2009). A fall and near-fall assessment and evaluation system. The Open Biomedical Engineering Journal, 3(1), 1-7. Web.
Hill, A. M., McPhail, S., Hoffmann, T., Hill, K., Oliver, D., Beer, C.,… Haines, T. P. (2009). A randomized trial comparing digital video disc with written delivery of falls prevention education for older patients in hospital. Journal of the American Geriatrics Society, 57(8), 1458-1463. Web.
The study has 43 sources
Jung, D., Lee, J., & Lee, S. (2008). A meta-analysis of fear of falling treatment programs for the elderly. Western Journal of Nursing Research, 31(1), 6-16. Web.
Zijlstra, G., Haastregt, J., Rossum, E., Eijk, J., Yardley, L., & Kempen, G. (2007). Interventions to reduce fear of falling in community-living older people: a systematic review. Journal of the American Geriatrics Society, 55(4), 603-615. Web.

Appendix B

The Summary of New Articles.

Criteria and Defining Characteristics Article 1: Article 2: Article 3:
Abstract
After reading the abstract what do you expect to learn from the article?
Carlucci et al. (2018) present an abstract which shows that a reader can expect to learn about a one-group quasi-experimental study of a fall prevention program. Gale, Cooper, and Sayer (2016) provide a detailed explanation of their survey-based study in the abstract. Gazibara et al. (2017) present an abstract which summarizes their quantitative investigation of falls, fear of falls, and related risk factors.
Introduction: Summarize the following in paragraph form.
  • What is the purpose of the study?
  • What is the scope of the study?
  • What is the rational for the study?
  • What is the hypothesis or research question?
  • What key concepts and terms are noted?
  • Is a review of the literature provided?
The introduction uses some literature to demonstrate the importance (rationale for) a study that addresses falls by motivating patients to participate. Falls, motivation, and fall prevention are the key concepts. The authors hypothesized that a motivational program that focuses on Joyful Movement would be effective, and the purpose of their inquiry was to evaluate its outcomes, patients’ feedback, and feasibility. A short literature review indicates that falls are a major problem and that there are few studies that consider sex-based differences, which justifies the study (rationale). The authors did not hypothesize, but they expressed the intent to use the English Longitudinal Study of Ageing to rectify the knowledge gap with respect to the differences and related risks (purpose and scope). The key concepts are falls and sex-specific differences. In a short literature review, the authors indicate the importance (rationale for) their study by discussing the key concepts of the article, including falls, fall risks, indoor and outdoor falls, and fear of falling. The authors point out the lack of research on risk factors in older adults, and they state that the purpose of their research was to fill that gap and study the fear of falling in the population (scope). No hypothesis was offered.
Methods: Summarize the following in paragraph form.
  • What is the population being sampled?
  • What data collection procedure is presented?
  • What other procedures are described?
A four-site pre- and post-test study involved community-dwelling older (over 60) adults from Canada who took part in an educational and movement-focused program that improved the participants’ attitudes toward physical activity (n=215). Before and after the program, the participants took the Functional Reach test and the Modified Falls Efficacy Scale. In the end, they also provided their feedback, and the data about falls were collected continuously. The survey sampled community-dwelling people who had been older than 50 at the time of 1998, 1999, or 2001 English health surveys (n=4,301). This project used the Wave 6 results, which took place in 2012-2013, to gain information about falls and lifestyle, sociodemographic, and medical factors. The authors recruited 354 older adults (over 65) from Serbia; they participated in interviews and filled out a Falls Efficacy Scale; also, their medical history was obtained.
Results: Summarize the following in paragraph form.
  • What are the given findings?
  • How was data collected?
  • Are the findings supported by graphs and charts?
  • What does the analysis of data state?
Qualitative data from the feedback were analyzed for themes, and quantitative data from the rest of the data collection methods were statistically analyzed. Illustrated with tables, the findings indicate that the patient’s reach and fall efficacy improved. The survey’s data were analyzed statistically (logistic regression) with the information adjusted to reflect non-response and other biases. The results, which were depicted in tables, suggested that in women, incontinence and frailty were increasing fall risks, and in men, the same outcome was associated with depression and problems with the standing balance test. The data from the interviews, records, and surveys were analyzed quantitatively (chi-square and multiple regression model). The results, which were illustrated by tables, showed that fear of falling, as well as being female, was a predictor of falls; most often, the participants fell while walking.
Conclusion: Summarize in paragraph form.
  • What is the summary of the study?
  • What is the conclusion of the hypothesis?
  • What are the questions for future research?
The authors concluded that the program was effective in some respects, which partially supports the hypothesis, but it requires further research. The authors conclude that differences between sexes are noteworthy and should be included in prevention strategies. They do not recommend future research, but they highlight their article’s similarities and differences with other studies, and their sample is only representative of English community-dwelling older adults. The authors conclude by stating that their findings were in line with other ones on the same topic and point out the importance of the fear of falling for falls. They recommend a follow-up study to identify the relationship between the two.
References
  • What are the total number of references used in the study?
  • List two of the references used.
The study has 28 sources.
Hu, G., & Baker, S. P. (2010). Recent increases in fatal and non-fatal injury among people aged 65 years and over in the USA. Injury Prevention, 16, 26-30.
Wurzer, B., Waters, D. L., Hale, L. A., & de la Barr, S. (2014). Long-term participation in peer-led fall prevention classes predicts lower fall incidence. Archives of Physical Medicine and Rehabilitation, 95, 1060-1066.
The study has 27 sources.
Sibley, K., Voth, J., Munce, S., Straus, S., & Jaglal, S. (2014). Chronic disease and falls in community-dwelling Canadians over 65 years old: a population-based study exploring associations with number and pattern of chronic conditions. BMC Geriatrics, 14(1), 1-11. Web.
Stevens, J. (2005). Gender differences for non-fatal unintentional fall related injuries among older adults. Injury Prevention, 11(2), 115-119. Web.
The study has 42 sources.
Rubenstein, L. (2006). Falls in older people: Epidemiology, risk factors and strategies for prevention. Age and Ageing, 35(suppl_2), ii37-ii41. Web.
Tinetti, M., De Leon, C., Doucette, J., & Baker, D. (1994). Fear of falling and fall-related efficacy in relationship to functioning among community-living elders. Journal of Gerontology, 49(3), M140-M147. Web.
Criteria and Defining Characteristics Article 4: Article 5: Article 6:
Abstract
After reading the abstract what do you expect to learn from the article?
Gomez, Wu, Auais, Vafaei, and Zunzunegui (2017) describe the details of their study in their abstract. The abstract of the article by Hill et al. (2019) contains all the key information about their RCT. Jie and Deng (2019) report all the key information about their study of fall prevention education for osteoporosis patients in the abstract.
Introduction: Summarize the following in paragraph form.
  • What is the purpose of the study?
  • What is the scope of the study?
  • What is the rational for the study?
  • What is the hypothesis or research question?
  • What key concepts and terms are noted?
  • Is a review of the literature provided?
The introduction contains a short literature review, in which the primary concept is fall risks, which are described as a critical feature of fall prevention (rationale). The study’s aim (purpose) and scope consist of developing a risk prediction algorithm for diverse primary care patients. No initial hypothesis is provided. The introduction uses its short literature review to rationalize the need for the study by highlighting the negative features of falls, the problem of the lack of fall-related knowledge in the studied population, as well as the lack of research on education intensity and duration. The purpose of the study was stated as evaluating the effects of adding fall prevention education to care-as-usual for post-discharge patients, which also explains the scope of the project. The hypothesis was that this approach would encourage participants to use fall prevention strategies, the latter being the primary concept of the project; the rest of the concepts included falls, fall risks, and fall prevention education. The introduction is very short, but it uses a literature review to indicate that the consequences of falls can be devastating and that being educated on the matter is important for patients, which was the rationale for the study. The key concepts of the study are osteoporosis patients, falls, and education, as well as zoledronic acid treatment. The authors state the aim (purpose), but they do not offer a hypothesis; the purpose is to reduce fall risks in patients, and the scope is limited to osteoporosis patients who undergo zoledronic acid treatment.
Methods: Summarize the following in paragraph form.
  • What is the population being sampled?
  • What data collection procedure is presented?
  • What other procedures are described?
The data were taken from the International Mobility in Aging Study, in which people over 65 years were included (n=1,718) who had reported data about their falls and potential risk factors. Australian older patients who had been discharged from rehabilitation wards were sampled. A total of 352 patients provided all the data (over the six months of the study); half of them received additional therapist-led education on fall prevention (based on a behavioral change theory). Individual fall diaries were the primary method of data collection. The study involved 178 osteoporosis patients (50-80 years old, all female) without cognitive impairments and with fragile bones, who underwent zoledronic acid treatment. An RCT was carried out, with 86 patients being tested for risk factors and receiving tailored education with phone-based follow-ups. A questionnaire was used to gather baseline data and follow-up data (one year after the beginning of the study); in addition, phone follow-ups were employed to track falls.
Results: Summarize the following in paragraph form.
  • What are the given findings?
  • How was data collected?
  • Are the findings supported by graphs and charts?
  • What does the analysis of data state?
The analysis of the data allowed determining patients with no falls and low, moderate, and high fall risks, which were predominantly associated with fear of falling, previous falls, and mobility issues. The fall diaries demonstrated that both groups experienced falls, including injurious ones, and the statistical analysis of the data (t-test, Mann-Whitney U, chi-square) was displayed in tables, showing that there were no statistically significant differences between them. The data from the survey and phone follow-ups were analyzed with t-test, and the results were displayed in tables. The analysis showed that the intervention group had reduced risk factors (except for diabetes), and they were also less likely to fall.
Conclusion: Summarize in paragraph form.
  • What is the summary of the study?
  • What is the conclusion of the hypothesis?
  • What are the questions for future research?
The authors conclude that their algorithm provided guidance based on the combination of risks for adults over 65 (and below 74). No recommendations for future studies are offered, but the authors recognize the limitations of the sample and reporting methods. The authors conclude that no improvements were achieved with the educational program, which did not support the hypothesis. They call for additional research on resolving the problem. The authors conclude that the education reduced falls and fall-related risk factors, even though no hypothesis was suggested. The authors propose no new studies, but they comment on the costs and cost-effectiveness of their intervention, which could be determined in future studies.
References
  • What are the total number of references used in the study?
  • List two of the references used.
The study has 48 sources.
Delbaere, K., Close, J. C., Heim, J., Sachdev, P. S., Brodaty, H., Slavin, M. J.,… Lord, S. R. (2010). A multifactorial approach to understanding fall risk in older people. Journal of The American Geriatrics Society, 58(9), 1679-1685. Web.
Grundstrom, A., Guse, C., & Layde, P. (2012). Risk factors for falls and fall-related injuries in adults 85 years of age and older. Archives of Gerontology and Geriatrics, 54(3), 421-428. Web.
The study has 37 sources.
Leppin, A. L., Gionfriddo, M. R., Kessler, M., Brito, J. P., Mair, F. S., Gallacher, K.,… Ting, H. H. (2014). Preventing 30-day hospital readmissions. JAMA Internal Medicine, 174(7), 1095-1107. Web.
Sherrington, C., Lord, S. R., Vogler, C. M., Close, J. C., Howard, K., Dean, C. M.,… Barraclough, E. (2014). A post-hospital home exercise program improved mobility but increased falls in older people: A randomised controlled trial. Plos ONE, 9(9), e104412. Web.
The study has 14 sources.
Leal, J., Gray, A., Prieto-Alhambra, D., Arden, N., Cooper, C., Javaid, M., & Judge, A. (2016). Impact of hip fracture on hospital care costs: A population-based study. Osteoporosis International, 27(2), 549-558. Web.
Maneeprom, N., Taneepanichskul, S., & Panza, A. (2018). Fall among physically active elderly in senior housings, Bangkok, Thailand: Situations and perceptions. Clinical Interventions in Aging, 13, 2149-2159. Web.
Criteria and Defining Characteristics Article 7: Article 8: Article 9:
Abstract
After reading the abstract what do you expect to learn from the article?
In the abstract, Kuhirunyaratn, Prasomrak, and Jindawong (2019) summarize the information about their quasi-experimental study, which was dedicated to testing a fall prevention intervention. Lim et al. (2018) wrote a short abstract that describes their exploratory study. Lyons and Hall (2016) state in the abstract that their article is about a study of an education program for fall prevention.
Introduction: Summarize the following in paragraph form.
  • What is the purpose of the study?
  • What is the scope of the study?
  • What is the rational for the study?
  • What is the hypothesis or research question?
  • What key concepts and terms are noted?
  • Is a review of the literature provided?
The introduction includes a short literature review, which was meant to explain the problem of falls and justify addressing it. The primary concept of the article is fall prevention; the authors explain that their project was supposed to determine the effect of fall prevention programs in Khon Kaen (Thailand) (purpose and scope). The rationale was that preventative methods are cost-effective and can have multiple beneficial effects. The article does not contain a hypothesis. The literature review is rather extensive, and it is arranged to cover the key concepts, including fall perceptions, fall prevention, and awareness of fall risks. The authors point out the importance of the problem and highlight the lack of studies on patients’ experiences (rationale). There is no hypothesis, but the purpose and scope are defined as exploring the experiences of falls and attitudes toward fall prevention. The literature review in the introduction and background explains that the study is needed because falls in Latin America are scarcely researched (rationale). The key terms include falls, fall prevention, and education. The authors state that the purpose of the program was fall reduction, and the purpose and scope of the study consisted of its investigation. No hypothesis is offered.
Methods: Summarize the following in paragraph form.
  • What is the population being sampled?
  • What data collection procedure is presented?
  • What other procedures are described?
In their quasi-experiment, the authors involved 204 older (over 60) primary care patients from Thailand and assigned half of them (nonrandomly) to receive a six-month prevention education program based on the health-belief model. The authors used questionnaires for fall risk assessments and for evaluating the participants’ health. Also, the same tools were employed for learning about the participants’ demographics. The project was qualitative; in it, 100 patients from Singapore who had been hospitalized and experienced a fall in their ward participated in interviews. Non-institutionalized Black patients from Grenada who were older than 63 took part in the program’s workshops, and they filled out surveys before and after their participation.
Results: Summarize the following in paragraph form.
  • What are the given findings?
  • How was data collected?
  • Are the findings supported by graphs and charts?
  • What does the analysis of data state?
The questionnaires’ data were analyzed statistically to demonstrate that the two groups did not have significant differences in their baseline fall risks. However, after the intervention, the intervention group showed lower risks, reduced balance impairment, and improved medicine use. The authors used charts to report the findings, and their analysis and discussion imply that the intervention was helpful in reducing fall risks. The interview data were analyzed with the help of coding, categorization, and abstraction; the findings were illustrated with a table and discussed. The analysis shows that many participants were apathetic or in denial about falls. Moreover, some of them were reluctant to impose on nurses, and others also had negative attitudes toward nurses. Some of the participants also overestimated themselves and found it difficult to remember fall prevention advice. The authors provide the survey’s checklist but not a table or chart with findings. They report that the participants were eager to participate and that the key risk factors of the sample included environmental conditions and one’s history of falling. The authors conclude that the program is feasible.
Conclusion: Summarize in paragraph form.
  • What is the summary of the study?
  • What is the conclusion of the hypothesis?
  • What are the questions for future research?
The program has had beneficial effects, which contributed to a reduction of fall risks. In other words, the authors conclude that the program was effective. However, the study of the program in different (in particular, rural) areas is advised. The authors conclude that many of the participants’ perspectives could complicate their fall prevention, and they recommend studying fall prevention approaches that take into account patient perspectives. The authors report that their findings on the fall risks in Grenada adults should be useful in future fall prevention efforts, and they view their program as feasible. They propose future research of the program and its wide implementation.
References
  • What are the total number of references used in the study?
  • List two of the references used.
The study has 37 sources.
Hendriks, M. R., Bleijlevens, M. H., Haastregt, J. C., Bruijn, F. H., Diederiks, J. P., Mulder, W. J.,… Eijk, J. T. M. (2008). A multidisciplinary fall prevention program for elderly persons: A feasibility study. Geriatric Nursing, 29(3), 186-196. Web.
Pynoos, J., Steinman, B., & Nguyen, A. (2010). Environmental assessment and modification as fall-prevention strategies for older adults. Clinics in Geriatric Medicine, 26(4), 633-644. Web.
The study has 26 sources.
Bunn, F., Dickinson, A., Barnett-Page, E., Mcinnes, E., & Horton, K. (2008). A systematic review of older people’s perceptions of facilitators and barriers to participation in falls-prevention interventions. Ageing and Society, 28(4), 449-472. Web.
McMahon, S., Talley, K., & Wyman, J. (2011). Older people’s perspectives on fall risk and fall prevention programs: A literature review. International Journal of Older People Nursing, 6(4), 289-298. Web.
The study has 24 sources.
Cerasi, M., Landi, F., Torre, S., Onder, G., Lattanzio, F., & Bernabei, R. (2002). Prevalence and risk factors for falls in an older community-dwelling population. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 57(11), M722–M726.
Reyes-Ortiz, C. A., Snih, S. A., & Markides, K. S. (2005). Falls among elderly persons in Latin America and the Caribbean and among elderly Mexican-Americans. Revista Panamericana de Salud Pu´blica = Pan American Journal of Public Health, 17(5–6), 362–369.
Criteria and Defining Characteristics Article 10: Article 11: Article 12:
Abstract
After reading the abstract what do you expect to learn from the article?
The abstract of the article by Radecki, Reynolds, and Kara (2018) states that their project consists of a qualitative study that focused on the patients’ ideas about fall prevention methods. Mamani et al. (2019) offer abstracts in two languages, which explain the specifics of their cross-sectional study of caregivers’ knowledge and practices related to fall prevention. Maneeprom, Taneepanichskul, Panza, and Suputtitada (2019) describe the objectives, methods, and results of their quasi-experimental study in the abstract.
Introduction: Summarize the following in paragraph form.
  • What is the purpose of the study?
  • What is the scope of the study?
  • What is the rational for the study?
  • What is the hypothesis or research question?
  • What key concepts and terms are noted?
  • Is a review of the literature provided?
A very short review of literature is dedicated to the key concepts of falls (and injuries related to them), fall prevention (as a complex, multimodal activity), and patients’ perspectives. The importance of the latter, especially for patient autonomy and for the design of patient-centered interventions, is viewed as a rationale for their investigation. The authors state that the purpose of their research is to investigate the perspectives of patients on fall prevention, and they specify that the scope was limited to acute care. No hypothesis is present in the article. The literature review highlights issues with the lack of knowledge on older caregivers, especially as related to falls. It also covers the problem of falls and that of the lack of falls-associated knowledge among caregivers. This information is used to justify (rationale) the purpose and scope of the study, which is to investigate the perspectives of older caregivers on fall prevention. No hypothesis is offered; the key terms are falls, perspectives, fall prevention, and caregivers. The literature review from the introduction involves the key concepts (falls, fall prevention, robotics, and senior housings) and rationale for the study. The latter is connected to the need to prevent falls (proven by their healthcare and economic consequences) and the potential of robotics in this field. The authors specify the aim (purpose) and scope of the research, which was supposed to study the effectiveness of a fall prevention program that involved robotics in improving knowledge, exercise, and fall rates in the elderly. No direct hypothesis is present in the article, although the authors mention hypothesis testing.
Methods: Summarize the following in paragraph form.
  • What is the population being sampled?
  • What data collection procedure is presented?
  • What other procedures are described?
The adult patients of a tertiary care Midwestern hospital who were at risk of falls and who were not placed in an intensive unit were sampled (n=12) and asked to answer interview questions. A total of 97 caregivers from Brazil participated in interviews. Over 70% of them were aged 40-69. The study involved 64 people from Thailand who were over 60 and at risk of falls. They were assigned to the control or intervention group; the latter received a robot with fall prevention software that coached the participants. The data were obtained through interviews, which were used for sociodemographic and medical factors, as well as fall rates. Also, the authors employed balance scales, recordings in exercise diaries, and knowledge questionnaires.
Results: Summarize the following in paragraph form.
  • What are the given findings?
  • How was data collected?
  • Are the findings supported by graphs and charts?
  • What does the analysis of data state?
The data from the interviews were analyzed by a team of investigators for themes. The results are presented by the article narratively, although the demographics are summarized in a table. The analysis of the findings indicated that many patients were aware of the possibility of falls and that their perceptions of fall prevention methods differed. Some participants found preventative measures useful, but others had negative comments related to the uselessness of some of the equipment (for example, gait belts) and the problem of the restriction of their movement. Also, the authors commented on the problem of toilet assistance; the need to go to the washroom tended to override the fear of falling. The authors pointed out that with differing perspectives, it would be reasonable to focus on patient-centered, unique interventions. The interview data were analyzed through coding and descriptive statistics; the findings are narrated and presented in figures and tables. The analysis shows that while most participants were aware of falls, the majority of them did not have any specific preventative strategies. In general, the authors describe their knowledge as superficial. A table summarized the findings, which were the result of statistical analysis, showing that the intervention group had a faster increase in knowledge, greater number of exercises, and improved balance. These data came predominantly from questionnaires; the reported falls were too rare to compare.
Conclusion: Summarize in paragraph form.
  • What is the summary of the study?
  • What is the conclusion of the hypothesis?
  • What are the questions for future research?
The authors highlight the limited nature of the study, and they recommend conducting research on patient self-assessment, especially standardized self-assessment tools as related to fall risks. Other than that, the authors summarize their findings (without hypothesis) to highlight the importance of taking into account patient expectations and perspectives. The authors conclude that the superficiality of knowledge and insufficiently serious attitudes toward falling are a problem for caregivers. They do point out that their sample is limited, which implies that future research can yield more data. The authors conclude that the program was a success and recommend some improvements for future robotics-based programs.
References
  • What are the total number of references used in the study?
  • List two of the references used.
The study has 25 sources.
Haines, T. P., Lee, D. C. A., O’Connell, B., McDermott, F., & Hoffmann, T. (2015). Why do hospitalized older adults take risks that may lead to falls? Health Expectations, 18(2), 233-249. Web.
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), e012363. Web.
The study has 47 sources.
Ashkanani, F., & Al-Sane, M. (2013). Knowledge, Attitudes and Practices of Caregivers in Relation to Oral Health of Preschool Children. Medical Principles and Practice, 22(2), 167-172. Web.
Hatamabadi, H., Mahfoozpour, S., Alimohammadi, H., & Younesian, S. (2013). Evaluation of factors influencing knowledge and attitudes of mothers with preschool children regarding their adoption of preventive measures for home injuries referred to academic emergency centres, Tehran, Iran. International Journal of Injury Control and Safety Promotion, 21(3), 252-259. Web.
The study has 53 sources.
Shubert, T., Goto, L., Smith, M., Jiang, L., Rudman, H., & Ory, M. (2017). The Otago Exercise Program: Innovative delivery models to maximize sustained outcomes for high risk, homebound older adults. Frontiers in Public Health, 5, 1-8. Web.
Shumway-Cook, A., Baldwin, M., Polissar, N., & Gruber, W. (1997). Predicting the probability for falls in community-dwelling older adults. Physical Therapy, 77(8), 812-819. Web.
Criteria and Defining Characteristics Article 13: Article 14: Article 15:
Abstract
After reading the abstract what do you expect to learn from the article?
Vonnes and Wolf (2017) explain the significance and purpose of their project, as well as its intervention and findings, in the abstract. The article tested a method of engaging patients and caregivers in preventing falls. Ott (2018) presents an abstract which describes a pilot study of a fall prevention education program meant for community-dwelling people. Yoo, Kim, Yim, and Jeon (2016) used the abstract to summarize their study of fall factors in rural and urban areas.
Introduction: Summarize the following in paragraph form.
  • What is the purpose of the study?
  • What is the scope of the study?
  • What is the rational for the study?
  • What is the hypothesis or research question?
  • What key concepts and terms are noted?
  • Is a review of the literature provided?
The authors use some literature to rationalize and justify the study and explain the problem of falls, especially in cancer patients, as well as the issue of engaging patients and caretakers in fall prevention. The authors explain that the purpose of the study was to investigate the effectiveness of an intervention aimed at patient and caretaker engagement, which was termed the Fall Prevention Agreement (FPA). The authors limited the scope of the project to a particular cancer unit in the US. The key concepts included fall risk, fall prevention, and FPA. The extensive literature review highlights the importance of the key concepts, including falls, falls in the elderly population, their consequences (including health-related and economic ones), and their prevention. The effectiveness of fall prevention education is treated as the primary rationale for the study. The study’s purpose and scope were defined as evaluating the effect of a particular program, but the author did not state a hypothesis. In a literature review, the authors discuss the key concepts, including falls and intrinsic (internal) and extrinsic (external) factors associated with them. They highlight the differences between rural and urban areas with respect to some of the factors, justifying the study (rationale), the purpose of which was to perform a comparative analysis of the two environments (purpose and scope). The article does not include any hypotheses.
Methods: Summarize the following in paragraph form.
  • What is the population being sampled?
  • What data collection procedure is presented?
  • What other procedures are described?
FPA was used to invite patients and families to demonstrate their understanding of the education they received and the risks of falls that they experienced. All the patients who visited the project’s unit (40% of them aged over 65) were provided with FPA. The authors used fall rates and fall-related injury rates, which were reported by the hospital automatically. They employed the baseline (pre-FPA) data and the quarterly fall rates after FPA’s implementation. As a pilot, the project only involved twenty older people (over 65 years), and eight of them participated in the program and filled out pre- and post-test surveys to determine their risk awareness. Also, their falls were recorded. A packet of questionnaires for sociodemographic factors, falls, fall prevention activities, fear of falling, and some other factors was administered by nurses to elderly Korean people (n=534).
Results: Summarize the following in paragraph form.
  • What are the given findings?
  • How was data collected?
  • Are the findings supported by graphs and charts?
  • What does the analysis of data state?
The authors narrate the process of FPA implementation, explaining that the Plan-Do-Study-Act framework was employed by them. They also use graphs and narration to report the changes in fall and injury rates. They did not employ inferential tests, but the decrease in falls ranged between 12% and 60%, and that for injuries ranged between 24% to 76%. The patients demonstrated a significant increase in knowledge, which was shown with the help of a chart. The survey data were analyzed statistically, and tables show that the two groups demonstrated significant differences in intrinsic and extrinsic factors, especially those related to medication, physical activity, and the specifics (safety) of their homes.
Conclusion: Summarize in paragraph form.
  • What is the summary of the study?
  • What is the conclusion of the hypothesis?
  • What are the questions for future research?
The authors suggest that engaging patients and their caretakers into fall prevention is empowering and can have positive effects. They also recommend studying the intervention with the help of multivariate analysis. The author concludes that the intervention improves knowledge, which means that the pilot was successful, and future studies can expand it. The authors conclude that there are differences between the two groups (rural and urban), which should be taken into account when developing interventions for them in future research.
References
  • What are the total number of references used in the study?
  • List two of the references used.
The study has 14 sources.
Burns, E., Stevens, J., & Lee, R. (2016). The direct costs of fatal and non-fatal falls among older adults — United States. Journal of Safety Research, 58, 99-103. Web.
Stone, C., Lawlor, P., Savva, G., Bennett, K., & Kenny, R. (2012). Prospective study of falls and risk factors for falls in adults with advanced cancer. Journal of Clinical Oncology, 30(17), 2128-2133. Web.
The study has 43 sources.
Nyman, S. R., & Yardley, L. (2009). Usability and acceptability of a website that provides tailored advice on falls prevention activities for older people. Health Informatics Journal, 15(1), 27–39. Web.
Zaloshnaja, E., Miller, T., Lawrence, B., & Romano, E. (2005). The costs of unintentional home injuries. American Journal of Preventive Medicine, 28(1), 88–94. Web.
The study has 26 sources.
Lord, S., Menz, H., & Sherrington, C. (2006). Home environment risk factors for falls in older people and the efficacy of home modifications. Age and Ageing, 35(suppl_2), ii55-ii59. Web.
Rubenstein, L. (2006). Falls in older people: Epidemiology, risk factors and strategies for prevention. Age and Ageing, 35(suppl_2), ii37-ii41. Web.

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