Volume 2, Issue 3 (Summer 2016 -- 2016)                   JCCNC 2016, 2(3): 135-144 | Back to browse issues page

XML Print

1- Department of Geriatric Nursing, School of Nursing & Midwifery, Iran University of Medical Sciences, Tehran, Iran.
2- Department of Community Health Nursing, School of Nursing & Midwifery, Iran University of Medical Sciences, Tehran, Iran.
3- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
4- Department of Orthopedics, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Abstract:   (1240 Views)

Background: Fear of falling is common amongst older adults, especially those who live in nursing homes. This study aimed to determinate factors associated with fear of falling and functional independence in older adults living in nursing homes.

Methods: This was a cross-sectional study using a convenience sampling method to enroll 200 older adults living in nursing homes from 25 senior centers in Tehran 1 and 2 districts between September 2015 and November 2015. Main outcome measurement instruments were the 16-Item falls efficacy scale international (FES-I, Persian version) and 11-Item Barthel index (BI) functional independence measure. In this study, variables were analyzed using Student’s t test and ANOVA. The Pearson coefficient correlation was used to examine the relationship between FES and BBS[g1] . A 2-tailed P value < 0.05 was considered statistically significant.

Results: The participants were mostly female (51.5%) and aged over 70 (mean age 76.89±8.50 years). Of 200 seniors within the study, 60.8% experienced one or more falls during the last year. Statistically significant relationships were found between the fear of falling and functional independence (r = - 0.524; P ≤ 0.001). There was a significant relationship between fear of falling and age (P = 0.039), history of falling (P=0.002), and chronic disease (P=0.009). In addition, there was a significant relationship between functional independence and some older adults’ characteristics, including gender (P = 0.048), education level (P = 0.028), duration of living in nursing home (P=0.002), history of falling (P=0.006), and chronic disease (P=0.01).

Conclusion: According to the findings, there was a high level of fear of falling in the older adults. The fear of falling in the older adults living in nursing homes is associated with age, history of falling, and chronic disease. There was a significant association between functional independence and variables of gender, education level, duration of living in nursing home, history of falling, and chronic disease.

 [g1]Expand this term.

Full-Text [PDF 600 kb]   (427 Downloads)    
Type of Study: Research | Subject: General
Received: 2016/07/17 | Accepted: 2016/09/19 | Published: 2016/12/25

1. Allison, L. K., Painter, J. A., Emory, A., Whitehurst, P., & Raby, A. 2013. Participation restriction, not fear of falling, predicts actual balance and mobility abilities in rural community-dwelling older adults. Journal of Geriatric Physical Therapy, 36(1), pp. 13–23. doi: 10.1519/jpt.0b013e3182493d20 [DOI:10.1519/JPT.0b013e3182493d20]
2. Anon. 2008. Self-reported falls and fall-related injuries among persons aged≥65 years—United States, 2006. JAMA, 299(14), pp. 1658. doi: 10.1001/jama.299.14.1658 [DOI:10.1001/jama.299.14.1658]
3. Araújo, M. O. P. H., & Ceolim, M. F. 2007. Avaliação do grau de independência de idosos residentes em instituições de longa permanência. Revista da Escola de Enfermagem da USP, 41(3), pp. 378–85. doi: 10.1590/s0080-62342007000300006 [DOI:10.1590/S0080-62342007000300006]
4. Austin, N., Devine, A., Dick, I., Prince, R., & Bruce, D. 2007. Fear of falling in older women: A longitudinal study of incidence, persistence, and predictors. Journal of the American Geriatrics Society, 55(10), pp. 1598–603. doi: 10.1111/j.1532-5415.2007.01317.x [DOI:10.1111/j.1532-5415.2007.01317.x]
5. Bertera, E. M., & Bertera, R. L. 2008. Fear of falling and activity avoidance in a national sample of older adults in the United States. Health & Social Work, 33(1), pp. 54–62. doi: 10.1093/hsw/33.1.54 [DOI:10.1093/hsw/33.1.54]
6. Binkin, N., Bertozzi, N., Bakken, E., & Vitali, P. 2007. Prevalence of and risk factors for functional dependence in the non-institutionalised elderly population of 11 Italian regions: Results of the Argento study, 2002. Ig Sanita Pubbl, 63(3):263-72. PMID: 17805352 [PMID]
7. Choi, K., & Ko, Y. 2015. Characteristics associated with fear of falling and activity restriction in South Korean older adults. Journal of Aging and Health, 27(6), pp. 1066–83. doi: 10.1177/0898264315573519 [DOI:10.1177/0898264315573519]
8. Dadgari, A., Hamid, T. A., Mousavi, S. A., Hakim, N., Hin, L. P. & Dadvar, L. 2016. Internal consistency of Persian version of falls efficacy scale and activity-specific balance scale. International Journal of Health Studies, 1(3), pp. 29-32.
9. Da Costa, E. M., Pepersack, T., Godin, I., Bantuelle, M., Petit, B., & Levêque, A. 2012. Fear of falling and associated activity restriction in older people: Results of a cross-sectional study conducted in a Belgian town. Archives of Public Health, 70(1). doi: 10.1186/0778-7367-70-1 [DOI:10.1186/0778-7367-70-1]
10. Denkinger, M. D., Lukas, A., Nikolaus, T., & Hauer, K. 2015. Factors associated with fear of falling and associated activity restriction in community-dwelling older adults: A systematic review. The American Journal of Geriatric Psychiatry, 23(1), pp. 72–86. doi: 10.1016/j.jagp.2014.03.002 [DOI:10.1016/j.jagp.2014.03.002]
11. Filiatrault, J., Desrosiers, J., & Trottier, L. 2009. An exploratory study of individual and environmental correlates of fear of falling among community-dwelling seniors. Journal of Aging and Health, 21(6), pp. 881–94. doi: 10.1177/0898264309340694 [DOI:10.1177/0898264309340694]
12. Freitas, R. S., Fernandes, M. H., Coqueiro, R. Da, S., Reis Júnior, W. M., Rocha, S. V., & et al. 2012. Capacidade funcional e fatores associados em idosos: Estudo populacional. Acta Paulista de Enfermagem, 25(6), pp. 933–9. doi: 10.1590/s0103-21002012000600017 [DOI:10.1590/S0103-21002012000600017]
13. Friedman, S. M., Munoz, B., West, S. K., Rubin, G. S., & Fried, L. P. 2002. Falls and fear of falling: Which comes first? A longitudinal prediction model suggests strategies for primary and secondary prevention. Journal of the American Geriatrics Society, 50(8), pp. 1329–35. doi: 10.1046/j.1532-5415.2002.50352.x [DOI:10.1046/j.1532-5415.2002.50352.x]
14. Gill, T., Taylor, A. W., & Pengelly, A. 2005. A population-based survey of factors relating to the prevalence of falls in older people. Gerontology, 51(5), pp. 340–5. doi: 10.1159/000086372 [DOI:10.1159/000086372]
15. Guthrie, D. M., Fletcher, P. C., Berg, K., Williams, E., Boumans, N., & Hirdes, J. P. 2011. The role of medications in predicting activity restriction due to a fear of falling. Journal of Aging & Health, 24(2), pp. 269–86. doi: 10.1177/0898264311422598 [DOI:10.1177/0898264311422598]
16. Hanlon, J. T., Landerman, L. R., Fillenbaum, G. G., & Studenski, S. 2002. Falls in African American and white community-dwelling elderly residents. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 57(7), pp. 473–8. doi: 10.1093/gerona/57.7.m473 [DOI:10.1093/gerona/57.7.M473]
17. Kalula, S. Z, Ferreira, M., Swingler, G. H., & Badri, M. 2016. Risk factors for falls in older adults in a South African urban community. BMC Geriatrics, 16:51. doi: 10.1186/s12877-016-0212-7 [DOI:10.1186/s12877-016-0212-7]
18. Kumar, A., Carpenter, H., Morris, R., Iliffe, S., & Kendrick, D. 2013. Which factors are associated with fear of falling in community-dwelling older people. Age & Ageing, 43(1), pp. 76–84. doi: 10.1093/ageing/aft154 [DOI:10.1093/ageing/aft154]
19. Kurella Tamura, M., Covinsky, K., Chertow, G., Yaffe, K., Landefeld, C., & Mc Culloch, C. 2009. Functional status of elderly adults before and after initiation of dialysis. New England Journal of Medicine, 361(16), pp. 1539–47. doi: 10.1056/nejmoa090465
20. Lach, H. W. 2005. Incidence and risk factors for developing fear of falling in older adults. Public Health Nursing, 22(1), pp. 45–52. doi: 10.1111/j.0737-1209.2005.22107.x [DOI:10.1111/j.0737-1209.2005.22107.x]
21. Mahoney, F. I., Barthel, D. W. 1965. Functional evaluation: The Barthel index. Maryland State Medical Journal, 14, pp. 61-65. PMID: 14258950 [PMID]
22. Mattos, I. E., Do Carmo, C. N., Santiago, L. M., & Luz, L. L. 2014. Factors associated with functional incapacity in elders living in long stay institutions in Brazil: A cross-sectional study. BMC Geriatrics, 14(1), pp. 47. doi: 10.1186/1471-2318-14-47 [DOI:10.1186/1471-2318-14-47]
23. Mann, R. 2006. Exploring the relationship between fear of falling and neuroticism: A cross-sectional study in community-dwelling women over 70. Age & Ageing, 35(2), pp. 143–7. doi: 10.1093/ageing/afj013 [DOI:10.1093/ageing/afj013]
24. Millán-Calenti, J. C., Tubío, J., Pita-Fernández, S., González-Abraldes, I., Lorenzo, T., Fernández-Arruty, T., et al. 2010. Prevalence of functional disability in activities of daily living, instrumental activities of daily living and associated factors, as predictors of morbidity and mortality. Archives of Gerontology and Geriatrics, 50(3), pp. 306–10. doi: 10.1016/j.archger.2009.04.017 [DOI:10.1016/j.archger.2009.04.017]
25. Morris, M., Osborne, D., Hill, K., Kendig, H., Lundgren-Lindquist, B., Browning, C., et al. 2004. Predisposing factors for occasional and multiple falls in older Australians who live at home. Australian Journal of Physiotherapy, 50(3), pp. 153–9. doi: 10.1016/s0004-9514(14)60153-7 [DOI:10.1016/S0004-9514(14)60153-7]
26. Mosallanezhad, Z., Salavati, M., Hellström, K., Reza Sotoudeh, G., Nilsson Wikmar, L., & Frändin, K. 2011. Cross-cultural adaptation, reliability and validity of the Persian version of the modified falls efficacy scale. Disability & Rehabilitation, 33(25-26), pp. 2446–53. doi: 10.3109/09638288.2011.574774 [DOI:10.3109/09638288.2011.574774]
27. Murphy, S. L., Williams, C. S. & Gill, T. M. 2002. Characteristics associated with fear of falling and activity restriction in community-living older persons. Journal of the American Geriatrics Society, 50(3), pp. 516–20. doi: 10.1046/j.1532-5415.2002.50119.x [DOI:10.1046/j.1532-5415.2002.50119.x]
28. Orces, C. H. 2014. Prevalence and determinants of fall-related injuries among oder adults in Ecuador. Current Gerontology & Geriatrics Research, 2014, pp. 1–7. doi: 10.1155/2014/863473 [DOI:10.1155/2014/863473]
29. Painter, J. A., Allison, L., Dhingra, P., Daughtery, J., Cogdill, K., & Trujillo, L. G. 2012. Fear of falling and its relationship with anxiety, depression, and activity engagement among community-dwelling older adults. American Journal of Occupational Therapy, 66(2), pp. 169–76. doi: 10.5014/ajot.2012.002535 [DOI:10.5014/ajot.2012.002535]
30. Shah, S., Vanclay, F., & Cooper, B. 1989. Improving the sensitivity of the barthel index for stroke rehabilitation. Journal of Clinical Epidemiology, 42(8), pp. 703–9. doi: 10.1016/0895-4356(89)90065-6 [DOI:10.1016/0895-4356(89)90065-6]
31. Scheffer, A. C., Schuurmans, M. J., Van Dijk, N., Vander Hooft, T., & De Rooij, S. E. 2007. Fear of falling: measurement strategy, prevalence, risk factors and consequences among older persons. Age & Ageing, 37(1), pp. 19–24. doi: 10.1093/ageing/afm169 [DOI:10.1093/ageing/afm169]
32. Soriano, T. 2008. Falls in the community-dwelling older adult: A review for primary-care providers. Clinical Interventions in Aging, 2(4), pp. 545–53. doi: 10.2147/cia.s1080 [DOI:10.2147/CIA.S1080]
33. Shumway-Cook, A., Brauer, S., & Woollacott, M. 2000. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Physical therapy, 80(9), pp. 896-903. [PMID]
34. Tagharrobi, Z., Sharifi, K., & Sooky, Z. 2011. [Psychometric evaluation of Shah version of modified Barthel index in elderly people residing in Kashan Golabchi nursing home (Persian)]. Feyz Journals of Kashan University of Medical Sciences, 15(3).pp: 213-224.
35. Tao, H., & McRoy, S. 2015. Caring for and keeping the elderly in their homes. Chinese Nursing Research, 2(2-3), pp. 31–4. doi: 10.1016/j.cnre.2015.08.002 [DOI:10.1016/j.cnre.2015.08.002]
36. Tinetti, M. E., Richman, D., & Powell, L. 1990. Falls efficacy as a measure of fear of falling. Journal of Gerontology, 45(6), pp. 239–43. doi: 10.1093/geronj/45.6.p239 [DOI:10.1093/geronj/45.6.P239]
37. Vavilala, M., Curry, P., & Ramaiah, R. 2011. Current trends and update on injury prevention. International Journal of Critical Illness & Injury Science, 1(1), pp. 57-65. doi: 10.4103/2229-5151.79283 [DOI:10.4103/2229-5151.79283]
38. Visschedijk, J., Achterberg, W., Van Balen, R., & Hertogh, C. 2010. Fear of falling after hip fracture: A systematic review of measurement instruments, prevalence, interventions, and related factors. Journal of the American Geriatrics Society, 58(9), pp. 1739–48. doi: 10.1111/j.1532-5415.2010.03036.x [DOI:10.1111/j.1532-5415.2010.03036.x]
39. Yardley, L., & Smith, H. 2002. A prospective study of the relationship between feared consequences of falling and avoidance of activity in community-living older people. The Gerontologist, 42(1), pp. 17–23. doi: 10.1093/geront/42.1.17 [DOI:10.1093/geront/42.1.17]
40. Zijlstra, G. A. R., Van Haastregt, J. C. M., Van Eijk, J. T. M., Van Rossum, E., Stalenhoef, P. A., & Kempen, G. I. J. M. 2007. Prevalence and correlates of fear of falling, and associated avoidance of activity in the general population of community-living older people. Age and Ageing, 36(3), pp. 304–9. doi: 10.1093/ageing/afm021 [DOI:10.1093/ageing/afm021]