“You just struggle on your own:” Exploring older consumers’ perspectives about falls prevention education in hospitals

Abstract

ABSTRACTIntroductionWhile individualised falls preventive education has been effective in reducing hospital falls among older patients, there is a dearth of research exploring consumers’ perspectives on hospital falls prevention education.ObjectiveThis study aimed to explore the knowledge of older consumers regarding preventing falls in hospital and their reflections on the education received during hospitalisation.MethodsA qualitative, exploratory study incorporating focus groups and semi-structured interviews was undertaken. The participants consisted of a purposively selected sample of community-dwelling consumers aged 65 and above (n=39 older adults and n=9 family carers of older adults) who had been admitted to a hospital within the past five years. Thematic analysis, incorporating deductive and inductive approaches, was applied and a capability-opportunity-motivation-behaviour model was utilised to comprehend the key determinants influencing the implementation of falls education for hospitalised older adults.ResultsFeedback from the participants (n=46, 25 females, age range 60 to 89 years) revealed five key themes: distress and disempowerment resulting from hospital falls, anxiety and uncertainty regarding required behaviour while hospitalised, insufficient and inconsistent falls prevention education, inadequate communication, and underlying ageism attitudes. These themes converged to provide the overarching theme: “This [support and education available to engage in safe falls prevention behavior] wasn’t what we expected!” Application of the behaviour change model indicated that older consumers often did not acquire falls prevention knowledge, awareness or motivation, and had limited opportunities to engage in falls preventive behaviour during hospitalisation.DiscussionIn summary, older consumers receive sporadic falls prevention education during hospital admissions, which fails to raise their awareness and knowledge of falls risks or their capability to engage in safe preventive behaviours. Conflicting messages contribute to consumer confusion and anxiety about maintaining safety during hospital stays.ConclusionFurther research is required to address these issues to enable older adults to undertake effective falls prevention behaviours in hospital settings. Hospital policies and guidelines need to prioritise falls prevention education. Policies can be designed to emphasise tailored education, effective communication, and the importance of addressing ageism to enhance patient safety and well-being.