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Fall prevention by nursing assistants among community‐living elderly people. A randomised controlled trial
Author(s) -
Fahlström Gunilla,
Kamwendo Kitty,
Forsberg Jenny,
Bodin Lennart
Publication year - 2018
Publication title -
scandinavian journal of caring sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.678
H-Index - 66
eISSN - 1471-6712
pISSN - 0283-9318
DOI - 10.1111/scs.12481
Subject(s) - berg balance scale , medicine , fear of falling , activities of daily living , psychological intervention , intervention (counseling) , physical therapy , balance (ability) , gerontology , fall prevention , randomized controlled trial , nursing assistant , timed up and go test , quality of life (healthcare) , nursing , nursing homes , injury prevention , poison control , environmental health , surgery
Falls among elderly are a major public health issue in Sweden. The aim was to determine whether nursing assistants can prevent falls by supervising community‐living elderly individuals with a history of falling in performing individually designed home exercise programmes. A randomised controlled trial was performed in Sweden, in eight municipalities in the county of Örebro, during 2007–2009. Community‐living persons 65 years or older having experienced at least one fall during the last 12 months were included. The intervention group consisted of 76 participants, and there were 72 in the control group. The interventions were free of charge and were shared between a physiotherapist and a nursing assistant. The former designed a programme aiming to improve balance, leg strength and walking ability. The nursing assistant supervised the performance of activities during eight home visits during a 5‐month intervention period. The measures and instruments used were health‐related quality of life ( SF ‐36), activity of daily living ( ADL ‐staircase), balance, (Falls Efficacy Scale, and Berg Balance Scale), walking ability (Timed Up and Go and the 3‐metre walking test), leg strength, (chair stand test). All participants were asked to keep a structured calendar of their physical exercise, walks and occurrence of falls during their 12‐month study period. Hospital healthcare consumption data were collected. Although the 5‐month intervention did not significantly decrease the risk for days with falls, RR 1.10 (95% CI 0.58, 2.07), p = 0.77, significant changes in favour of the intervention group were noted for balance (p = 0.03), ADL (p = 0.035), bodily pain (p = 0.003) and reported health transition over time (p = 0.008) as well as less hospital care due to fractures (p = 0.025). Additional studies with more participants are needed to establish whether or not falls can be significantly prevented with this model which is workable in home‐based fall prevention.

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