Clinical Interventions in Aging (Jun 2020)
Barriers and Facilitators to Older Adults Participating in Fall-Prevention Strategies After Transitioning Home from Acute Hospitalization: A Scoping Review
Abstract
Huey-Ming Tzeng,1 Udoka Okpalauwaekwe,2 Elizabeth J Lyons3 1The University of Texas Medical Branch, School of Nursing, Galveston, TX, USA; 2University of Saskatchewan, College of Medicine, Saskatoon, Saskatchewan S7N 2Z4, Canada; 3University of Texas Medical Branch, Department of Nutrition and Metabolism, School of Health Professions, Galveston, TX, USACorrespondence: Huey-Ming TzengThe University of Texas Medical Branch at Galveston, School of Nursing, 301 University Boulevard, Galveston, TX 77555, USATel +1-734-358-0358Email [email protected]: Approximately, 14% of older adults aged 65 years and over experience a fall within 1 month post-hospital discharge. Adequate self-management may minimize the impact of these falls; however, research is lacking on why some older adults engage in self-management to prevent falls while others do not.Methods: We conducted a scoping review to identify barriers and facilitators to older adults participating in fall-prevention strategies after transitioning home from acute hospitalization. Eligibility criteria were peer-reviewed journal articles published during 2009– 2019 which were written in English and contained any of the following keywords or their synonyms: “fall-prevention,” “older adults,” “post-discharge” and “transition care.” We systematically and selectively summarized the findings of these articles using the Joanna Briggs Institute guidelines and the PRISMA-ScR reporting guidelines. Seven bibliographic databases were searched: PubMed/MEDLINE, ERIC, CINAHL, Cochrane Library, Scopus, PsycINFO, and Web of Science. We used the Capability-Opportunity-Motivation-Behavior (COM-B) model of health behavior change as a framework to guide the content, thematic analysis, and descriptive results.Results: Seventeen articles were finally selected. The most frequently mentioned barriers and facilitators for each COM-B dimension differed. Motivation factors include such as older adults lacking inner drive and self-denial of being at risk for falls (barriers) and following-up with older adults and correcting inaccurate perceptions of falls and fall-prevention strategies (facilitators).Conclusion: This scoping review revealed gaps and future research areas in fall prevention relative to behavioral changes. These findings may enable tailoring feasible fall-prevention interventions for older adults after transitioning home from acute hospitalization.Keywords: falls, falls with injury, older adults, post-discharge care, transition care, patient-centered care
