Fall behaviors and risk factors among elderly patients with hip fractures

This descriptive and cross-sectional study was performed at a university hospital in Izmir, Turkey between January 2014 and December 2015. Data were collected using the Fall Behaviors Scale for Old People. This study was conducted with 103 patients who had a hip fracture caused by falling. Descriptive statistics, Mann Whitney U and Kruskal-Wallis tests were used.

Results

There was a significant difference between age groups in this score (KW = 6.85, p = 0.03). The patients aged 85-96 years obtained significantly higher scores for the sub-scales of protective mobility (KW = 8.71, p = 0.01) and avoidance (KW = 6.03, p = 0.04) than patients in the other age groups. There was not a significant difference in fall prevention behaviors between the elderly with a history of a repeated falls and those without a repeated fall history.

Conclusion

Although elderly people with hip fractures due to falling has highly protective behavior, they have fallen. Advanced age patient has showed more protective behavior for falling.

Key words
Geriatric nursing; Perioperative nursing; Aged; Hip injuries; Fractures; Risk factors

Characteristics		X̅±SD	Min-Max
		78.78 ± 7.49	65-96
		n	%
Age
	65-74	36	35.0
	75-84	48	46.6
	85 and above	19	18.4
Gender
	Female	73	70.9
	Male	30	29.1
Education
	Literate	40	38.8
	Elementary education	45	43.7
	High School and above	18	17.5
Marital status
	Married	49	47.6
	Widowed	41	39.8
	Divorced	5	4.8
	Unmarried	8	7.7
Occupation
	Housewife	62	60.2
	Civil servant	3	2.9
	Retired	38	36.9
Living alone at home
	Yes	32	31.1
	No	71	68.9
Anatomic area of fracture
	Femur neck	29	28.2
	Intertrochanteric	72	69.9
	Femur head	2	1.9
Prior fall history
	Yes	68	66
	No	35	34
Prior number of falls
	One	35	34.0
	Two	33	32.0
	Three	31	30.1
	Four	3	2.9
	Five	1	1.0
Chronic diseases^* * Patients can select more than one option; SD - Standard Deviation
	Hypertension	70	67.9
	Diabetes Mellitus	65	63.1
	Parkinson/Dementia	12	11.6
	Thyroid	28	27.1
	None	19	18.4
Place of fall
	Indoors	93	90.2
	Outdoors	10	9.8

Selected risk factors		X̅±SD	Test	p-value
Selected risk factors		X̅±SD	^* * P< 0.05; SD: Standard Deviation; KW: Kruskal-Wallis test: U: Mann-Whitney U test p	^* * P< 0.05; SD: Standard Deviation; KW: Kruskal-Wallis test: U: Mann-Whitney U test p
Age group
	65-75	84.41±12.04	KW = 6.85	0.03^* * P< 0.05; SD: Standard Deviation; KW: Kruskal-Wallis test: U: Mann-Whitney U test
	76-85	88.72±13.05
	86-96	93.21±15.01
Gender
	Female	89.06±12.69	U = 950.000	0.29
	Male	85.56±14.71
Education
	Literate	90.55±14.09	KW = 2.84	0.24
	Elementary Education	86.11±12.35
	High School and above	90.86±11.09
Marital status
	Married	85.91±12.46	U = 1057.500	0.07
	Single	89.98±13.90
Living alone at home
	Yes	90.03±13.72	U = 978.500	0.26
	No	87.15±13.15
Prior fall history
	Yes	89.07±1.63	U = 1350.500	0.24
	No	86.05±2.20
Prior fall numbers
	One	86.05±2.20	KW = 1.41	0.49
	Two	88.09±2.04
	3 and above	88.48±2.76

Variables		Total scale point		Cognitive adaptation		Avoidance		Awareness		Practical strategies		Displacing activities
Variables		X̅±SS	Test	X̅±SS	Test	X̅±SS	Test	X̅±SS	Test	X̅±SS	Test	X̅±SS	Test
Age
	65-75 n(36)	84.41±12.04	KW:6.85	18.08±3.17	KW:4.95	16.02±2.57	KW:6.03	11.80±1.58	KW:1.15	7.38±1.38	KW:1.79	3.13±0.86	KW:2.73
	76-85 n(48)	88.72±13.05		19.33±2.75		16.47±3.01		12.04±1.87		7.81±2.16		3.08±0.73
	86-96 n(19)	93.21±15.01	p:0.03*	19.84±3.37	p:0.08	17.47±3.31	p:0.04*	12.26±2.02	p:0.56	8.21±2.27	p:0.40	3.36±0.83	p:0.25
Gender
	Female n(73)	89.06±12.69	U:950	19.28±2.86	U:923.5	16.78±2.88	U:908.5	12.09±1.73	U:951.0	7.91±2.13	U:916.5	3.12±0.86	U:956.5
	Male n(30)	85.56±14.71	p: 0.29	18.26±3.47	p:0.21	15.83±2.24	p:0.17	11.76±1.95	P:0.28	7.30±2.05	p:0.19	3.23±0.62	p:0.82
Education
	Literate n(40)	90.55±14.09	KW:6.85	19.60±3.09	KW:3.93	16.97±2.97	KW:5.31	11.80±1.85	KW:0.55	8.15±2.25	KW:7.26	3.32±0.69	KW:2.88
	Elementary Education n(45)	86.11±12.35		18.73±2.83		16.24±3.63		12.11±1.65		7.35±1.83		3.00±0.95
	High School and above n(18)	90.86±11.09	p:0.03	18.80±2.95	p:0.26	16.73±3.63	p:0.15	12.73±1.66	p:0.75	8.26±2.28	p:0.06	3.13±0.51	p:0.41
Marital Status
	Married n(49)	85.91±12.46	U:1057.5	18.44±2.94	U:915.5	16.08±2.79	U:937.5	11.79±1.60	U:995.5	7.63±2.14	U:958.5	3.26±0.72	U:981.5
	Single n(54)	89.98±13.90	p:0.07	19.48±3.13	p:0.06	16.88±3.17	p:0.21	12.18±1.95	p:0.39	7.83±2.11	p:0.23	3.05±0.85	p:0.32
Living Alone at Home
	Yes n(32)	90.03±13.72	U	19.28±3.28	U:1021	17.62±2.74	U:861	12.03±1.95	U:1074	7.84±1.96	U:1100	3.03±0.86	U:1005
	No n(71)	87.15±13.15	p:0.31	18.85±2.98	p:0.41	16.00±3.00	p:0.06	11.98±1.73	p:0.65	7.64±2.20	p:0.79	3.21±0.77	p:0.31

Variables		Protective Mobility		Changes in Level		Getting to the Phone		Pace		Being Observant
Variables		X̅±SS	Test	X̅±SS	Test	X̅±SS	Test	X̅±SS	Test	X̅±SS	Test
Age
	65-75 n(36)	11.50±3.82	KW:8.71	5.72±1.08	KW:0.27	3.08±1.13	KW:1.56	5.00±1.94	KW:3.39	2.69±0.89	KW:1.19
	76-85 n(48)	13.47±2.80		5.70±1.05		2.85±1.22		5.33±2.03		2.60±1.00
	86-96 n(19)	14.47±4.08	p:0.01*	5.84±1.34	p:0.87	3.21±1.13	p:0.45	6.00±2.22	p:0.18	2.52±1.17	p:0.90
Gender
	Female n(73)	13.35±3.98	U:898.0	5.79±1.07	U:993.5	2.91±1.22	U:975.5	5.16±2.07	U:907.0	2.53±1.04	U:1069
	Male n(30)	12.05±3.90	p:0.15	5.60±1.19	p:0.44	3.20±1.03	p:0.35	5.79±2.09	p:0.16	2.56±0.85	p:0.84
Education
	Literate n(40)	15.12±4.06	KW:6.62	5.65±1.09	KW:3.35	3.20±1.09	KW:3.35	5.20±2.25	KW:1.87	2.52±1.10	KW:2.72
	Elementary Education n(45)	12.08±3.70		5.80±1.12		2.84±1.26		5.28±1.99		2.64±0.88
	High School and above n(18)	13.26±3.59	p:0.06	6.00±1.00	p:0.34	3.06±1.09	p:0.34	6.00±1.64	p:0.60	2.86±1.06	p:0.43
Marital Status
	Married n(49)	12.14±3.68	U:956.5	5.59±1.03	U:964.5	3.08±1.05	U:957.5	5.16±2.00	U:9715	2.71±0.95	U:956.5
	Single n(54)	13.72±4.14	p:0.08	5.87±1.16	p:0.67	2.92±1.27	p:0.71	5.50±2.09	p:0.72	2.51±1.02	p:0.25
Living Alone at Home
	Yes n(32)	13.31±4.13	U:1058	5.93±0.94	U:985.5	2.87±1.31	U:978.5	5.56±1.84	U:1043	2.53±1.07	U:1057
	No n(71)	12.81±3.94	p:0.57	5.64±1.17	p:0.26	3.03±1.10	p:0.26	5.23±2.24	p:0.67	2.64±0.95	p:0.55

Escola Paulista de Enfermagem, Universidade Federal de São Paulo R. Napoleão de Barros, 754, 04024-002 São Paulo - SP/Brasil, Tel./Fax: (55 11) 5576 4430 - São Paulo - SP - Brazil
E-mail: actapaulista@unifesp.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Corresponding author Hale Turhan Damar DokuzEylul University, Nursing Faculty, Balcova, Incialti, Izmir, Turkey. hale.turhan1986@gmail.com