Practices of caregivers when evaluating the risk of falls in the admission of older adults to nursing homes

Baixinho, Cristina Lavareda; Dixe, Maria dos Anjos

doi:10.1590/1980-57642020dn14-040008

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Dementia & Neuropsychologia

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Original Article • Dement Neuropsychol 14 (4) • Dec 2020 • https://doi.org/10.1590/1980-57642020dn14-040008 copy

Practices of caregivers when evaluating the risk of falls in the admission of older adults to nursing homes

PRÁTICA DOS CUIDADORES NA AVALIAÇÃO DO RISCO DE QUEDA NA ADMISSÃO DO IDOSO NAS INSTITUIÇÕES DE LONGA PERMANÊNCIA PARA IDOSOS

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT.

Falls are a complex problem for the older population residing in nursing homes. Despite recommendations, many difficulties remain in the evaluation of and systematic information on fall risk factors.

Objectives:

To build and validate the Scale for Practices of Identification of and Information on Fall Risk Factors in the Admission of Older Adults; to describe the practices of professionals in identifying and providing information on fall risk factors in the admission of older adults; and to associate these practices with the training, experience, and age of the caretakers.

Methods:

This is a methodological study. Based on a literature review, we analyzed the contexts, consulted specialists, selected indicators, and designed the scale, which was evaluated by experts. The process included a pre-test, reformulation, application, and validation.

Results:

The response rate was 65.52%. The validated scale has 13 items and 2 dimensions: risk factor evaluation practices and information practices; it presents good psychometric properties (α=0.913) to evaluate the risk of falls in the admission of older adults.

Conclusions:

Caregivers who received training during professional activities had better practices as to the provision of information to older adults about the risk of falls. The risk associated with gait and balance changes is more significant compared to the cognitive state.

Keywords:
nursing; accidental falls; aged; homes for the aged; cognitive dysfunction

Item number and content	Pearson's correlation of the total without the item	Cronbach's α without the item
1. I check whether they use mobility aids	0.613	0.907
2. I check whether they have diffculty walking	0.656	0.906
3. I observe whether their balance changes when they walk	0.730	0.904
4. I check whether they have diffculty sitting/standing up from the chair	0.656	0.907
5. I check whether they have diffculty laying down/getting up from the bed	0.724	0.904
6. I check whether they have diffculty going upstairs/downstairs	0.630	0.907
7. I check whether they know their bearings in time and space	0.629	0.907
8. I check whether they have diffculty bathing	0.626	0.907
9. I inform them about the location of the bathroom	0.599	0.909
10. I inform them about the location of the lift	0.657	0.906
11. I inform them about the use of stairs and the ramp	0.590	0.909
12. I inform them that there is a call button	0.719	0.903
13. I inform them about the motion-activated lights	0.561	0.910
Total alpha	0.913

Item number and content	H2	F1	F2
1. I check whether they use mobility aids	0.628	0.773
2. I check whether they have diffculty walking	0.686	0.804
3. I observe whether their balance changes when they walk	0.720	0.793
4. I check whether they have diffculty sitting/standing up from the chair	0.772	0.869
5. I check whether they have diffculty laying down/getting up from the bed	0.626	0.645
6. I check whether they have diffculty going upstairs/downstairs	0.520	0.636
7. I check whether they know their bearings in time and space	0.500	0.500
8. I check whether they have diffculty bathing	0.485	0.477
9. I inform them about the location of the bathroom	0.589		0.738
10. I inform them about the location of the lift	0.564		0.665
11. I inform them about the use of stairs and the ramp	0.534		0.687
12. I inform them that there is a call button	0.729		0.799
13. I inform them about the motion-activated lights	0.679		0.818
Total explained variance		61.803
% of variance explained per factor		33.53	28.26
Kaiser-Meyer-Olkin measure		0.870
Bartlett's sphericity test: 1149.298; p<0.001

Item number and content	Mean	SD
1. I check whether they use mobility aids	4.43	0.88
2. I check whether they have diffculty walking	4.37	0.92
3. I observe whether their balance changes when they walk	4.32	0.88
4. I check whether they have diffculty sitting/standing up from the chair	4.37	0.87
5. I check whether they have diffculty laying down/getting up from the bed	4.36	0.85
6. I check whether they have diffculty going upstairs/downstairs	4.19	1.00
7. I check whether they know their bearings in time and space	4.05	1.00
8. I check whether they have diffculty bathing	4.37	0.94
9. I inform them about the location of the bathroom	4.34	1.05
10. I inform them about the location of the lift	4.30	1.02
11. I inform them about the use of stairs and the ramp	4.11	1.15
12. I inform them that there is a call button	4.36	0.98
13. I inform them about the motion-activated lights	4.21	1.10
Total results	47.07	12.69
F1 – Practices of risk factor assessment/identifcation	30.09	7.37
F2 – Practices of informing the older adult about how to prevent falls	16.98	5.32

Practice/Training before starting this professional activity		n	M. Rank	U	Z	p-value
Scale – factor 1	yes	41	67.23	1895.500	-0.054	0.957
Scale – factor 1	no	93	67.62	1895.500	-0.054	0.957
Scale – factor 2	yes	44	76.83	1789.500	-1.397	0.162
Scale – factor 2	no	95	66.84	1789.500	-1.397	0.162
Scale – total	yes	40	67.60	1596.000	-0.752	0.452

Practice/Training before and during the professional activity		n	M. Rank	U	Z	p-value
Scale – factor 1	yes	91	69.36	1787.000	-0.818	0.413
Scale – factor 1	no	43	63.56	1787.000	-0.818	0.413
Scale – factor 2	yes	92	75.20	1683.500	-2.187	0.029
Scale – factor 2	no	47	59.82	1683.500	-2.187	0.029
Scale – total	yes	86	67.52	1460.500	-1.570	0.116

Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento R. Vergueiro, 1353 sl.1404 - Ed. Top Towers Offices, Torre Norte, São Paulo, SP, Brazil, CEP 04101-000, Tel.: +55 11 5084-9463 | +55 11 5083-3876 - São Paulo - SP - Brazil
E-mail: revistadementia@abneuro.org.br | demneuropsy@uol.com.br

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[1] Cristina Lavareda Baixinho. Escola Superior de Enfermagem de Lisboa, Avenida Professor Egas Moniz – 1600-190 – Lisboa – Portugal. E-mail: crbaixinho@esel.pt