Knowledge assessment instrument on basic support of hip fractures in the elderly

Santos, Ednei Fernando dos; Aprile, Maria Rita; Alonso, Angelica Castilho; Garcez-Leme, Luis Eugênio; Greve, Julia Maria D'Andréa

doi:10.1590/1413-78522015230400976

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Original Articles • Acta ortop. bras. 23 (4) • Jul-Aug 2015 • https://doi.org/10.1590/1413-78522015230400976 copy

Knowledge assessment instrument on basic support of hip fractures in the elderly

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

To validate an instrument to determine the graduate students' knowledge level of health care on the basic support of life procedures, risk factors, damage and disorders in elderly patients with hip fractures.

METHOD:

A group of experts was asked to analyze the instrument in two steps. Firstly, the procedure was done subjectively and according to objective analysis using the Likert scale proposed by the Delphi method. After adjustment according to the suggestions, the version of the instrument was applied to 179 undergraduate students in the health area.

RESULT:

The instrument has achieved in its entirety and in parts (risk factors), the minimum criteria established for the Cronbach's alpha (i.e., ≥0.70). There was no change in the Cronbach's alpha (0.551) for the maintenance of initial items of the instrument, as well as the deletion of seven assessment items.

CONCLUSION:

The instrument developed has sufficient internal validity to determine the level of knowledge of undergraduate students in the health area on basic life support, damage, injuries and risk factors in elderly patients with hip fractures from falls. Level of Evidence III, Diagnostic Study,

Aged; Femoral fractures; Cardiopulmonary resuscitation; Accidental falls

		Frequency	Percentage
Course	Physical Education	5	3
	Nursing	65	36
	Physiotherapy	30	17
	Medicine	79	44
Semester	Tenth	40	22
	Second	1	1
	Fifth	1	1
	Sixth	28	15
	Seventh	39	22
	Eighth	40	22
	Ninth	30	18
Contact with the topic	Yes	158	88
Contact with the topic	No	21	12
Semester in which respondents had contact with the topic	First	5	3
	Second	12	7
	Third	16	9
	Fourth	39	22
	Fifth	15	8
	Sixth	25	14
	Seventh	41	23
	Eighth	3	2
	Ninth	2	2
	Tenth	1	1

Parts	Cronbach's Alpha	Number of items
Risk factors	0.579	18
Damage and injuries	0.748	17
Basic life support	0.837	55
Total	0.849	90

	Inter-item correlation	Cronbach's alpha if the item was excluded
Ingesting alcoholic beverages alters the senses that potentiate the risk of falls;	-0.024	0.585
Half of the falls is due to environmental causes (slippery or uneven floors, areas, inadequate lighting and paving);	0.071	0.580
Half of the number of falls occur in their own homes;	0.143	0.573
Incontinence and cognitive disorders are also often present in victims of falls;	0.325	0.540
Cognitive disorders are clearly associated with increased risk of falls;	0.272	0.551
Caucasians fall more often than African descents, Latino or Asian;	0.172	0.569
Muscle weakness, gait disorders, loss of balance and use of assistive devices are risk factors for falls;	0.076	0.579
The prevalence of falls increases with age;	0.098	0.577
Balance and mobility limitations substantially contribute to the risk of falls;	0.295	0.559
There is a significant increase in the risk of falls with the use of medicines as psychotropic drugs, antiarrhythmic drugs, digoxin, diuretics and sedatives;	0.346	0.539
Orthopedic abnormalities, loss of sensitivity and inappropriate footwear are associated with high risk of falls;	0.159	0.570
The presence of circulatory diseases, chronic obstructive pulmonary disease, depression and arthritis are associated with high risk of falls;	0.327	0.538
The risk of fractures in men is half that observed in women;	0.192	0.569
Dizziness, vertigo and syncope are common causes of falls;	0.172	0.569
Elderly people often slip and stumble, besides having inefficient mechanisms to preventing falls;	0.100	0.578
Institutionalized elderly fall more often than those living in community;	0.188	0.569
The visual safety, contrast sensitivity, cataracts, glaucoma, macular degeneration and the use of bi-and multifocal lenses contribute to falls;	0.219	0.561
Fear of falling is reported by a large proportion of victims of falls.	0.350	0.541

	Inter-item correlation	Cronbach's Alpha if the item was excluded
Depression, fear of falling and other psychological problems – the "post-fall syndrome" – are common effects after repeated falls;	0.177	0.746
Most undamaged falls are often never reported to health professionals;	0.248	0.743
The loss of self-confidence, confusion and social isolation can occur after falls even without damages;	0.295	0.739
Laying in the ground for more than 12h after a fall is associated with blood pressure issues, dehydration, hypothermia, pneumonia and death;	0.298	0.739
Falls are the factor responsible for most of the admissions to long term care facilities;	0.416	0.729
A fall without damage can still be fatal if the person is unable to get up from the ground and ask for help;	0.410	0.729
Hip fractures account for about 25% of fractures caused by falls in community resident elderlies;	0.316	0.737
The most common age-related fractures are in the wrist, spine, hip, humerus and pelvis;	0.294	0.739
Falls are the leading cause of death for people over 65 years old;	0.325	0.736
Mortality and hospitalization rates due to damages resulting from falls increase exponentially with age;	0.270	0.741
About 20% of deaths related to falls in people over 85 years old occur in long term care facilities;	0.318	0.752
Half of those who fall require help to get up after the fall;	0.229	0.744
Half of fall victims with hip fractures never return to walk properly;	0.438	0.726
In a period of one year after the fall, 20% of victims are either still in hospital, require full-time care or die;	0.465	0.724
The damage caused by falls lead to five times more hospital admissions than those caused by other reasons;	0.483	0.722
Elderly people who fall once are two to three times more likely to fall again within a one year period;	0.356	0.734
At least 95% of hip fractures are caused by falls among institutionalized individuals.	0.419	0.729

	Lower than 70%	Higher than 70%	Total
Risk factors (13)	51 (29)	126 (71)	177 (100)
Damage and injuries (12)	107 (60)	71 (40)	178 (100)
Basic life support (15)	45 (25)	134 (75)	179 (100)
Total	76 (43)	101 (57)	177 (100)

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[1] Correspondence: Angelica Castilho Alonso, Rua Dr. Ovídio Pires De Campos, 333, Cerqueira Cesar, 05403-010 São Paulo, Sp, Brazil. angelicacastilho@msn.com