title: Fall prevention and monitoring of assisted living patients: an exploratory study of physician perspectives.
abstract: OBJECTIVE
  Explore physician perspectives on their involvement in fall prevention and monitoring for residential care/assisted living (RC/AL) residents.
  
  
  METHODS
  Exploratory cross-sectional study; mailed questionnaire.
  
  
  METHODS
  Four RC/AL communities, North Carolina.
  
  
  METHODS
  Primary physicians for RC/AL residents.
  
  
  METHODS
  Past Behavior and future Intentions of physicians with regard to (1) fall risk assessment and (2) collaboration with RC/AL staff to reduce falls and fall risks among RC/AL residents were explored using Theory of Planned Behavior (TPB) constructs. Predictor variables examined (1) physicians' views on their own responsibilities (Attitude), (2) their views of expectations from important referent groups (Subjective Norms), and (3) perceived constraints on engaging in fall prevention and monitoring (Perceived Behavioral Control).
  
  
  RESULTS
  Physicians reported conducting fall risk assessments of 47% of RC/AL patients and collaborating with RC/AL staff to reduce fall risks for 36% of RC/AL patients (Behavior). These proportions increased to 75% and 62%, respectively, for future Intentions. TPB-based models explained approximately 60% of the variance in self-reported Behavior and Intentions. Physician's involvement in fall prevention and monitoring was significantly associated (P < .05) with their perceptions of barriers and facilitators-ease, time, reimbursement, and expertise.
  
  
  CONCLUSIONS
  This study provides first data on physician beliefs regarding their involvement in fall risk assessment of RC/AL patients and collaboration with RC/AL staff to reduce fall risks of individual patients. Challenges to physician involvement identified in our study are not unique or specific to the RC/AL setting, and instead relate to clinical practice and reimbursement constraints in general.
authors: Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC 27517, USA. kanyrop@gmail.com
authors: Kirsten A
authors: KA
authors: Nyrop
authors: Sheryl
authors: S
authors: Zimmerman
authors: Philip D
authors: PD
authors: Sloane
authors: Srikant
authors: S
authors: Bangdiwala
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000328:Adult; D000368:Aged; D040561:Assisted Living Facilities; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D010820:Physicians / Q000523:psychology*; D040242:Risk Reduction Behavior