title: Mechanical falls: are patients willing to discuss their risk with a health care provider?
abstract: BACKGROUND
  Falls in the elderly cause serious injury.
  
  
  OBJECTIVE
  We aimed to determine subjects' comfort in discussing fall risk and home safety evaluations.
  
  
  METHODS
  This prospective study surveyed a convenience sample of subjects (≥50 years old) in an emergency department (ED), health fair (HF), and family practice (FP). The survey included the Falls Efficacy Scale and Vulnerable Elders Survey-validated surveys measuring fall concern and functional decline. Other data-environmental living conditions, participant behaviors, fall frequency-were collected. The associations between perceived fall risk and participant characteristics were assessed using descriptive statistics and random-effects logistic regression.
  
  
  RESULTS
  Participants (n = 416, 38% males, 62% females) had a mean age of 67.6 years; 35% were high fall risk. Previous year falls (p = 0.002), use of assistive device (p < 0.001), having at least one alcoholic drink/week (p = 0.043), and poor or fair perceived health status (p < 0.001) were associated with perceived fall risk. HF respondents were more willing than FP respondents to discuss falls (84.9% vs. 73.1%, p = 0.025). The difference was not significant between the HF and ED respondents (84.9% vs. 76.9, p = 0.11). HF subjects were more willing than FP to have a home safety inspection (68.9% vs. 45.9%, p < 0.001). The difference was not significant between the HF and ED respondents (68.9% vs 58.5, p = 0.09).
  
  
  CONCLUSIONS
  Perceived and actual fall risks are highly associated. Most participants are willing to discuss their fall risk and a home safety evaluation. HF subjects were most willing to have these discussions; ED subjects were less willing than HF, but not significantly different from health fair participants. FP participants were significantly less willing to have these discussions than HF participants. This may suggest a meaningful opportunity for fall risk prevention in outpatient settings such as health fairs and the ED.
authors.affiliation: Department of Emergency Medicine, Lehigh Valley Hospital and Health Network, Allentown, Pennsylvania.
authors.forename: Marna Rayl
authors.initials: MR
authors.lastname: Greenberg
authors.affiliation: Department of Emergency Medicine, Lehigh Valley Hospital and Health Network, Allentown, Pennsylvania.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Nguyen
authors.affiliation: Department of Family Practice, Lehigh Valley Hospital and Health Network, Allentown, Pennsylvania.
authors.forename: Brian
authors.initials: B
authors.lastname: Stello
authors.affiliation: Department of Family Practice, Lehigh Valley Hospital and Health Network, Allentown, Pennsylvania.
authors.forename: Arnold R
authors.initials: AR
authors.lastname: Goldberg
authors.affiliation: Department of Surgery, Lehigh Valley Hospital and Health Network, Allentown, Pennsylvania.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Barraco
authors.affiliation: Department of Emergency Medicine, Lehigh Valley Hospital and Health Network, Allentown, Pennsylvania.
authors.forename: Bernadette G
authors.initials: BG
authors.lastname: Porter
authors.affiliation: Department of Emergency Medicine, Lehigh Valley Hospital and Health Network, Allentown, Pennsylvania.
authors.forename: Anita
authors.initials: A
authors.lastname: Kurt
authors.affiliation: Department of Emergency Medicine, Lehigh Valley Hospital and Health Network, Allentown, Pennsylvania.
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Dusza
authors.affiliation: Department of Emergency Medicine, Lehigh Valley Hospital and Health Network, Allentown, Pennsylvania.
authors.forename: Bryan G
authors.initials: BG
authors.lastname: Kane
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000428:Alcohol Drinking; D003142:Communication; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D006277:Health Fairs / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D008297:Male; D010358:Patient Participation / Q000523:psychology*; D010465:Perception; D010817:Physician-Patient Relations; D010865:Pilot Projects; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012449:Safety; D012656:Self-Help Devices
keywords: ED; fall risk; fear of falling; mechanical fall