title: 'My independent streak may get in the way': how older adults respond to falls prevention education in hospital.
abstract: The aim of the study was to determine how providing individualised falls prevention education facilitated behaviour change from the perspective of older hospital patients on rehabilitation wards and what barriers they identified to engaging in preventive strategies.
  
  
  
  A prospective qualitative survey.
  
  
  
  Older patients (n=757) who were eligible (mini-mental state examination score>23/30) received falls prevention education while admitted to eight rehabilitation hospital wards in Western Australia. Subsequently, 610 participants were surveyed using a semistructured questionnaire to gain their response to the in-hospital education and their identified barriers to engaging in falls prevention strategies. Deductive content analysis was used to map responses against conceptual frameworks of health behaviour change and risk taking.
  
  
  
  Participants who responded (n=473) stated that the education raised their awareness, knowledge and confidence to actively engage in falls prevention strategies, such as asking for assistance prior to mobilising. Participants' thoughts and feelings about their recovery were the main barriers they identified to engaging in safe strategies, including feeling overconfident or desiring to be independent and thinking that staff would be delayed in providing assistance. The most common task identified as potentially leading to risk-taking behaviour was needing to use the toilet.
  
  
  
  Individualised education assists older hospital rehabilitation patients with good levels of cognition to engage in suitable falls prevention strategies while on the ward. Staff should engage with patients to understand their perceptions about their recovery and support patients to take an active role in planning their rehabilitation.
authors.affiliation: School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Hill
authors.affiliation: Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Western Australia, Australia.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Francis-Coad
authors.affiliation: Department of Physiotherapy, Monash University, Melbourne, Victoria, Australia Allied Health Research Unit, Monash Health, Melbourne, Victoria, Australia.
authors.forename: Terry P
authors.initials: TP
authors.lastname: Haines
authors.affiliation: Department of Rehabilitation and Aged Care, Armadale Kelmscott Memorial Hospital, Perth, Western Australia, Australia Health Strategy and Networks, Strategic System, Policy & Planning, Department of Health, Government of Western Australia, Perth, Western Australia, Australia.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Waldron
authors.affiliation: WA Centre for Health and Ageing, Royal Perth Hospital Unit, School of Medicine & Pharmacology and Centre for Medical Research, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Christopher
authors.initials: C
authors.lastname: Etherton-Beer
authors.affiliation: WA Centre for Health and Ageing, Royal Perth Hospital Unit, School of Medicine & Pharmacology and Centre for Medical Research, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Leon
authors.initials: L
authors.lastname: Flicker
authors.affiliation: Department of Rehabilitation and Aged Care, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
authors.forename: Katharine
authors.initials: K
authors.lastname: Ingram
authors.affiliation: Centre for Functioning and Health Research, Metro South Health, Brisbane, Queensland, Australia Institute of Health and Biomedical Innovation and School of Public Health & Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.
authors.forename: Steven M
authors.initials: SM
authors.lastname: McPhail
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D001290:Attitude; D001364:Awareness; D003071:Cognition; D004644:Emotions; D006760:Hospitalization; D006761:Hospitals; D006801:Humans; D009042:Motivation; D010353:Patient Education as Topic; D011446:Prospective Studies; D036301:Qualitative Research; D012309:Risk-Taking; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D014038:Toilet Facilities; D014904:Western Australia
keywords: GERIATRIC MEDICINE