title: Investigating the relationship between reduced self-awareness of falls risk, rehabilitation engagement and falls in older adults.
abstract: The present study aimed to investigate whether self-awareness of falls risk is associated with rehabilitation engagement, motivation for rehabilitation, and number of falls after hospital discharge. The sample comprised 91 older adults (Mage=77.97, SD=8.04) undergoing inpatient rehabilitation. The Self-Awareness of Falls Risk Measure (SAFRM) was used to measure different aspects of self-awareness. The treating physiotherapist and occupational therapist rated the patient's engagement in rehabilitation and the patient reported his/her motivation for treatment. Falls information was collected from the patient and significant other once a month for three months following hospital discharge. Significant correlations were found between physiotherapist-rated engagement and intellectual (rs=-0.22, p<0.05) and anticipatory awareness (rs=-0.24, p<0.05). Occupational therapist-rated engagement and patient-reported motivation for rehabilitation was correlated with emergent awareness (rs=-0.38 and -0.31, p<0.05, respectively) and overall self-awareness (rs=-0.31 and -0.26, p<0.05, respectively). Regression analyses indicated that overall self-awareness provided a unique contribution to occupational therapist-rated engagement when controlling for age, gender, cognition and functional ability. Falls were reported by 29.9% of participants, however, self-awareness did not differ significantly between fallers and non-fallers. The findings suggest that self-awareness of falls risk is associated with rehabilitation engagement and motivation. Therefore, improving patient self-awareness of falls risk may increase engagement in therapy leading to better patient outcomes.
authors.affiliation: School of Psychological Sciences, Monash University, Wellington Road, Clayton, VIC 3800, Australia.
authors.forename: Tijana
authors.initials: T
authors.lastname: Mihaljcic
authors.affiliation: Department of Physiotherapy, Monash University, McMahons Road, Frankston, VIC 3199, Australia; Allied Health Research Unit, Monash Health, Warrigal Road, Cheltenham, VIC 3192, Australia.
authors.forename: Terry P
authors.initials: TP
authors.lastname: Haines
authors.affiliation: School of Psychological Sciences, Monash University, Wellington Road, Clayton, VIC 3800, Australia; Monash-Epworth Rehabilitation Research Centre, Suite 1.7, 173 Lennox Street, VIC 3121, Australia.
authors.forename: Jennie L
authors.initials: JL
authors.lastname: Ponsford
authors.affiliation: School of Psychological Sciences, Monash University, Wellington Road, Clayton, VIC 3800, Australia. Electronic address: Rene.Stolwyk@monash.edu.
authors.forename: Renerus J
authors.initials: RJ
authors.lastname: Stolwyk
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001364:Awareness; D003071:Cognition / Q000502:physiology*; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D009042:Motivation / Q000502:physiology*
keywords: Engagement; Falls; Motivation; Rehabilitation; Self-awareness