title: Listening with a narrative ear: Insights from a study of fall stories in older adults.
abstract: OBJECTIVE
  To determine the value of adding a patient narrative to the clinical assessment of falls in the elderly.
  
  
  METHODS
  Qualitative study of interviews.
  
  
  METHODS
  A fall prevention clinic in Calgary, Alta.
  
  
  METHODS
  Fifteen older adults on a wait list for assessment by the fall clinic and the physiotherapists who assessed them.
  
  
  METHODS
  Participants' stories were audiorecorded and later transcribed and summarized. Stories were collected using open-ended questions, first inviting participants to tell the interviewer about themselves, and then the circumstances of their falls and their reflections on them. In a subsequent visit, transcriptions or summaries were returned to patients for member checking. Narratives were read and analyzed by all 4 investigators using a narrative approach and a close-reading technique. With the patients' additional consent, stories were shared with the fall prevention team for their insights and reactions. Interviews with physiotherapists were audiorecorded and transcribed.
  
  
  RESULTS
  The narrative analysis provided new insights into the attitudes about and perceptions of the causes of falls, their effects, and rehabilitation. Close reading exposed presentation of self, locus of control, and underlying social and emotional issues.
  
  
  CONCLUSIONS
  The addition of patient narratives to clinical assessments offers clinicians an understanding of patients' perspectives, which can be used to better engage patients in rehabilitation.
authors.affiliation: Family physician with a community geriatric practice in Calgary, Alta, and is Assistant Clinical Professor and a member of the Health Humanities group at the University of Calgary. perelesl@telus.net.
authors.forename: Laurie
authors.initials: L
authors.lastname: Pereles
authors.affiliation: Retired from the Department of English at the University of Calgary.
authors.forename: Roberta
authors.initials: R
authors.lastname: Jackson
authors.affiliation: Associate Professor Emeritus of Critical Care Medicine in the Cumming School of Medicine at the University of Calgary, Founding Medical Director of Clinical Informatics for the Calgary Health Region, and a founding member of the Health Humanities group at the University of Calgary.
authors.forename: Tom
authors.initials: T
authors.lastname: Rosenal
authors.affiliation: Assistant Professor in the Cumming School of Medicine at the University of Calgary and a family physician working in a community health centre for inner-city older adults.
authors.forename: Lara
authors.initials: L
authors.lastname: Nixon
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D000416:Alberta; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D033262:Narration; D036301:Qualitative Research