An evidence-based guideline for reducing fear of falling among community-dwelling older adults : a multi-component psycho-therapeutic intervention

Abstract

Falls among the elderly are a major health issue in Hong Kong. This problem has been worsening and has become a public concern for the aging population. In Hong Kong, over 30,000 community-dwelling older adults have needed hospital admission after falling, and billions of dollars are spent on the related medical costs. The prevalence of recurrent falls is high. However, a lack of concern in helping community-dwelling older adults to prevent recurrent falling currently persists in clinical field.

A local study reported that most community-dwelling older adults have a fear of falling (FOF) after an accidental fall. Thus, reducing FOF can reduce the fall rate because FOF and falls are interdependent. A systematic review can show that multi-component psycho-therapeutic intervention is effective in reducing FOF. Therefore, the establishment of a standardized evidence-based practice (EBP) guideline to reduce FOF among community-dwelling older adults via multi-component psycho-therapeutic intervention is necessary.

This thesis aims to develop an EBP guideline to reduce FOF among community-dwelling older adults via multi-component psycho-therapeutic intervention. Seven related studies were reviewed and appraised as having a high level of evidence. These studies also reported to have significantly positive effects on the clients. The transferability and feasibility of the proposed program in Hospital A were examined, and the results show that the transferability and feasibility of the proposed program were high. An EBP guideline and an implementation plan were then developed. A pilot test was proposed to determine and solve the difficulties in the implementation process. Then, the guideline was refined. A comprehensive evaluation plan of the proposed program is included in the final chapter.

The standardized EBP guideline, which is an evidence-based approach, provides a clear pathway for practitioners to educate community-dwelling older adults in reducing FOF via multi-component psycho-therapeutic intervention. This method contributes to the reduction in the recurrent fall rate and the decrease in related medical costs.