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http://dx.doi.org/10.4040/jkan.21230

Development and Effects of a Person-Centered Fall Prevention Program for Older Adults with Dementia in Long-Term Care Hospitals: For Older Adults with Dementia and Caregivers in Long-Term Care Hospitals  

Lim, Jeong Ok (Department of Nursing, Kyongbuk Science College)
Gu, Mee Ock (College of Nursing, Gyeongsang National University)
Publication Information
Journal of Korean Academy of Nursing / v.52, no.3, 2022 , pp. 341-358 More about this Journal
Abstract
Purpose: This study examined the effects of a person-centered fall prevention program for older adults with dementia in long-term care hospitals. Methods: A nonequivalent control group pretest-posttest design was used. The study sample included 42 older adults with dementia (experimental group: 21, control group: 21) and 42 caregivers (experimental group: 21, control group: 21). The program comprised 48 sessions held over 12 weeks and included exercise intervention with resistance and balance, dance walking (45~60 min, three times/week), cognitive and emotional intervention (35~50 min, once per week), and person-centered fall prevention education (10 min, once per week). The program for caregivers consisted of six educational sessions (i.e., fall prevention competency enhancement and person-centered care strategy education, 80 min, once per week) for six weeks. Data were collected before participation and 12 weeks after program completion from February 18 to May 12, 2019. Data analysis was conducted using the chi-square test, t-test, and Mann-Whitney U test with SPSS/WIN 21.0. Results: The experimental group of older adults with dementia showed significant improvement in physical and cognitive functions, and a decrease in depression, and behavioral and psychological symptoms, when compared with the control group. caregivers in the experimental group exhibited significant improvement in fall-related knowledge and person-centered care of older adults with dementia compared to the control group. Conclusion: The study findings indicate that this program was effective as a nursing intervention for fall prevention among older adults with dementia in long-term care hospitals.
Keywords
Dementia; Accidental Falls; Caregiver; Long-Term Care;
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1 Ministry of Health and Welfare (MOHW). The 4th national dementia plan (2021-2025). Sejong: Ministry of Health and Welfare; 2020. p. 60.
2 Health Insurance Review and Assessment Service, National Health Insurance Service. 2020 National health insurance statistical yearbook. Wonju: Health Insurance Review and Assessment Service, National Health Insurance Service; 2021. p. 845.
3 Kwon JD. Social services for the elderly. 5th ed. Seoul: Hakjisa; 2013. p. 526.
4 Chung SH, Jho KH, Shin YM. Analysis of the risk factors and psychotropics' role in the falls of the dementic elderlies in a nursing home. Journal of Korean Geriatric Psychiatry. 2001;5(1):76-85.
5 Kim HS. A study on the attitudes toward working with older adults and the behavior toward the elderly among caregivers. Journal of Welfare for the Aged. 2013;59:95-114. https://doi.org/10.21194/kjgsw..59.201303.95   DOI
6 Chenoweth L, King MT, Jeon YH, Brodaty H, Stein-Parbury J, Norman R, et al. Caring for Aged Dementia Care Resident Study (CADRES) of person-centred care, dementia-care mapping, and usual care in dementia: A cluster-randomised trial. Lancet Neurology. 2009;8(4):317-325. https://doi.org/10.1016/S1474-4422(09)70045-6 Erratum in: Lancet Neurology. 2009;8(5):419.   DOI
7 Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods. 2009;41(4):1149-1160. https://doi.org/10.3758/BRM.41.4.1149   DOI
8 Pellfolk T, Gustafsson T, Gustafson Y, Karlsson S. Risk factors for falls among residents with dementia living in group dwellings. International Psychogeriatrics. 2009;21(1):187-194. https://doi.org/10.1017/S1041610208007837   DOI
9 Lim JO, Gu MO. Fall-related circumstances and fall risk factors among inpatients with dementia in long-term care hospital. Journal of Korean Gerontological Nursing. 2016;18(2): 72-83. https://doi.org/10.17079/jkgn.2016.18.2.72   DOI
10 Kanemura N, Kobayashi R, Inafuku K, Hosoda M, Minematsu A, Sasaki H, et al. Analysis of risk factors for falls in the elderly with dementia. Journal of Physical Therapy Science. 2000;12(1):27-31. https://doi.org/10.1589/jpts.12.27   DOI
11 Hong S, Park H. A meta-analysis of the risk factors related to falls among elderly patients with dementia. Korean Journal of Adult Nursing. 2017;29(1):51-62. https://doi.org/10.7475/kjan.2017.29.1.51   DOI
12 Shin J. Prevalence and management of falls among elderly in a hospital [master's thesis]. Seoul: Hanyang University; 2011. p. 1-63.
13 Cha HS, Hwang SW. Analyses of studies on the intervention programs for the prevention of falls in elderly with dementia. Journal of the Korea Academia-Industrial Cooperation Society. 2018;19(6):391-404. https://doi.org/10.5762/KAIS.2018.19.6.391   DOI
14 Lim JO, Gu MO. The influence of fall-related knowledge and fall prevention self-efficacy of care-givers working in longterm care hospitals with older adults with dementia on fall prevention behaviors and fall management behaviors. Korean Journal of Health Service Management. 2018;12(4):155-172. https://doi.org/10.12811/kshsm.2018.12.4.172   DOI
15 McCormack B, McCance T. Person-centred nursing: Theory, models and methods. Chichester: Wiley-Blackwell; 2010. p. 1-31.
16 Kim YJ. Effects of a resistant balance exercise on ADL and fall-related fitness of older adults with dementia [master's thesis]. Seoul: Korea National Sport University; 2015. p. 1-60.
17 Kim M, Kim JS. Effects of the Fall Prevention Education Program (FPEP) for caregivers in elderly care facilities on fall-related knowledge, fall-related burden, and caring behaviors for fall prevention. Journal of the Korea Contents Association. 2013;13(11):778-790. https://doi.org/10.5392/JKCA.2013.13.11.778   DOI
18 Sheikh JI, Yesavage JA. Geriatric Depression Scale (GDS) recent evidence and development of a shorter version. In: Brink TL, editor. Clinical gerontology: a guide to assessment and intervention. New York (NY): The Haworth Press; 1986. p. 165-173.
19 Suhonen R, Gustafsson ML, Katajisto J, Valimaki M, Leino-Kilpi H. Nurses' perceptions of individualized care. Journal of Advanced Nursing. 2010;66(5):1035-1046. https://doi.org/10.1111/j.1365-2648.2009.05256.x   DOI
20 Capezuti E, Taylor J, Brown H, Strothers HS 3rd, Ouslander JG. Challenges to implementing an APN-facilitated falls management program in long-term care. Applied Nursing Research. 2007;20(1):2-9. https://doi.org/10.1016/j.apnr.2005.11.002   DOI
21 Ju HJ, Jeon MY. Effects of walking program with dance on gait, cognition, and risk of falls of elderly with dementia in a long-term care hospital. Journal of Korean Biological Nursing Science. 2018;20(3):141-149. https://doi.org/10.7586/jkbns.2018.20.3.141   DOI
22 Kwon YC, Park JH. Korean version of mini-mental state examination (MMSE-K) part 1: Development of the test for the elderly. Journal of the Korean Neuropsychiatric Association. 1989;28(1):125-135.
23 Kee BS. A preliminary study for the standardization of geriatric depression scale short form-Korea version. Journal of the Korean Neuropsychiatric Association. 1996;35(2):289-307.
24 Bohannon RW. Sit-to-stand test for measuring performance of lower extremity muscles. Perceptual and Motor Skills. 1995;80(1):163-166. https://doi.org/10.2466/pms.1995.80.1.163   DOI
25 Schoenfelder DP. A fall prevention program for elderly individuals: Exercise in long-term care settings. Journal of Gerontological Nursing. 2000;26(3):43-51. https://doi.org/10.3928/0098-9134-20000301-09   DOI
26 Health Insurance Review and Assessment Service (HIRA). Long term care hospital health insurance cost guidelines pilot projects. 3rd ed. Seoul: Health Insurance Review and Assessment Service; 2005. p. 1-20.
27 Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged. The index of ADL: A standardized measure of biological and psychosocial function. JAMA. 1963;185:914-919. https://doi.org/10.1001/jama.1963.03060120024016   DOI
28 Kim JM, Shin IS, Yoon JS, Lee HY. Comparison of diagnostic validities between MMSE-K and K-MMSE for screening of dementia. Journal of Korean Neuropsychiatric Association,. 2003;42(1):124-130.
29 Lee NY, Kim SH, Kim TY. The effect of proprioceptive neuromuscular facilitation and traditional trunk stabilization training on the rectus abdominis muscle contraction. Journal of the Korean Academy of Clinical Electrophysiology. 2009; 7(1):43-48. https://doi.org/10.5627/KACE.2009.7.1.043   DOI
30 Yao L, Giordani BJ, Algase DL, You M, Alexander NB. Fall risk-relevant functional mobility outcomes in dementia following dyadic Tai Chi exercise. Western Journal of Nursing Research. 2013;35(3):281-296. https://doi.org/10.1177/0193945912443319   DOI
31 Yoon JA, Cho YN. Effect of cognitive occupational therapy programs for community-dwelling elderly with dementia. Journal of Occupational Therapy for the Aged and Dementia. 2009;3(2):33-43.
32 Wesson J, Clemson L, Brodaty H, Lord S, Taylor M, Gitlin L, et al. A feasibility study and pilot randomised trial of a tailored prevention program to reduce falls in older people with mild dementia. BMC Geriatrics. 2013;13:89. https://doi.org/10.1186/1471-2318-13-89   DOI
33 Choi SH, Na DL, Kwon HM, Yoon SJ, Jeong JH, Ha CK. The Korean version of the neuropsychiatric inventory: A scoring tool for neuropsychiatric disturbance in dementia patients. Journal of Korean Medical Science. 2000;15(6):609-615. https://doi.org/10.3346/jkms.2000.15.6.609   DOI
34 Hwang IY. A study on knowledge, attitude, and implementation of clinical nursing practice guideline for fall prevention among hospital nurses working in the small and medium sized hospitals [master's thesis]. Jinju: Gyeongsang National University; 2011. p. 1-75.
35 Dykes PC, Carroll D, McColgan K, Hurley AC, Lipsitz SR, Colombo L, et al. Scales for assessing self-efficacy of nurses and assistants for preventing falls. Journal of Advanced Nursing. 2011;67(2):438-449. https://doi.org/10.1111/j.1365-2648.2010.05501.x   DOI
36 Zieschang T, Schwenk M, Oster P, Hauer K. Sustainability of motor training effects in older people with dementia. Journal of Alzheimer's Disease. 2013;34(1):191-202. https://doi.org/10.3233/JAD-120814   DOI
37 Gu MO, Jeon MY, Eun Y. The development & effect of an tailored falls prevention exercise for older adults. Journal of Korean Academy of Nursing. 2006;36(2):341-352. https://doi.org/10.4040/jkan.2006.36.2.341   DOI
38 Kim SN. Effects of a multifactorial fall prevention program on physical.psychological function and home environmental hazards in community dwelling low-income elderly. Journal of the Korean Gerontological Society. 2012;32(2):377-395.
39 Song JA, Park JW. Effects of an institution-based group walking program(IGWP) to manage wandering behavior of persons with dementia residing in nursing homes: A pilot study. Journal of Korean Gerontological Nursing. 2011;13(1): 37-47.
40 Jeong H, Park M. A predictive model on patient-centered care of hospital nurses in Korea. Journal of Korean Academy of Nursing. 2019;49(2):191-202. https://doi.org/10.4040/jkan.2019.49.2.191   DOI
41 Lim YM. Effects of movement/exercise on physical and emotional functioning in elders with cognitive impairments. Journal of the Korea Gerontological Society. 2002;21(3):197-211.
42 Rosendahl E, Gustafson Y, Nordin E, Lundin-Olsson L, Nyberg L. A randomized controlled trial of fall prevention by a high-intensity functional exercise program for older people living in residential care facilities. Aging Clinical and Experimental Research. 2008;20(1):67-75. https://doi.org/10.1007/BF03324750   DOI
43 Kang JH. A qualitative study on care workers' care experiences regarding falls at nursing home settings. Social Science Research Review Kyungsung University. 2016;32(3):129-154. https://doi.org/10.18859/ssrr.2016.08.32.3.129   DOI
44 Rolland Y, Pillard F, Klapouszczak A, Reynish E, Thomas D, Andrieu S, et al. Exercise program for nursing home residents with Alzheimer's disease: A 1-year randomized, controlled trial. Journal of the American Geriatrics Society. 2007;55(2):158-165. https://doi.org/10.1111/j.1532-5415.2007.01035.x   DOI
45 Toulotte C, Fabre C, Dangremont B, Lensel G, Thevenon A. Effects of physical training on the physical capacity of frail, demented patients with a history of falling: A randomised controlled trial. Age and Ageing. 2003;32(1):67-73. https://doi.org/10.1093/ageing/32.1.67   DOI
46 Jung JY, Jung GH. The affect factors of geriatric hospital nurse's falls prevention activities. Journal of Health Informatics and Statistics. 2016;41(2):203-211. https://doi.org/10.21032/jhis.2016.41.2.203   DOI
47 Pitkala KH, Poysti MM, Laakkonen ML, Tilvis RS, Savikko N, Kautiainen H, et al. Effects of the Finnish Alzheimer disease exercise trial (FINALEX): A randomized controlled trial. JAMA Internal Medicine. 2013;173(10):894-901. https://doi.org/10.1001/jamainternmed.2013.359   DOI