The purpose of this study to develop a fringed fall prevention program based on King's goal attainment theory and education. This study is applied to the personal, interpersonal, and social systems of fall high-risk patients to test its effects.

This study was a nonequivalent control group pre- and post-test design. There were 52 fall high-risk patients in the experimental group and 45 in the control group. The experimental group received six sessions, with the group sessions lasting 60 minutes and the individual sessions lasting 20~30 minutes. Data were analyzed using descriptive statistics, an χ²-test, a paired sample t-test, and a Wilcoxon signed-ranks test utilizing IBM SPSS software.

For the 3-month intervention period, the fall prevention program was found to be particularly effective for patients in the experimental group (from 3.38 to 1.69 per 1000 patient days; p=.044), as opposed to the control group (from 1.94 to 1.49 per 1000 patient days; p=.300). For the 6-month follow up period, the fall prevention program was again found to be effective for patients in the experimental group (from 3.26 to 0.76 per 1000 patient days; p=.049) compared to the control group (from 1.98 to 1.01 per 1000 patient days; p=.368).

These results indicate that the fringed fall prevention program is very effective in reducing falls, not only during the intervention period, but also after the intervention period has ended. We can therefore recommend this program for use concerning fall high-risk patients in long-term care hospitals.

The aim of this study was to explore characteristics of and risk factors for accidental inpatient falls.

Participants were classified as fallers or non-fallers based on the fall history of inpatients in a tertiary hospital in Seoul between June 2014 and May 2015. Data on falls were obtained from the fall report forms and data on risk factors were obtained from the electronic nursing records. Characteristics of fallers and non-fallers were analyzed using descriptive statistics. Risk factors for falls were identified using univariate analyses and logistic regression analysis.

Average length of stay prior to the fall was 21.52 days and average age of fallers was 61.37 years. Most falls occurred during the night shifts and in the bedroom and were due to sudden leg weakness during ambulation. It was found that gender, BMI, physical problems such elimination, gait, vision and hearing and medications such as sleeping pills, antiarrhythmics, vasodilators, and muscle relaxant were statistically significant factors affecting falls.

The findings show that there are significant risk factors such as BMI and history of surgery which are not part of fall assessment tools. There are also items on fall assessment tools which are not found to be significant such as mental status, emotional unstability, dizziness, and impairment of urination. Therefore, these various risk factors should be examined in the fall risk assessments and these risk factors should be considered in the development of fall assessment tools.

The purpose of this study was to identify which nursing interventions are the most effective in fall prevention for hospitalized patients.

From 3,675 papers searched, 34 were selected for inclusion in the meta-analysis. Number of fallers, falls, falls per 1,000 hospital-days, and injurious falls, fall protection activity, knowledge related to falls, and self-efficacy about falls were evaluated as outcome variables. Data were analyzed using the Comprehensive Meta Analysis (CMA) 2.2 Version program and the effect sizes were shown as the Odd Ratio (OR) and Hedges's g.

Overall effect size of nursing interventions for fall prevention was OR=0.64 (95% CI: 0.57~0.73, p <.05) and Hedges's g= - 0.24. The effect sizes (OR) of each intervention ranged from 0.34 to 0.93, and the most effective nursing intervention was the education & environment intervention (OR=0.34, 95% CI: 0.28~0.42, p <.001), followed by education intervention (OR=0.57, 95% CI: 0.50~0.67, p =.001). Subgroup analyses showed that multifaceted interventions (OR=0.76, 95% CI: 0.73~0.79, p <.001) were more effective than unifactorial interventions, and that activities for prevention of falls (OR=0.08, 95% CI: 0.05~0.15, p <.001) showed the largest effect size among outcome variables.

Falls in hospitalized patients can be effectively prevented using the nursing interventions identified in this study. These findings provide scientific evidence for developing and using effective nursing interventions to improve the safety of hospitalized patients.

The purposes of this study was to develop a comprehensive community-based fall prevention program and to test the effects of the program on the muscle strength, postural balance and fall efficacy for elderly people.

The design of this study was a nonequivalent control group pretest-posttest design. There were 28 participants in the experimental group and 29 in the control group. The program consisted of balance exercises, elastic resistance exercises and prevention education. The program was provided five times a week for 8 weeks and each session lasted 90 minutes. Data were analyzed using χ²-test, independent t-test and paired t-test using the SPSS program.

Muscle strength of the lower extremities, postural balance and fall efficacy scores significantly improved in the experimental group compared to the control group.

These results suggest that this program can improve lower extremity muscle strength, postural balance and fall efficacy in elders. Therefore, this program is recommended for use in fall prevention programs for elders living in the community.

This study was done to propose and test a predictive model that would explain and predict fall prevention behaviors in postmenopausal women. The health belief model was the theoretical basis to aid development of a nursing intervention fall prevention program.

Data for 421 postmenopausal women were selected from an original data set using a survey design. The structural equation model was tested for 3 constructs: modifying factors, expectation factors, and threat factors. Expectation factors were measured as relative perceived benefit (perceived benefit minus perceived barrier), self-efficacy, and health motivation; threat factors, as perceived susceptibility (fear of falling) and perceived severity (avoiding activity for fear of falling); and modifying factors: level of education and knowledge about fall prevention. Data were analyzed using SPSS Windows and AMOS program.

Mean age was 55.7 years (range 45-64), and 19.7% had experienced a fall within the past year. Fall prevention behaviors were explained by expectation and threat factors indicating significant direct effects. Mediating effect of health beliefs was significant in the relationship between modifying factors and fall prevention behaviors. The proposed model explained 33% of the variance.

Results indicate that fall prevention education should include knowledge, expectation, and threat factors based on health belief model.

This study was conducted to determine the effects of a fall prevention program on falls, physical function, psychological function, and home environmental safety in frail elders living at home in rural communities.

The design of this study was a nonequivalent control group pre posttest design. The study was conducted from July to November, 2012 with 30 participants in the experimental group and 30 in the control group. Participants were registered at the public health center of E County. The prevention program on falls consisted of laughter therapy, exercise, foot care and education. The program was provided once a week for 8 weeks and each session lasted 80 minutes.

The risk score for falls and depression in the experimental group decreased significantly compared with scores for the control group. Compliance with prevention behavior related to falls, knowledge score on falls, safety scores of home environment, physical balance, muscle strength of lower extremities, and self-efficacy for fall prevention significantly increased in the experimental group compared with the control group.

These results suggest that the prevention program on falls is effective for the prevention of falls in frail elders living at home.

The purpose of this study was to identify risk factors for pediatric inpatients falls.

The study was a matched case-control design. The participants were 279 patients under the age of 6 who were admitted between January 1, 2004 and December 31, 2009. Through chart reviews, 93 pediatric patients who fell and 186 ones who did not fall were paired by gender, age, diagnosis, and length of stay. Five experts evaluated the 38 fall risk factors selected by the researchers.

In a general hospital, pediatric patients with secondary diagnosis, tests that need the patient to be moved, intravenous lines, hyperactivity, anxiolytics, sedatives and hypnotics, and general anesthetics showed significance for falls on adjusted-odds ratios. Conditional logistic regression analysis was performed to elucidate the factors that influence pediatric inpatient falls. The probability of falls increased with hyperactivity and general weakness. Patients who didn't have tests that required them to be moved and intravenous line had a higher risk of falls.

These findings provide information that is relevant in developing fall risk assessment tools and prevention programs for pediatric inpatient falls.

This study was done to explore factors relating to number of falls among community-dwelling elders, based on gender.

Participants were 403 older community dwellers (male=206, female=197) aged 60 or above. In this study, 8 variables were identified as predictive factors that can result in an elderly person falling and as such, supports previous studies. The 8 variables were categorized as, exogenous variables; perceived health status, somatization, depression, physical performance, and cognitive state, and endogenous variables; fear of falling, ADL & IADL and frequency of falls.

For men, ability to perform ADL & IADL (β₃₂=1.84, p<.001) accounted for 16% of the variance in the number of falls. For women, fear of falling (β₃₁=0.14, p<.05) and ability to perform ADL & IADL (β₃₂=1.01, p<.001) significantly contributed to the number of falls, accounting for 15% of the variance in the number of falls.

The findings from this study confirm the gender-based fall prediction model as comprehensive in relation to community-dwelling elders. The fall prediction model can effectively contribute to future studies in developing fall prediction and intervention programs.

This study was done to identify effects of a fall prevention program on physical fitness and psychological functions in community dwelling elders.

A quasi-experimental study was carried out with a nonequivalent control group pre & post-test design. The program, which included exercises and education, consisted of a 12-week group program and an 8-week self-management program using a health calendar. An experimental group (32) and a control group (21) participated.

There were significant differences in SPPB (t=-3.92, p<.001), TUG test (t=4.94, p<.001), standing with right leg (t=-3.60, p=.001), standing with left leg (t=-3.74, p<.001), front and rear maximum step length test (t=-4.34, p<.001), right-left maximum step length test (t=-2.65, p=.011), and fall efficacy (t=-2.42, p=.019). Fall efficacy, fear of falling and depression showed significant differences following the 12-week exercise program and 8-week self-management program in the experimental group.

Study findings indicate that the fall prevention program is an effective nursing intervention to enhance physical fitness and psychological functions for elders. Using a health calendar, the self-management program was more effective for psychological functions compared to only the group program. Therefore, health providers should develop diversified fall prevention programs which include motivation plans to encourage clients in participating.

This study was done to determine the risk factors for recurrent fallers (2+falls) compared to single fallers.

Participants were 104 community-dwelling people 65 yr of age or older. The data were collected from June 1, 2008 to June 30, 2009 using the Residential Assessment Instrument-Home Care.

Over the past 90 days, 55.7% of the 104 participants fell once, and 44.2% experienced recurrent falls (2+falls). In comparison of recurrent fallers with single fallers, there were significant differences in scores on the following factors: gender (χ²=4.22, p=.040), age (χ²=5.74, p=.017), educational level (χ²=5.22, p=.022), living arrangements (χ²=35.02, p<.001), cardiovascular diseases (χ²=17.10, p<.001), hypertension (χ²=4.43, p=.035), diabetes mellitus (χ²=4.44, p=.035), glaucoma (χ²=13.95, p<.001), Minimal Data Set (MDS)-Pain (t=-2.56, p=.012), fear of falling (χ²=4.08, p=.034), reduced vision (t=-3.06, p=.003), MDS-activity of daily living (t=3.46, p=.001), MDS-Instrumental Activities of daily living (t=3.24, p=.002), cognition (MDS-Cognition Performance Scale) (t=3.40, p=.001), and 'difficulties entering and leaving the house' (χ²=4.53, p=.033).

It is important to assess the risk factors for recurrent falls and develop differentiated strategies that will help prevent recurrent falls. Additionally, utilizing a standardized tool, such as RAI-HC, would help health professionals assess multi-variate fall risk factors to facilitate comparisons of different community care settings.

The purpose of this study was to investigate the factors that increase of the risk for falls in low-income elders in urban areas.

The participants were elderly people registered in one of public health centers in one city. Data were collected by interviewing the elders, assessing their environmental risk factors, and surveying relevant secondary data from the public health center records. For data analysis, descriptive statistics and multiple logistic regression were performed using SPSS version 14.

Stroke, diabetes, visual deficits, frequency of dizziness, use of assistive devices and moderate depression were statistically significant risk factors. The comorbidity of chronic diseases with other factors including depression, visual deficit, dizziness, and use of assistive devices significantly increased the risk of falls. From multiple logistic regression analysis, statistically significant predictors of falls were found to be stroke, total environmental risk scores, comorbiditiy of diabetes with visual deficits, and with depression.

Fall prevention interventions should be multifactorial, especially for the elders with stroke or diabetes, who were identified in this study as the high risk group for falls. A fall risk assessment tool for low-income elders should include both the intrinsic factors like depression, dizziness, and use of assistive devices, and the extrinsic factors.

The purpose of this study was to identify the mediating effect of depression in the relationship between muscle strength of extremities and falls among community-dwelling elderly.

Two hundred forty-seven participants were recruited from a public health center, a hall for the aged and a school for the aged in B city. Face-to-face interviews were conducted using questionnaires from May to September of 2007. Data was analyzed with descriptive statistics, Pearson correlation, and multiple regression using the SPSS WIN 14.0 program.

There was a significantly negative relationship between muscle strength of lower extremities and falls, muscle strength of left upper extremity and falls, and muscle strength of right upper extremity and falls. Depression positively correlated with falls. Depression showed mediating effects between muscle strength of extremities and falls. Weakness of muscle strength of extremities increased depression and the increased depression increased the frequencies of falls.

For the effective management and prevention of community-dwelling older adults’ falls, exercise programs including depression-decreasing strategies should be established. These exercise programs can decrease depression which is the mediator role between the degrees of muscle strength of extremities and falls.

This study was to determine whether the Sun-style 24 forms of Tai Chi exercise improve pain, stiffness, disability, knee joint motion, mobility, balance or falling.

Forty-six community-dwelling elderly subjects (mean age, 75.46±6.28) voluntarily participated in an intervention group of either 24 forms of Sun-style Tai Chi for 60 min, 2 times per week for 12 weeks or a control group. A on-equivalent pretest-posttest design was used. Independent t-test and ANCOVA were used to examine group differences by using SPSS12.0.

The experimental group had significantly less pain (F=7.60, p=.008) and stiffness (t=-3.19, p=.003) than the control group. Also there were significant improvements in knee joint motion on the right knee (t=2.44, p=.019), left knee (t=2.30, p=.026), rising time (F=8.03, p=.07), balance on the left single leg test (t=2.20, p=.033), and fear of falling (t=-2.33, p=.024) in the Tai Chi exercise group. No significant group differences were found in disability and falls efficacy.

The Sun-style 24 forms Tai Chi exercise is effective in decreasing pain, stiffness, fear of falling and it improves balance, rising time, and knee joint motion. We suggest a continuing long term intervention to decrease disability and increase efficacy concerning falls.