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Original Article
A Predictive Model of Fall Prevention Behaviors in Postmenopausal Women
Hyun-Jung Jang1, Sukhee Ahn2
Journal of Korean Academy of Nursing 2014;44(5):525-533.
DOI: https://doi.org/10.4040/jkan.2014.44.5.525
Published online: October 15, 2014

1Department of Nursing, Kkottongnae University, Chungju

2College of Nursing, Chungnam National University, Daejeon, Korea

1Department of Nursing, Kkottongnae University, Chungju

2College of Nursing, Chungnam National University, Daejeon, Korea

Address reprint requests to : Ahn, Sukhee College of Nursing, Chungnam National University, 266 Munwha-ro, Jung-gu, Daejeon 301-747, Korea Tel: +82-42-580-8324 Fax: +82-42-580-8309 E-mail: sukheeahn@cnu.ac.kr
• Received: June 2, 2014   • Revised: June 19, 2014   • Accepted: August 18, 2014

Copyright © 2014 Korean Society of Nursing Science

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

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  • Purpose
    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.
  • Methods
    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.
  • Results
    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.
  • Conclusion
    Results indicate that fall prevention education should include knowledge, expectation, and threat factors based on health belief model.
Figure 1.
Theoretical framework for this study.
jkan-44-525f1.jpg
Figure 2.
Standardized estimates and explained variances in model for fall prevention behaviors.
jkan-44-525f2.jpg
Table 1.
Descriptive Statistics and Relationships among Study Variables for Fall Prevention Behaviors (N=421)
Variables Categories (Range) n (%) or M±SD x1
x2
x3
y1
y2
y3
y4
y5
r (p) r (p) r (p) r (p) r (p) r (p) r (p) r (p)
x1 ≤High school 262 (62.2) 1
≥College 159 (37.8)
x2 (6-24) 18.16±3.90 .12 (.013) 1
x3 Yes 83 (19.7) .04 .06 1
No 338 (80.3)
y1 (-11-16) 2.53±4.72 .10 (.041) .27 (<.001) .07 1
y2 (7-35) 26.43±4.73 .06 .39 .04 .37 1
(<.001) (<.001)
y3 (6-30) 20.00±4.07 .18 .26 −.01 .33 .33 1
(<.001) (<.001) (<.001) (<.001)
y4 (1-4) 1.96±0.71 −.06 −.03 .09 −.04 −.10 −.01 1
(.044)
y5 (11-34) 15.40±5.17 −.17 −.18 .10 −.15 −.28 −.07 .32 1
(<.001) (<.001) (.044) (.002) (<.001) (<.001)
y6 (7-28) 15.66±4.51 .06 .25 .12 .46 .16 .29 .10 .04
(<.001) (.018) (<.001) (.001) (<.001) (.036)

x1=Level of education (1=college and above); x2=Knowledge about fall prevention; x3=History of falls (1=yes); y1=Perceived benefits-barriers; y2=Perceived self-efficacy; y3=Health motivation; y4=Perceived susceptibility; y5=Perceived severity; y6=Fall prevention behaviors.

Table 2.
Effects of Explanatory Variables on Fall Prevention Behaviors (N=421)
Endogenous variables Exogenous variables Direct effect
Indirect effect
Total effect
SMC
ß (p) ß (p) ß (p)
Expectation factors Modifying factors .86 (<.001) .86 .73
Threat factors Modifying factors −.38 (<.001) −.38 .14
Fall prevention behaviors Modifying factors .43 (.022) .43 .33
Expectation factors .61 (<.001) .63
Threat factors .25 (<.001) .26

ß=Standardized coefficients; SMC=Squared multiple correlation.

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Figure & Data

REFERENCES

    Citations

    Citations to this article as recorded by  
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    A Predictive Model of Fall Prevention Behaviors in Postmenopausal Women
    Image Image
    Figure 1. Theoretical framework for this study.
    Figure 2. Standardized estimates and explained variances in model for fall prevention behaviors.
    A Predictive Model of Fall Prevention Behaviors in Postmenopausal Women
    Variables Categories (Range) n (%) or M±SD x1
    x2
    x3
    y1
    y2
    y3
    y4
    y5
    r (p) r (p) r (p) r (p) r (p) r (p) r (p) r (p)
    x1 ≤High school 262 (62.2) 1
    ≥College 159 (37.8)
    x2 (6-24) 18.16±3.90 .12 (.013) 1
    x3 Yes 83 (19.7) .04 .06 1
    No 338 (80.3)
    y1 (-11-16) 2.53±4.72 .10 (.041) .27 (<.001) .07 1
    y2 (7-35) 26.43±4.73 .06 .39 .04 .37 1
    (<.001) (<.001)
    y3 (6-30) 20.00±4.07 .18 .26 −.01 .33 .33 1
    (<.001) (<.001) (<.001) (<.001)
    y4 (1-4) 1.96±0.71 −.06 −.03 .09 −.04 −.10 −.01 1
    (.044)
    y5 (11-34) 15.40±5.17 −.17 −.18 .10 −.15 −.28 −.07 .32 1
    (<.001) (<.001) (.044) (.002) (<.001) (<.001)
    y6 (7-28) 15.66±4.51 .06 .25 .12 .46 .16 .29 .10 .04
    (<.001) (.018) (<.001) (.001) (<.001) (.036)
    Endogenous variables Exogenous variables Direct effect
    Indirect effect
    Total effect
    SMC
    ß (p) ß (p) ß (p)
    Expectation factors Modifying factors .86 (<.001) .86 .73
    Threat factors Modifying factors −.38 (<.001) −.38 .14
    Fall prevention behaviors Modifying factors .43 (.022) .43 .33
    Expectation factors .61 (<.001) .63
    Threat factors .25 (<.001) .26
    Table 1. Descriptive Statistics and Relationships among Study Variables for Fall Prevention Behaviors (N=421)

    x1=Level of education (1=college and above); x2=Knowledge about fall prevention; x3=History of falls (1=yes); y1=Perceived benefits-barriers; y2=Perceived self-efficacy; y3=Health motivation; y4=Perceived susceptibility; y5=Perceived severity; y6=Fall prevention behaviors.

    Table 2. Effects of Explanatory Variables on Fall Prevention Behaviors (N=421)

    ß=Standardized coefficients; SMC=Squared multiple correlation.


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