Objective To integrate the falling experience and coping styles of stroke home patients with falls through Meta synthesis, summarize existing problems based on the integration results, and propose suggestions. Methods We searched databases including PubMed, Medline, Embase, Web of Science, etc., from database establishment to January 2023, to collect qualitative studies on stroke patients’ falling experience at home. The quality of included studies was evaluated by “JBI Australian Evidence-based Health Care Centre (2008) Qualitative Research Quality Assessment Criteria”. The results were integrated by integrating methods. Results A total of 6 references were included, and 18 clear research results were extracted. Similar results were summarized and combined to form 6 new categories, and integrated into 3 main themes. The integration results showed that stroke patients with falls had severe psychological problems, poor coping styles, and unmet needs for fall prevention, resulting in reduced social participation and exercise. Conclusions It is necessary to improve the content of fall assessment and provide corresponding fall prevention health education based on the assessment results. It helps stroke patients and caregivers at home to establish correct coping strategies, thereby avoiding the occurrence of falls.
Objective To construct an intervention program for postoperative fear of falling in elderly patients with hip fracture based on cognitive behavioral theory. Methods Based on cognitive behavioral theory and literature review, an initial draft of intervention plan for postoperative fear of falling in elderly patients with hip fracture was constructed. From January to March 2025, after two rounds of expert consultations and revisions, the final plan was formed. Results A total of 16 experts across the country were invited to participate in two rounds of Delphi expert consultations, covering areas such as orthopedic clinical nursing, orthopedic clinical medicine, nursing education, nursing management, rehabilitation therapy, and psychological therapy. The active participation rates for the two rounds of consultations were 94.12% and 100.00%, respectively. The expert authority coefficients were 0.860 and 0.907, respectively, and the Kendall harmony coefficients were 0.369 and 0.524, respectively. Ultimately, a program composed of 5 primary indicators (fall fear management team, fall fear management goals, fall fear assessment, fall fear intervention measures, and post-intervention effect evaluation), 17 secondary indicators, and 31 tertiary indicators was constructed. Conclusion The intervention program for postoperative fear of falling in elderly patients with hip fracture based on cognitive behavior theory constructed in this study is scientific and operable, which can provide reference and guidance for clinical nursing staff.
Objective To evaluate the effect of Otago exercise program (OEP) on fear of falling in central hemiplegia patients in communities. Methods We collected the clinical data of 61 central hemiplegia patients in the Department of Neurology of Pangang General Hospital from January to June 2014. They were randomly divided into treatment group (n=30) and control group (n=31) after discharge. The treatment group had OEP, while the control group had not. After 20 weeks of follow-up, we evaluated fall self-efficacy, balance and mobility of patients in the two groups. Results The OEP adherence rate was 73.3% for the treatment group. In the treatment group, modified fall efficacy scale (MFES) score and Berg balance scale (BBS) score were significantly higher than those before intervention (P<0.05); time up and go test (TUGT) score was significantly lower than that before intervention (P<0.05). In the control group, MFES score, BBS score and TUGT score were not significantly changed (P>0.05). After intervention, MFES score and BBS score of the treatment group were significantly higher than those of the control group (P<0.05), but TUGT score was not significantly different (P>0.05). Conclusion OEP for central hemiplegia patients after discharge can reduce fall self-efficacy and increase balance ability of the patients.
Objective To systematically review injury, death, and their causes in elderly people in China from 2000 to 2020 and to prevent and reduce the occurrence of injuries and death. Methods The CNKI, VIP, WanFang Data, PubMed, SinoMed, and Web of Science databases were searched to collect studies on injury and death among elderly people over 60 years of age who resided in China from January 2000 to December 2020. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. A meta-analysis was then performed using R 4.1.2 software. Results A total of 41 studies with 187 488 subjects were included, including 125 million elderly individuals. The pooled injury mortality rate was 135.58/105 (95%CI 113.36/105 to 162.14/105, P<0.001). Subgroup analysis showed that male injury death (146.00/105, 95%CI 116.00 to 183.74, P=0.001) was significantly higher than that of females (127.90/105, 95%CI 102.31 to 159.88, P=0.001) and that overall injury mortality increased exponentially with age (R2=0.957), especially in those over 80 years old. The spatial distribution showed that the injury death rate in the central region was higher than that in the east and west and higher in the countryside than in the city. The time of death distribution showed that after China became an aging society (2000-2020), the time of death was significantly later than before (1990-2000). There were more than 12 types of injuries that caused death, the top three of which were falling, traffic accidents, and suicide. Conclusion From 2000 to 2020, the injury mortality rate of the elderly people in China initially increase and then slightly decrease. The phenomenon affects more men than women, especially those beyond the age of 80. Regional differences are identified, and the types of injuries that cause death are mainly falls, traffic accidents, and suicide. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.