Defining a fall and reasons for falling: Comparisons among the views of seniors, health care providers, and the research literature

School of Kinesiology, The University of Western Ontario, London, ON, N6A 3K7 Canada.
The Gerontologist (Impact Factor: 3.21). 07/2006; 46(3):367-76. DOI: 10.1093/geront/46.3.367
Source: PubMed

ABSTRACT The purpose of this study was (a) to obtain information about the perceptions held by seniors and health care providers concerning what constitutes a fall and potential reasons for falling, and (b) to compare these perceptions to the research literature.
As part of a larger telephone survey, interviewers asked 477 community-dwelling seniors to define a fall and to provide reasons for falling. In addition, we interviewed 31 health care providers from the community on the same topics. In order to capture patterns in conceptualized thinking, we used content analysis to develop codes and categories for a fall definition and reasons for falling. We reviewed selected articles in order to obtain a comprehensive overview of fall definitions currently used in the research and prevention literature.
A fall had different meanings for different groups. Seniors and health care providers focused mainly on antecedents and consequences of falling, whereas researchers described the fall event itself. There were substantial differences between the reasons for falling as reported by seniors and the risk factors as identified in the research literature.
If not provided with an appropriate definition, seniors can interpret the meaning of a fall in many different ways. This has the potential to reduce the validity in studies comparing fallers to nonfallers. Research reports and prevention programs should always provide an operational definition of a fall. In communication between health care providers and seniors, an appropriate definition increases the possibility for early detection of seniors in greater need of care and services.

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    • "When surveyed, older adults suggested that their balance, inattention and medical conditions were the most frequent reasons for falls (Zecevic et al. 2006). When interviewed about a recent fall in the hospital, the major reason patients said they fell was the need to use the toilet coupled with loss of balance and unexpected weakness (Carroll et al. in press). "
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    • "False-reporting or not reporting of falls can be related to the cognitive status of the subjects, the shame of reporting, the fear of consequences, or simply difficulties in defining a fall. Zecevic et al. showed that fallers and caregivers may have different definitions of falling [2]. For example, falling to the ground without an injury might not be interpreted as a fall by every person. "
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    • "Note: bold categories were unique to the autonomy-supportive condition; categories in italics were unique to the controlling condition Motiv Emot (2008) 32:200–212 207 the analysis that although similar phrases had been used in both conditions, the extent to which participants used these differed. In a similar fashion to Zecevic et al. (2006), a unit frequency graph was compiled to further illustrate differences between the two content analyses (see Fig. 2). This shows a differing pattern in the frequency of self-talk content across the two conditions, in that fewer controlling or restrictive (e.g., explicit instructions, self-criticism) and more informative (e.g., feedback regarding task progress, planning) statements were used in the autonomy-supportive condition. "
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