Developing a fall prevention program in an inpatient spinal cord injury rehabilitation unit: A participatory action research study.

IMPORTANCE: Spinal cord injury is a lifelong disability necessitating early management of falls during inpatient admissions. However, there is a paucity of research on fall prevention and management in Spinal cord injury rehabilitation. OBJECTIVE(S): This study aimed at developing a fall prevention program in an inpatient rehabilitation Spinal cord injury unit. METHOD: A participatory action research approach utilizing a before-and-after, mixed-method design was employed for this study. The study was performed at Rofaydeh Rehabilitation Hospital in Tehran, Iran, from 2021 to 2022. the study implemented Cohen's four-stage model, encompassing the design of a change program, action, observation and evaluation, and feedback stages. A purposeful sampling method was utilized to select 19 nurses and members of the rehabilitation team from the hospital, ensuring maximum diversity. Data collection involved semi-structured interviews, focus groups, and a checklist for fall prevention measures. Qualitative content analysis, alongside descriptive (frequency, mean, and standard deviation) and inferential statistics (paired t-tests and Chi-square tests), were employed for data analysis. The study adhered to COREQ guidelines. RESULTS: Falls were most common among patients aged fifty years or older (P = 0.026). Throughout the study period, men were more likely to experience falls than women (P = 0.01). Preventive interventions have led to significant improvements in indicators of patient monitoring and care, patient education, and environmental safety, as demonstrated by a paired-sample t-test (P<0.001). Moreover, factors contributing to patients' falls included "shortcomings in fall prevention policies" and "lack of knowledge and participation among patients and caregivers." Changes implemented in the Spinal Cord Injury unit involved enhancing interprofessional interactions, conducting educational workshops for patients and their companions, and identifying high-risk patients. These findings indicate a significant decrease in the incidence of falls following the intervention (P = 0.02). CONCLUSIONS: The study found that a multifaceted intervention can increase knowledge about fall risks and substantially reduce both falls and associated minor injuries.

Persian translation and validation of the Back Pain Functional Scale.

BACKGROUND: Patient-reported questionnaires provide important tools that can be utilized for the assessment of treatment efficacy in clinic and research. This study aimed to translate, cross-culturally adapt, and validate the Back Pain Functional Scale into Persian (BPFSp). METHODS: In this cross-sectional and prospective cohort of adult patients with low back pain (LBP), the translation and adaptation was performed according to standardized guidelines and pretested (n = 30). Psychometric testing was conducted with 100 patients with LBP and 50 healthy subjects. Fifty patients with LBP recompleted the BPFSp at least 7 days later for test-retest reliability. RESULTS: The Persian adapted version of the BPFS was produced and validated. No floor and ceiling effects were revealed. The Cronbach'α coefficient for internal consistency was 0.895. The test-retest reliability was excellent (ICCagreement = 0.88, CI 95%: 0.80-0.93). The standard error of measurement and smallest detectable change were 9.9% and 27.5%, respectively. Construct convergent validity was demonstrated with the Persian Functional Rating Index (r = -0.77). Criterion validity was established with the Numerical Pain Rating Scale (r = -0.67). Total BPFSp scores discriminated between patients with LBP and healthy subjects. Factor structure showed two latent factors explaining a total variance of 60.1%. CONCLUSION: The BPFSp presented excellent reliability and validity for assessing the functional status in Persian speaking patients with LBP.