Perspectives of Inpatients With Cancer on Engagement in Fall Prevention.

PURPOSE: To explore perspectives of hospitalized adults with cancer regarding engagement in fall prevention plans. The primary aim was to discover new knowledge about patients' perspectives and improve the design of fall prevention strategies. A secondary aim was to compare fall-related perspectives of patients who had and who had not fallen. PARTICIPANTS & SETTING: 30 inpatients with cancer at a teaching hospital in a statewide academic health system in the midwestern United States. METHODOLOGIC APPROACH: A descriptive exploratory approach framed qualitative data collection through interviews with inpatients. Data were analyzed thematically. FINDINGS: Themes reflected six perspectives related to engagement in fall prevention. A need to go to the bathroom triggered a two-step process in which participants decided whether to ask staff for assistance to mobilize and to wait for assistance to arrive. If necessary, participants would disengage from fall prevention plans and move to the bathroom without assistance to avoid incontinence, preserve privacy, and maintain independence in toileting. Factors influencing decisions were assessments of mobilization capacity and views of nurses' behaviors. IMPLICATIONS FOR NURSING: Nurses can foster patient engagement in fall prevention by developing trusting, authentic relationships with at-risk patients, involving patients in assessing their own fall risk, and tailoring toileting plans to ensure continence.

Perceptions Related to Falls and Fall Prevention Among Hospitalized Adults.

BACKGROUND: Prevention of falls during hospitalization depends in part on the behaviors of alert patients to prevent falls. Research on acutely ill patients' intentions to behave in ways that help prevent falls and on the patients' perceptions related to falls is limited. OBJECTIVE: To explore hospitalized adults' perceptions related to risk for falling, fear of falling, expectations of outcomes of falling, and intention to engage in behaviors to prevent falls. METHODS: Adult, alert, acutely ill inpatients (N = 158) at risk for falling completed a survey consisting of 4 scales and 3 single items. Nurses' assessments and patients' perceptions of the risk for falling were compared. RESULTS: Decreased intentions to engage in behaviors to prevent falls were correlated with patients' increased confidence in their ability to perform high-risk behaviors without help and without falling (P < .001), decreased fear of falling (P < .001), and decreased perceived likelihood of adverse outcomes if they did fall (P < .001). Although nurses' assessments indicated a risk for falls, 55.1% of the patients did not perceive a high likelihood of falling while hospitalized. Whereas 75% of patients intended to ask for help before getting out of bed, 48% were confident that they could get out of bed without help and without falling. CONCLUSIONS: Although assessments may indicate a risk for falling, acutely ill inpatients may not perceive they are likely to fall. Patients' intentions to engage in behaviors to prevent falls vary with the patients' fall-related perceptions of confidence, outcomes, and fear related to falling.