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Learning Objective 1: Describe components of an instructional DVD program on safe mobility for reducing patient falls.
Learning Objective 2: Discuss how the transactional model for cancer family caregiving skill can be applied to educational interventions.
Scientific advances in cancer therapies have improved patient survival. The burden of their care often rests with family members who are not adequately prepared for caregiving demands. One demand is fall prevention in the home. Fall risk is a significant health problem for cancer patients, who are vulnerable to fall and sustain injury. An instructional DVD program on safe mobility and fall prevention, designed on the basis of Schumacher's Transactional Model of Cancer Family Caregiving Skills, was developed to target cancer family caregivers. It includes a comprehensive review of cancer patient fall risks, ways to make the home safer, skills training on patient ambulation and transfer techniques, enactments of communicating with a patient's physician, and community resources. A feasibility study was conducted to determine if family caregivers’ perceptions of caregiving preparedness and knowledge about fall prevention improved after viewing the DVD program and if caregivers were satisfied with the program. The study also compared the occurrence of falls among patients before and after their caregivers viewed the DVD. A convenience sample of 38 cancer patient and family caregiver dyads were enrolled. Family caregivers' knowledge about fall prevention improved significantly (p=.0001). Overall caregiver preparedness scores improved, but increases were non-significant (p=.26). 40.9% of all study patients reported falls within 3 months prior to the study and 18.2% of those returning diaries reported falls during the 3 months post intervention. Fall reduction was clinically significant, but borderline significant statistically (p=.059). No fall-related injuries were reported and fall risk scores significantly declined (p =.01). Caregivers positively evaluated the DVD for content, relevance, and utility. The transactional model of cancer family caregiving skill is excellent for designing future family caregiving skills programs. The model should also be tested in developing caregiving skills programs for patients with all forms of chronic disease. A clinical trial testing the DVD program is pending.
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