The Effect of Safe-Movement and Walking Program on Reducing the Fear of Falling in Elderly

Sunday, 30 July 2017

Gulcan Kar, PhD
Nursing Department, Karabuk University Faculity of Health Science, Karabuk, Turkey
Saime Erol, PhD
Community Health Nursing Department, Nursing Division, Faculty of Health Science, Marmara University,81326 Haydarpasa/Istanbul/TURKEY, Health Sciences Faculty Nursing Program Department of Public Health Nursing, Istanbul, Turkey

Purpose:  The aim of this study is to determine the effects of “Safe Movement and Walking Program” on reducing the fear of falling in elderly individuals living in a nursing home.

 Methods:  The study was carried out in a nursing home in İstanbul between November 2012 and April 2013 in a quasi-experimental research design with the pretest and posttest groups. The population of the study consists of 73 individuals who were volunteers for the research, aged 65 and above, having mental scores higher than 24 and were able to move themselves or with the help of walking aids. Those participants were randomly assigned to experimental (n=37) and control (n=36) groups. Elderly Information Form, Tinetti Falls Efficacy Scale (FES), Elderly Falls Behavioral (FaB) Scale and Tinetti Balance and Gait Assessment Form (BGAF) were used as a data collection instrument. Data was collected by the researchers and volunteer participants were educated using the methods of face to face interview and observation before and just after the application of the program and 3 months later. The content of “Safe Movement and Walking Program” was prepared in order to reduce the individuals’ fear of falling and make them able to take their own precautions within the literature studies. The topics such as “Falling”, “the Fear of Falling”, “Safe Movement”, “Physical Activities and Walking” were provided to the participants in groups of 8-10 in a six-week schedule. Verbal lecture, barcovision, catechism, sample case, observation, interview and demonstration methods were used in the education program and an educative booklet was also provided for each participant after the program. Student 1 and Mann-Whitney U test were used in the evaluation of the obtained data. The analysis of variance was used in repeated measures and Bonferroni test was used within group comparisons.

Results:  The “Fear of Falling” scores showed no difference between the experimental and control groups in either pretest or posttest, as well as the follow-up observations. Scale scores remained the same in the control group (p>0.05) whereas it increased in the experimental group which is statistically significant.The average scores of Tinetti Falls Efficacy Scale showed no difference between the experimental and control groups in all of the three measurements (p>0.05). A statistically significant difference in experimental group in the pretest, posttest as well as the follow-up observations (p<0.05). The total score of Elderly Falls Behavioral (FaB) Scale and the sub scale scores of Cognitive Accommodation, Activity, Avoidance, Awareness, Practicability, Level Change, Catching up Phone Calls and Carefulness were measured higher (p<0.05) than the scores of the control group for the mentioned topics above. The levels of the sub scale scores of the elderly individuals about taking a walk tirelessly for 30 minutes and starting regular walking in last 6 months were measured higher (p>0.05) than the scores of the control group.

Conclusion:  The program showed no efficacy in reducing the fear of falling whereas it is found helpful in the affairs such as taking a walk for 30 minutes each day, avoidance of falling, foreseeing the dangers in falling and planning. In order to reduce the fear of falling, it can be proposed that thorough interviews can be carried out, awareness raising applications can be done and coping strategies about fear can be taught to the elderly.