Most Proposed Topic :
Committed and Happy Staff (staff wellness / OSH / retention)
Authors: (including presenting author): :
Chan Y (1), Chu CY (1), Tan YK (1), Yip ST (1), Lui NF (1), Tiu KL (2), Lee KB (2), Li KK (2)
Affiliation: :
(1) Occupational Therapy Department, Queen Elizabeth Hospital
(2) Department of Orthopedics & Traumatology, Queen Elizabeth Hospital
Introduction: :
Fragility hip fracture (FHF), one of the common severe injuries of elderly after fall incident, is expected to increase under global ageing. Fear of falling (FoF) and actual falls are both strong predictors to FHF. Addressing fall risk and fall efficacy could be the strategies for secondary fall prevention through this lens.
Objectives: :
This study evaluates fall risk and fall efficacy among elderly with FoF following hip fracture.
Methodology: :
Hip fracture patients, who aged 65 or above, attended Fragility Fracture Clinic between January 2018 to November 2023 were included in this retrospective study. The result of self-reported FoF was self-reported, by results all subjects were categorized into: Group A (with FoF) and Group B (without FoF). Fall risk and self-efficacy in daily activities for both two groups were measured by Fall Risk Assessment Test (FRAT) and Fall Efficacy Scale (FES), higher score means higher risk and better confidence respectively.
Result & Outcome: :
761 patients were included with mean age 82.4. Majority of patients (63.4%) had FoF. Total scores were categorized into three risk extents in FRAT: Low, Medium and High. 68.2% patients were classified in Low, 17.5 % in Medium and 14.3% in High Risk. There was statistically significant difference in FRAT total score between two groups, which Group A had higher total score than B. Risk factors in FRAT: recent fall(p<0.01), medication(p=0.034) and psychological(p=0.02), showed statistically significant differences between two groups, Group A scored higher than B. Patients with FoF might have higher fall tendency.
Among the patients, 173 patients (76% with FoF ; 23.8% without FoF) were assessed by FES. Mean FES score in Group A was 54.4 while Group B was 78.9. In Group A, 55.2% patients were classified as High Risk in FRAT with mean FES score 54.7. Group A might tend to have lower self confidence in fall prevention with higher actual fall risk than Group B. 12.7 % patients reported no FoF with higher self-efficacy (FES mean score 77.7) was classified into High Risk, which indicated that they might not have clear perception towards their functional capacity.
Patients with FoF tended to have higher fall risk and lower self-efficacy. A proportion of elderly might have poor judgment in preventing falls. Education on self-management and fall prevention to elderly is paramount but challenging. Occupational therapists could address elderly’s awareness to reduce fall incident.
