Falls among elderly is a serious public health concern in our increasingly growing population of older people.Falls aredefined as unintended coming to rest on the ground, floor, or other lower level, in the exception of position change for intentional rest, fallssignificantly limit older adults’ ability to remain self-sufficient. Forolder people, a fall is perceived as an event resulting from a loss of balance. It has been estimated that one out of every three older adults aged 65 or older fall every year, yet less than half talk to their health care provider about it.Fallshave devastating physical and medical consequences that make them a major source of increased rates of hospitalization, dysfunction and disability, and dependence Falls affect the quality of life of older adults and are a strong predictor of skilled nursing facility placement in the community. Several intrinsic and extrinsic risk factors increase the likelihood of falling. Intrinsic risk factors are those related to the individual’s illness condition or medication side effects and can be grouped as: (1) Biological risk factors - increasing age, vision impairment or vision loss, chronic health conditions, medication use, mobility impairments due to balance and muscle weakness problems, gait, foot problems, cognitive impairment, loss of sensation in feet, and history of falls and (2) Behavioral risk factors - lack of physical activity and exercise, alcohol and drug use, and fear of falling. Extrinsic risk factors, on the other hand include: (1) environmental conditions- tripping, slipping, uneven floor, poor lighting, inappropriate footwear, absence of handrails, use of defective equipment and assistive devices, and (2) socio economic conditions- poor nutrition due to poverty, limited nutrition knowledge, limited education, limited income, elder abuse and discrimination, and living alone.
About 40% of older adults aged 65 year and older live in the home, and 33.3% of them experience falls each year. Many elderly receive home health services so this program was going to take advantage that since nurses were already visiting homes that they could also make an impact on preventing falls among their elderly clients. (http://www.cdc.gov/HomeandRecreationalSafety/pdf/CDC_Falls_Compendium_lowres.pdf ). The purpose of this quality improvement project is to evaluate any behavioral or environmental changes made as a result of a prevention initiative.
The sample consisted of one elderly clientage 60 or olderselected randomly from50 households. In addition to chart notes on a patient’s health status (e.g., biological risk factors noted above ) a 5 item elderly fall screening test[EFST, http://www.wcrtac-wi.org/uploads/Falls_Screening___Referral.pdf]rated the risk for falling (Cwikel et al, 1998),a physical activity scale (PASE, Washburn t al, 1999)) and a fall prevention checklist of environmental conditions (a sum of 36 yes/no items) and personal risk factors (a sum of 16 yes/no items)[http://www.minnesotasafetycouncil.org/SeniorSafe/fallcheck.pdf]was conducted on home visits during the month of May. A reassessment was collected 6 months later.
Using the dataset
ProposalAnalysis_FALLSdata.xlx
:
Step 1:In your own words write a brief synopsis of the study, describe the sample and the data you have. Include a table (APA format) that includes the appropriate descriptive data of all the variables
Step 2:
Select any
two
of the following hypotheses - if selecting #5 choose only 5A or 5B do not choose both.
1. There is an association between living alone and risk of falling.
2. There is a correlation and a predictive relationship between age and the baseline physical activity score.
3. There is a predictive relationship between the age and follow-up physical activity score while also controlling for baseline environmental risk score, baseline personal risk score, and living alone.
4. The change in environmental condition score differs by risk of falling.
5A. Baseline environmental and personal risk scores will differ from follow-up scores.
OR
5B. Baseline environmental and personal risk scores do not differ by living alone status.
Then for each hypothesis selected answer the following:
5. What is the statistical test you chose and why was this particular test chosen? Be sure to indicate which hypothesis was chosen and if the assumptions for the statistical test you choose are met.
6. State the null hypothesis and perform your analysis
7. Summarize your findings (include excel summary output tables) and indicate if you found support for the null hypothesis or not.
Step 3: Use a figure/graphic (APA format) to illustrate something important relevant to one of the hypothesis mentioned above. Include a description of the findings that the figure/graphic portray. It is OK if you want to integrate the figure/graphic description within your hypothesis testing summary.
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