Article

OBJECTIVE: To identify factors that explain differences in patients with high and
low levels of fear of falling after a hip fracture. DESIGN: Cross-sectional study
in 10 skilled nursing facilities in the Netherlands. PATIENTS: A total of 100
patients aged >/= 65 years admitted to a skilled nursing facility after a hip
fracture. METHODS: Participants were divided into 2 groups; low and high level of
fear of falling, based on median Falls Efficacy Score - International. Data
relating to factors that might explain fear of falling were collected, including
demographic variables, aspects of functioning, psychological factors, and
comorbidities. For every factor a univariate logistic regression was conducted.
For the multivariate regression model a backward procedure was used in which
variables with p < 0.05 were included. RESULTS: Walking ability and activities of
daily living before fracture, number of complications, activities of daily living
after fracture, anxiety and self-efficacy were significantly associated
univariately with fear of falling. Multivariate analysis showed that walking
ability before fracture (odds ratio (OR) 0.34, 95% confidence interval (CI)
0.14-0.83), activities of daily living after fracture (OR 0.89, 95% CI
0.80-0.99), and anxiety (OR 1.22, 95% CI 1.05-1.42) were independently associated
with fear of falling. CONCLUSION: Impaired walking ability before fracture,
impaired activities of daily living after fracture, and increased anxiety help
distinguish between older persons with high and low levels of fear of falling
after hip fracture. Because the last 2 factors are modifiable, this information
enables the development of specific interventions for older persons with a high
level of fear of falling.

Langue : ANGLAIS