'Balancing risk' after fall-induced hip fracture: the older person's need for information

Laura McMillan, Joanne Booth, Kay Currie, Tracey Howe

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Hip fracture is a significant cause of morbidity and mortality in older people. Healthcare professionals have a role to identify and respond to challenges and concerns that older people face as they strive to manage risk of future falls and rebuild confidence and independence after discharge.

AIMS AND OBJECTIVES: This study aimed to explore the postdischarge concerns of older people after fall-induced hip fracture.

METHOD: Glaser's approach to the grounded theory method guided qualitative interviews conducted with 19 older people in their own homes up to 3 months post discharge, in two health authority areas.

RESULTS: A theory of 'taking control' was generated. 'Balancing risk' emerged as a key strategy that older people employed to help them to take control after discharge home. Older people attempted to control or 'balance' their risk of future falls and dependence by implementing two further strategies: 'protective guarding' and 'following orders'. The instinctive strategy of protective guarding and the learned strategy of following orders were implemented simultaneously and were characterised by older people aiming to pace their progress and balance risk safely and appropriately. To apply these strategies, older people required information from healthcare professionals. In circumstances where older people did not receive or did not understand the information provided, they were left 'grasping to understand' and were more likely to miscalculate risk. This leads to damaged confidence and in some cases further falls.

CONCLUSIONS: The concept of balancing risk aims to help healthcare professionals understand the older person's perspective of hip fracture and to recognise the efforts that people make to guard against further injury and dependence in the early postdischarge period.

Original languageEnglish
Pages (from-to)249-57
Number of pages9
JournalInternational journal of older people nursing
Volume9
Issue number4
DOIs
Publication statusPublished - Dec 2014

Fingerprint

Hip Fractures
Delivery of Health Care
Interviews
Morbidity
Mortality
Health
Wounds and Injuries

Keywords

  • Accidental Falls
  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • Female
  • Health Services Needs and Demand
  • Hip Fractures
  • Humans
  • Interviews as Topic
  • Male
  • Patient Discharge
  • Psychological Theory
  • Recovery of Function
  • Risk
  • Scotland

Cite this

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abstract = "BACKGROUND: Hip fracture is a significant cause of morbidity and mortality in older people. Healthcare professionals have a role to identify and respond to challenges and concerns that older people face as they strive to manage risk of future falls and rebuild confidence and independence after discharge.AIMS AND OBJECTIVES: This study aimed to explore the postdischarge concerns of older people after fall-induced hip fracture.METHOD: Glaser's approach to the grounded theory method guided qualitative interviews conducted with 19 older people in their own homes up to 3 months post discharge, in two health authority areas.RESULTS: A theory of 'taking control' was generated. 'Balancing risk' emerged as a key strategy that older people employed to help them to take control after discharge home. Older people attempted to control or 'balance' their risk of future falls and dependence by implementing two further strategies: 'protective guarding' and 'following orders'. The instinctive strategy of protective guarding and the learned strategy of following orders were implemented simultaneously and were characterised by older people aiming to pace their progress and balance risk safely and appropriately. To apply these strategies, older people required information from healthcare professionals. In circumstances where older people did not receive or did not understand the information provided, they were left 'grasping to understand' and were more likely to miscalculate risk. This leads to damaged confidence and in some cases further falls.CONCLUSIONS: The concept of balancing risk aims to help healthcare professionals understand the older person's perspective of hip fracture and to recognise the efforts that people make to guard against further injury and dependence in the early postdischarge period.",
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'Balancing risk' after fall-induced hip fracture : the older person's need for information. / McMillan, Laura; Booth, Joanne; Currie, Kay; Howe, Tracey.

In: International journal of older people nursing, Vol. 9, No. 4, 12.2014, p. 249-57.

Research output: Contribution to journalArticle

TY - JOUR

T1 - 'Balancing risk' after fall-induced hip fracture

T2 - the older person's need for information

AU - McMillan, Laura

AU - Booth, Joanne

AU - Currie, Kay

AU - Howe, Tracey

N1 - © 2013 Blackwell Publishing Ltd.

PY - 2014/12

Y1 - 2014/12

N2 - BACKGROUND: Hip fracture is a significant cause of morbidity and mortality in older people. Healthcare professionals have a role to identify and respond to challenges and concerns that older people face as they strive to manage risk of future falls and rebuild confidence and independence after discharge.AIMS AND OBJECTIVES: This study aimed to explore the postdischarge concerns of older people after fall-induced hip fracture.METHOD: Glaser's approach to the grounded theory method guided qualitative interviews conducted with 19 older people in their own homes up to 3 months post discharge, in two health authority areas.RESULTS: A theory of 'taking control' was generated. 'Balancing risk' emerged as a key strategy that older people employed to help them to take control after discharge home. Older people attempted to control or 'balance' their risk of future falls and dependence by implementing two further strategies: 'protective guarding' and 'following orders'. The instinctive strategy of protective guarding and the learned strategy of following orders were implemented simultaneously and were characterised by older people aiming to pace their progress and balance risk safely and appropriately. To apply these strategies, older people required information from healthcare professionals. In circumstances where older people did not receive or did not understand the information provided, they were left 'grasping to understand' and were more likely to miscalculate risk. This leads to damaged confidence and in some cases further falls.CONCLUSIONS: The concept of balancing risk aims to help healthcare professionals understand the older person's perspective of hip fracture and to recognise the efforts that people make to guard against further injury and dependence in the early postdischarge period.

AB - BACKGROUND: Hip fracture is a significant cause of morbidity and mortality in older people. Healthcare professionals have a role to identify and respond to challenges and concerns that older people face as they strive to manage risk of future falls and rebuild confidence and independence after discharge.AIMS AND OBJECTIVES: This study aimed to explore the postdischarge concerns of older people after fall-induced hip fracture.METHOD: Glaser's approach to the grounded theory method guided qualitative interviews conducted with 19 older people in their own homes up to 3 months post discharge, in two health authority areas.RESULTS: A theory of 'taking control' was generated. 'Balancing risk' emerged as a key strategy that older people employed to help them to take control after discharge home. Older people attempted to control or 'balance' their risk of future falls and dependence by implementing two further strategies: 'protective guarding' and 'following orders'. The instinctive strategy of protective guarding and the learned strategy of following orders were implemented simultaneously and were characterised by older people aiming to pace their progress and balance risk safely and appropriately. To apply these strategies, older people required information from healthcare professionals. In circumstances where older people did not receive or did not understand the information provided, they were left 'grasping to understand' and were more likely to miscalculate risk. This leads to damaged confidence and in some cases further falls.CONCLUSIONS: The concept of balancing risk aims to help healthcare professionals understand the older person's perspective of hip fracture and to recognise the efforts that people make to guard against further injury and dependence in the early postdischarge period.

KW - Accidental Falls

KW - Activities of Daily Living

KW - Aged

KW - Aged, 80 and over

KW - Female

KW - Health Services Needs and Demand

KW - Hip Fractures

KW - Humans

KW - Interviews as Topic

KW - Male

KW - Patient Discharge

KW - Psychological Theory

KW - Recovery of Function

KW - Risk

KW - Scotland

U2 - 10.1111/opn.12028

DO - 10.1111/opn.12028

M3 - Article

VL - 9

SP - 249

EP - 257

JO - International journal of older people nursing

JF - International journal of older people nursing

SN - 1748-3735

IS - 4

ER -