Acceptability of fall prevention strategies for older people with vision impairment
, , and | Jan 01, 2020
About this article
Published Online: Jan 01, 2020
Page range: 22 - 30
DOI: https://doi.org/10.21307/ijom-2018-004
© 2018 Lisa Dillon, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Figure 1
Figure 2
Themes identified using the components of the behaviour change wheel (BCW).
| BCW Component | Construct | Subset | Themes |
|---|---|---|---|
| Sources of behaviour | Capability |
|
‘Falls are just bad luck!’ |
|
|
‘Exercise will hurt’ | ||
| Competing priorities Vision loss limits safety and mobility | |||
| Motivation |
|
‘Already doing enough’ | |
| Belief in own ability ‘Use it or lose it’ | |||
|
|
Closed to trying new things Depressive mood state | ||
| Opportunity |
|
‘I can’t get to the venue’ ‘I don’t want to be a burden on my loved ones’ | |
|
|
Stigma of participating in falls prevention program Benefits of participating in groups | ||
| Intervention Functions | Environmental restructuring | Preference for home modifications Preference for home-based programs Reduced mobility due to uneven footpaths | |
| Education | No awareness of fall prevention programs | ||
| Persuasion, Incentivization & Coercion | Doctor’s influence | ||
| Enablement | Consistent and supportive interventions. |
The script used in each focus group and semi-structured interview, including ice-breaker question, areas of discussion and associated prompts.
|
|
|
| ‘To start with, I want you to introduce yourselves, one at a time using your first name only, and tell the group if you have experienced having a fall or fear having a fall, been injured having a fall or know of someone who has had a fall over the age of 60 years.’ | |
|
|
|
| Vision loss increases the risk of falling | Is there an increased risk of falling because of vision loss? What are your current challenges and coping skills? What is the impact of injurious and non-injurious falls? |
| Awareness of preventative strategies to minimise harm from falling | What are the attitudes and opinions of current programs? Under what circumstances would you participate or not participate? Would you be willing to engage in group or individual exercise programs or would you prefer to have modifications made to reduce risk of falls in your environment? |
| Description of three different fall prevention strategies and environmental modifications | The Otago Exercise Programme E.g. What are your likes and dislikes of a home-based exercise program? Tai Chi group classes E.g. What are your thoughts on group programs, location, transportation and timing? Home modifications E.g. What have you tried already? What has worked and what hasn’t worked and what would you like to change in your home? |
| Adherence to exercise programs | What are your preferred physical activities and what do you do at the moment? What are the barriers to exercise? What are the psychological barriers to physical exercise? What are the psychological benefits to exercise? What are your opinions on well-designed appropriate programs aimed at older people who have a vision impairment to reduce the risk of falls? |
Characteristics of the study population.
| Age | 76 ± 8 (range 63–;91) |
| Gender | 16 female, 3 male |
| Vision condition | 6 age-related macular degeneration (AMD), 5 cataract, 2 cataract and glaucoma, 1 cataract and AMD, 1 cataract, glaucoma and retinitis pigmentosa, 1 cataract and undisclosed, 1 glaucoma and AMD, 1 glaucoma, 1 undisclosed |
| Housing | 17 house, 2 unit |
| Lives alone | 11 (58%) |
| Mobility limited due to vision loss | 5 (26%) |
| Mobility aids | 4 support cane, 3 walking/rollator frame, 2 human guide, 1 long cane, 1 quad stick, 8 none |