Alexandra M B Korall1, Fabio Feldman2, Vicky J Scott3, Michael Wasdell4, Roslyn Gillan5, Donna Ross5, Tracey Thompson-Franson5, Pet-Ming Leung6, Lisa Lin1. 1. Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, Canada. 2. Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, Canada; Older Adult Program, Fraser Health Authority, Surrey, Canada. Electronic address: Fabio.Feldman@fraserhealth.ca. 3. British Columbia Injury Research and Prevention Unit, Vancouver, Canada; School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada. 4. Research and Academics, Ontario Shores Centre for Mental Health Sciences, Ontario, Canada. 5. Island Health, British Columbia, Canada. 6. Older Adult Program, Fraser Health Authority, Surrey, Canada.
Abstract
BACKGROUND: Hip protectors represent an attractive strategy for reducing hip fractures among high-risk fallers in long-term care facilities. However, clinical studies yield conflicting results regarding their clinical value. This is mainly due to poor acceptance and adherence among users in wearing these devices. As a result, there is an urgent need to identify potential barriers and facilitators to initial acceptance and continued adherence with hip protector use. PURPOSE: The objective of this systematic review is to synthesize available research evidence to identify factors that influence acceptance and adherence among older adults living in long-term care facilities. METHODS: A key word search was conducted for studies published in English between 2000 and 2013 that employed quantitative, qualitative, or mixed-methods research designs. Two independent reviewers evaluated each article for inclusion, with a third reviewer when needed to resolve discrepancies. RESULTS: Twenty-eight articles met our inclusion criteria, and facilitators and barriers were clustered into 4 socio-ecological levels: system (eg, facility commitment, staff shortages), caregiver (eg, belief in the efficacy of protectors, negative perceptions), resident (eg, clinical risk factors for falls and related fractures, acute illness), and product (eg, soft shell, discomfort). DISCUSSION: The outcomes provide decision makers, health professionals, and caregivers with a greater awareness of strategies to improve compliance with the use of hip protectors. Furthermore, researchers can use this information to design clinical trials that yield high acceptance and adherence.
BACKGROUND: Hip protectors represent an attractive strategy for reducing hip fractures among high-risk fallers in long-term care facilities. However, clinical studies yield conflicting results regarding their clinical value. This is mainly due to poor acceptance and adherence among users in wearing these devices. As a result, there is an urgent need to identify potential barriers and facilitators to initial acceptance and continued adherence with hip protector use. PURPOSE: The objective of this systematic review is to synthesize available research evidence to identify factors that influence acceptance and adherence among older adults living in long-term care facilities. METHODS: A key word search was conducted for studies published in English between 2000 and 2013 that employed quantitative, qualitative, or mixed-methods research designs. Two independent reviewers evaluated each article for inclusion, with a third reviewer when needed to resolve discrepancies. RESULTS: Twenty-eight articles met our inclusion criteria, and facilitators and barriers were clustered into 4 socio-ecological levels: system (eg, facility commitment, staff shortages), caregiver (eg, belief in the efficacy of protectors, negative perceptions), resident (eg, clinical risk factors for falls and related fractures, acute illness), and product (eg, soft shell, discomfort). DISCUSSION: The outcomes provide decision makers, health professionals, and caregivers with a greater awareness of strategies to improve compliance with the use of hip protectors. Furthermore, researchers can use this information to design clinical trials that yield high acceptance and adherence.
Authors: Alexandra M B Korall; Judith Godin; Fabio Feldman; Ian D Cameron; Pet-Ming Leung; Joanie Sims-Gould; Stephen N Robinovitch Journal: BMC Geriatr Date: 2017-05-03 Impact factor: 3.921