Mary E Walsh1, Rose Galvin2, David J P Williams3,4, Joseph A Harbison5,6, Sean Murphy3,7,8, Ronan Collins6,9, Dominick J H McCabe10,11,12, Morgan Crowe13, N Frances Horgan1. 1. a School of Physiotherapy , Royal College of Surgeons in Ireland , Dublin , Ireland. 2. b Department of Clinical Therapies, Faculty of Education and Health Sciences , Health Research Institute, University of Limerick, Limerick , Ireland. 3. c School of Medicine , Royal College of Surgeons in Ireland , Dublin , Ireland. 4. d Department of Geriatric and Stroke Medicine , Beaumont Hospital , Dublin , Ireland. 5. e Department of Medicine for the Elderly , St James' Hospital , Dublin , Ireland. 6. f Discipline of Medical Gerontology, School of Medicine , University of Dublin Trinity College , Dublin , Ireland. 7. g Department of Medicine for the Older Person , Mater Misericordiae University Hospital , Dublin , Ireland. 8. h School of Medicine , University College Dublin , Dublin , Ireland. 9. i Department of Age-related Healthcare , The Adelaide and Meath Hospital Dublin, Incorporating the National Children's Hospital , Dublin , Ireland. 10. j Department of Neurology, Vascular Neurology Research Foundation and Stroke Service , The Adelaide and Meath Hospital Dublin, Incorporating the National Children's Hospital , Dublin , Ireland. 11. k Department of Clinical Neurosciences , Royal Free Campus, University College London Institute of Neurology , London , UK. 12. l Academic Unit of Neurology, School of Medicine , University of Dublin Trinity College , Dublin , Ireland. 13. m Department of Medicine for the Elderly , St Vincent's University Hospital , Dublin , Ireland.
Abstract
PURPOSE: Understanding the experiences of fallers after stroke could inform falls-prevention interventions, which have not yet shown effectiveness in this population. The aim of this study was to explore the experience of recurrent fallers post-stroke in relation to recovery and living with falls. METHODS: Participants who had more than one fall in the first year after stroke were identified from a prospective cohort study. The methods of grounded theory informed data collection and analysis. Semi-structured interviews were conducted, audio-recorded and transcribed. Coding was conducted and categories were developed inductively. RESULTS: Nine stroke survivors aged 53-85 were interviewed 18-22 months post-discharge. Participants had experienced between 2 and 9 falls and one participant suffered a fracture. Three inter-linked categories were identified: (i) Judging the importance of falls by exploring cause and consequence, (ii) getting back up, and (iii) being careful. CONCLUSIONS: Stroke survivors' assessment of their own falls-risk and their individual priorities contribute to their decisions around activity participation. "Being careful" could be described as a form of self-managing falls-risk. The inclusion of self-management principles, peer-educators, and education to rise from the floor in falls-management programmes warrants investigation. Not all falls were considered equally important by participants. This could be considered when defining falls-related outcomes. Implications for Rehabilitation Healthcare professionals may be able to offer an increased sense of control to stroke survivors through education about how to avoid particular causes and consequences of falls. Falls-related advice should be specific, relevant to the individual, and respectful of their sense of identity. Being able to rise from the floor appears to be important for coping with falls and falls-risk. Professionals should be cognisant of the potential differences of opinion between stroke survivors and their families around management of falls-risk.
PURPOSE: Understanding the experiences of fallers after stroke could inform falls-prevention interventions, which have not yet shown effectiveness in this population. The aim of this study was to explore the experience of recurrent fallers post-stroke in relation to recovery and living with falls. METHODS:Participants who had more than one fall in the first year after stroke were identified from a prospective cohort study. The methods of grounded theory informed data collection and analysis. Semi-structured interviews were conducted, audio-recorded and transcribed. Coding was conducted and categories were developed inductively. RESULTS: Nine stroke survivors aged 53-85 were interviewed 18-22 months post-discharge. Participants had experienced between 2 and 9 falls and one participant suffered a fracture. Three inter-linked categories were identified: (i) Judging the importance of falls by exploring cause and consequence, (ii) getting back up, and (iii) being careful. CONCLUSIONS:Stroke survivors' assessment of their own falls-risk and their individual priorities contribute to their decisions around activity participation. "Being careful" could be described as a form of self-managing falls-risk. The inclusion of self-management principles, peer-educators, and education to rise from the floor in falls-management programmes warrants investigation. Not all falls were considered equally important by participants. This could be considered when defining falls-related outcomes. Implications for Rehabilitation Healthcare professionals may be able to offer an increased sense of control to stroke survivors through education about how to avoid particular causes and consequences of falls. Falls-related advice should be specific, relevant to the individual, and respectful of their sense of identity. Being able to rise from the floor appears to be important for coping with falls and falls-risk. Professionals should be cognisant of the potential differences of opinion between stroke survivors and their families around management of falls-risk.
Entities:
Keywords:
Stroke; accidental falls; fear of falling; grounded theory; qualitative research
Authors: Mary E Walsh; Jan Sorensen; Rose Galvin; David Jp Williams; Joseph A Harbison; Sean Murphy; Ronan Collins; Dominick Jh McCabe; Morgan Crowe; N Frances Horgan Journal: Eur Stroke J Date: 2018-03-15
Authors: Mialinn Arvidsson Lindvall; Anette Forsberg; Peter Appelros; Agneta Anderzén-Carlsson Journal: Int J Qual Stud Health Well-being Date: 2021-12