Anners Lerdal1,2, Line Wangsvik Sigurdsen3, Heidi Hammerstad4, Tove Irene Granheim3, Caryl L Gay2,5. 1. Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway. 2. Department for Patient Safety and Research, Lovisenberg Diaconal Hospital, Oslo, Norway. 3. Department of Surgery, Lovisenberg Diaconal Hospital, Oslo, Norway. 4. Medical Department, Lovisenberg Diaconal Hospital, Oslo, Norway. 5. Department of Family and Health Care Nursing, University of California, San Francisco, CA, USA.
Abstract
AIM AND OBJECTIVES: To describe associations between patient fall risk and common symptoms among hospitalised inpatients. BACKGROUND: Predictors of falls have been identified in a variety of populations and settings, but the role of inpatients' symptom experience has not been adequately evaluated. DESIGN: Cross-sectional. METHODS: Participants included 614 medical and elective surgical patients in an acute hospital in Norway. Patient falls during hospitalisation were assessed by self-report and incident reports. Pain intensity and the occurrence and distress of 15 other symptoms were assessed by self-report. RESULTS: Patient falls were associated with male sex and having more comorbidities. Medical patients were more likely to fall than elective surgical patients. In logistic regression analyses, higher symptom counts were associated with increased risk of fall, with each additional symptom conferring a 15% increase in fall risk. Symptom distress related to concentration difficulties, lack of energy, sleep problems, nausea, vomiting and diarrhoea was associated with increased risk of fall, even after adjusting for the influence of age, sex and comorbidities (odds ratios ranged 2.3-4.8). Severe pain, as well as symptom distress related to drowsiness, itching, dizziness or swelling of arms/legs, was also associated with patient falls, although these associations were attenuated after accounting for age, sex and comorbidities. Overall, symptom distress was more strongly associated with fall risk than symptom occurrence. CONCLUSIONS: Symptom burden and distress may help identify hospital patients at risk for fall. Additional research is needed to determine whether symptoms are useful for assessing fall risk among hospital patients and other high-risk populations. If symptoms are useful indicators of fall risk, they should be considered for inclusion in standardised risk assessments. RELEVANCE TO CLINICAL PRACTICE: Clinicians ought to pay particular attention to increased fall risk among patients reporting many symptoms and those experiencing distress from concentration difficulties, fatigue, sleep problems, nausea, vomiting and diarrhoea.
AIM AND OBJECTIVES: To describe associations between patient fall risk and common symptoms among hospitalised inpatients. BACKGROUND: Predictors of falls have been identified in a variety of populations and settings, but the role of inpatients' symptom experience has not been adequately evaluated. DESIGN: Cross-sectional. METHODS:Participants included 614 medical and elective surgical patients in an acute hospital in Norway. Patient falls during hospitalisation were assessed by self-report and incident reports. Pain intensity and the occurrence and distress of 15 other symptoms were assessed by self-report. RESULTS:Patient falls were associated with male sex and having more comorbidities. Medical patients were more likely to fall than elective surgical patients. In logistic regression analyses, higher symptom counts were associated with increased risk of fall, with each additional symptom conferring a 15% increase in fall risk. Symptom distress related to concentration difficulties, lack of energy, sleep problems, nausea, vomiting and diarrhoea was associated with increased risk of fall, even after adjusting for the influence of age, sex and comorbidities (odds ratios ranged 2.3-4.8). Severe pain, as well as symptom distress related to drowsiness, itching, dizziness or swelling of arms/legs, was also associated with patient falls, although these associations were attenuated after accounting for age, sex and comorbidities. Overall, symptom distress was more strongly associated with fall risk than symptom occurrence. CONCLUSIONS: Symptom burden and distress may help identify hospital patients at risk for fall. Additional research is needed to determine whether symptoms are useful for assessing fall risk among hospital patients and other high-risk populations. If symptoms are useful indicators of fall risk, they should be considered for inclusion in standardised risk assessments. RELEVANCE TO CLINICAL PRACTICE: Clinicians ought to pay particular attention to increased fall risk among patients reporting many symptoms and those experiencing distress from concentration difficulties, fatigue, sleep problems, nausea, vomiting and diarrhoea.
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