Evaluation Of Risk Factors For Incident Falls In Women And Older Men

Main Body

This paper evaluates the risk factors for the incident falls in women and older men. It has summarized the article and reflects the aims, methodology and findings of the paper. Through analysing this paper the nurses can get an idea about the risk factors that are linked with the Evaluation of this paper can help the nursing students to manage the risk of falls in a proper manner in the future nurse role. In order to evaluate and reflect on how this article can help in a future nursing role, the role reflective model has been used.

According to Gale et al. (2018), falls or fear of falls can lead to different restrictions and decline in the function of physical mechanisms. Falls are one of the major causes of death in elderly people, especially women. In many cross-sectional surveys, it has been found that there are some risk factors linked with the past the falls that may be gender-specific but it is not clear that the risk factors of falls differ for different sexes. This paper has identified the possibility of risk factors that can be different among men and women. This article has highlighted that female have a greater risk of falls in comparison to men. In order to determine whether programmes of fall prevention are designed by keeping gender in mind (Gale et al. 2018). It is vital to have longitudinal type of evidence of whether the factors can be predicted the incident falls different between the genders. However, in this paper, it is investigated that different risk factors for the incident fall over an average timelimit of 4 years in women and men in different ways by applying the data from the English Longitudinal Study of Ageing.

In the methodology of this article, the ELSA sample has been considered for those people who have aged a minimum of 50 years and who have participated in surveys for England in 1998, 1999 and 2001. This sample has been considered by the sector of postcode and also stratified by the overall percentage of the households and the health authority who are belonging to the non-manual type of socioeconomic sections. Every 4 years the participants have been asked to have a visit to a nurse about the measurement of physical function. In order to make sure the representation of the people who have age between 50-75 has been maintained in the sample. The additional kind of samples from the Health Survey for the England have been added at the 3 wave and 4^th wave. In Wave 4, the 60 years aged participants had to answer the question related to the falls and incident risks. The question has been used to derive the variable for the past cases of falls (Gale et al. 2018). The question referred to that the participants have experienced fallen down in the last years. On waves 5 and 6, the participants has age of 60 or over were also asked the same question. However, these questions have been applied to extract a variable for the findings of the study, incident falls over 4 years within waves of 4 and 6.

Roelf’s Reflective Model

In order to identify independent variables, the sociodemographic features and the position in socioeconomic have been considered. Lifestyle factors, household wealth and clinical features have been chosen. However, in this category of independent variables the walking speed or the grip strength has not been considered as they are fried phenotypes and also highly correlated with it. This study has measured the cognitive and physical abilities such as a general cognitive function for daily tasks, balance and lung function. In the survey they have questions related to their job type and physical activity in jobs, smoking habits and also measured BMI (Gale et al. 2018). In the surveys, the grip strength, depression level, and balance are assessed by the nurse who is visiting the home of the participants. For example, the nurse has asked the participant to semi tandem stand for 10 seconds alone and if the participant can do then the nurse is invited to do a full tandem stand. Generally speed of walking is examined by measuring the time that has been taken to walk 8 ft. Incontinence has been assessed by the questions that are asking whether they have lost on their loss of urine. The participants were also given the tests of cognitive function such as verbal memory assessment and prospective memory assessment. Even the executive function is also assessed by the testing verbal fluency of the participants. However, the four test scores are subjected to principal analysis of the elements and also extracted the unrotated component of principal that has responsible for 46 percentage of the total variance. It can provide a standardized applicable measure of general cognitive development (Gale et al. 2018).

 In the analysis of the data 3298 population has been used as only they have completed the data on variables of interest. The Poisson regression with the robust of variance estimation has been used for deriving the linked risks for the link within characteristics of participants at the baseline. In this statistical analysis, the variables that have been associated with the falling value are p<0.2 and included the model of sex-specific mutually adjusted. In order to make sure the comparison of sizes of the effect, sex-specific SD scores have been derived continuously. However, the statistical analysis has been performed using the Stata (Gale et al. 2018).

This paper obtained findings that 41% of men and 48% of women in a total of 3298 people faced an incident fall within the waves of 4 and 6. This study has presented the summary of the statistics of cognitive, physical and clinical features at Wave 4 and Wave 6 in a table. From the tables, it has been found that men with high-level pain and poor balance factors are affected or increased the risk of falls (Gale et al. 2018). Poorer hearing is linked with the increased risk of falling the men. On the other hand, incontinence, unmarried, and higher depression have a link with an increased risk of falling among women. Lower physical activity, smoking or alcohol consumption are linked with a higher risk of incident falls. Otherwise, poorer eyesight, incontinence, higher level of pain, and poor cognition factors are identified in men and women. In discussion, it has been discussed the strength and weaknesses of the study. The questions of the study are not addressed what was meant by the fall. It is stated that almost 25 studies have found that there is a random link within higher levels of the depression and raised risk of falls. Cognitive ability, fried frailty status and the limits of other risks. It has been highlighted in the discussion the link between the fall risk and full-tandem stand significantly by sex. However, this paper concludes that there are differences in the risk factors between men and women for incident falls (Gale et al. 2018). There might be an association between balance, pain, comorbidity and incident risk falls that can be varied by needs of sex. There is required more investigation in the other cohort studies on this topic for a clear picture.

Rolfe's reflective cycle has a straightforward approach that is based on three key questions (Rolfe 2017). It is developed for nursing and education of care then it has become broader and it has been applied in different areas (Edwards 2017). These three stages of the model generated reflective thought and changes in behaviour that can be analysed (Chinh et al. 2021). This results in inappropriate changes in thought and behaviour.

What

There are different risk factors that impact the incident falls of the men and women differently. Depression, never being married, and inconsistency have increased the risk of incident falls for the women (Johansson et al. 2017). On the other hand, pain, poor hearing and poor eyesight are linked with a high risk of incident falls among men.

So what

It results in different styles of management of the men and women patients to reduce the incident falls. Health professionals need to advocate and need to keep in mind the factors during the management of elderly patients (Luzia et al. 2018). It has taught the students how to behave with men and women regarding the incidents of falls.

Now What

These findings help the nurses or nursing students in future nursing roles how they can manage men and women in a different way to avoid the risk of incident falls. Nurses can make their intervention by following the different factors and their effects in a different manner. The nurses have developed the skills and knowledge that how to deal with the risk of incident falls. They can involve exercise, medication and dietary supplements in a different manner from men and women (Steven et al. 2020). It is easy for the nurses to recognize the risks and avoid them or easily control them. They can respond to the incidents promptly and maintain risk prevention. It increases the efficiency of the nurses in future practice. 

Conclusion

It can be concluded that this analysis of the article has given a clear picture that the risk factors are different in men and women regarding incident falls. It can be pain, comorbidity or balance. The nurses gain knowledge that which factors are mostly associated with men and which are women. It helps the nurses to make interventions and prevent the risks of incident falls. These incident falls can cause major injuries or chronic health issues. After appropriate avoiding or preventing the risks people can get better health outcomes. Not only patients but the nurses and doctors can also be better in the management of incident falls cases after knowing the associated factors.

References

Chinh, N.T.M., Ngoc, P.T.B., Loi, N.M., Hang, D.T.T., Huy, D.T.N. and Van Tung, P., 2021. Deepening analysis on preventing fall risk with knowledge and practices of nurses and nursing. Systematic Reviews in Pharmacy, 12(3), pp.417-422.

Edwards, S., 2017. Reflecting differently. New dimensions: reflection-before-action and reflection-beyond-action. International Practice Development Journal, 7(1).

Gale, C.R., Westbury, L.D., Cooper, C. and Dennison, E.M., 2018. Risk factors for incident falls in older men and women: the English longitudinal study of ageing. BMC geriatrics, 18(1), pp.1-9.

Gale, C.R., Westbury, L.D., Cooper, C. and Dennison, E.M., 2018. Risk factors for incident fall in older men and women: the English longitudinal study of ageing. BMC geriatrics, 18(1), pp.1-9.

Johansson, J., Nordström, A., Gustafson, Y., Westling, G. and Nordström, P., 2017. Increased postural sway during quiet stance as a risk factor for prospective falls in community-dwelling elderly individuals. Age and ageing, 46(6), pp.964-970.

Luzia, M.D.F., Cassola, T.P., Suzuki, L.M., Dias, V.L.M., Pinho, L.B.D. and Lucena, A.D.F., 2018. Incidence of falls and preventive actions in a University Hospital. Revista da Escola de Enfermagem da USP, 52.

Rolfe, G., 2017. Chapter Eight: The Reflective Practitioner as Critical Theorist. Pflegewissenschaft und Pflegebildung, p.169.

Steven, A., Wilson, G., Turunen, H., Vizcaya-Moreno, M.F., Azimirad, M., Kakurel, J., Porras, J., Tella, S., Pérez-Cañaveras, R., Sasso, L. and Aleo, G., 2020. Critical incident techniques and reflection in nursing and health professions education: systematic narrative review. Nurse educator, 45(6), pp.E57-E61.