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Visual impairment and falls: a register study
Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).ORCID iD: 0000-0002-2333-4316
Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
2009 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 18, no 3, p. 366-372Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of this register study was to investigate falls and fall injuries of inpatients 65 years and over to determine whether a causal factor of visual impairment was documented.

Background: All Organisation for Economic Cooperation and Development (OECD) countries have an increasing older population with falls and fall injuries becoming a major problem. A visual impairment can be an independent risk factor for falls but can also occur in combination with other intrinsic and extrinsic risk factors.

Design: A retrospective non-randomised register study.

Methods: In 2004, all documented falls of inpatients aged 65 years and over were examined. Medical records and eye clinic records were scrutinised to identify whether any visual impairment have been documented.

Conclusion: The majority of falls occurred between the hours of 24:00-06:00 and the inpatients most often affected were those with a visual impairment. The falls occurred in connection with movement when the inpatient was unaccompanied. Documentation in records at the medical clinic was defective and subjectively perceived visual impairment was not documented at all. Both subjective and objective visual impairment occurred in all eye clinic records. Relevance to clinical practice.

Visual impairment along with the ageing process are features affecting falls and the hospital environment needs to be adapted by improving the use of strong, contrasting colours and providing good lighting for older inpatients with visual impairment during the night time period. Hospital safety for older people with visual impairment is a concern if falls are to be reduced. Healthcare professionals need to undertake individual risk assessments to establish the degree of visual impairment of the older person so that appropriate interventions can be implemented to reduce the incidence of falls and fall injuries.

Place, publisher, year, edition, pages
Oxford: Blackwell Publishing, 2009. Vol. 18, no 3, p. 366-372
Keywords [en]
documentation, falls, nursing intervention, older, opthalmology, quality of life, accidental falls, aged, hospitals, statistics & numerical data, humans, nursing, quality of life, retrospective studies, vision disorders
National Category
Psychology Clinical Medicine
Identifiers
URN: urn:nbn:se:hh:diva-2796DOI: 10.1111/j.1365-2702.2008.02516.xISI: 000262476100006PubMedID: 19191983Scopus ID: 2-s2.0-58349121732Local ID: 2082/3198OAI: oai:DiVA.org:hh-2796DiVA, id: diva2:240014
Available from: 2009-08-14 Created: 2009-08-14 Last updated: 2022-09-13Bibliographically approved
In thesis
1. Being on the trail of ageing: Functional visual ability and risk of falling in an increasingly ageing population
Open this publication in new window or tab >>Being on the trail of ageing: Functional visual ability and risk of falling in an increasingly ageing population
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The elderly population is estimated to increase worldwide. One of the major health determinants identified in this population are injuries where one of the most prevalent causes are falls. The overall aim of this thesis was to describe and explore visual impairment and falls of inpatients and independently living elderly in the community and how daily life activities were influenced by visual ability and risk of falling. Methods in the studies were a quantitative retrospective descriptive design for study I followed by two quantitative retrospective and explorative studies where in study II perceived vision related quality of life and in study III performance-based visual ability were investigated. Study IV was a qualitative explorative study using classic grounded theory. In study I all falls of inpatients at a medical clinic 65 years and older (n=68) were registered during one year. In study II and III a random sample (n=212) of independently living elderly between 70 and 85 years of age participated in both studies. In study IV seven women and six men between 73 and 85 years of age from the two previous studies and six visual instructors (n=19) participated. The data in study I was collected during 2004, study II and III between February 2009 to March 2010 and study IV December 2009 to January 2013. The results in study I showed that most falls in five hospital wards occurred at night and those most affected had an established visual impairment. Almost half the population in study II and III fell at least once. Perceived vision when performing daily life activities showed a positive association between visual impairment and falls in men but not in women (II). No associations were found between performance-based measured visual ability and falls (III). Visually impaired elderly did not consider risk of falling as a problem (IV). Their main concern is to remain themselves as who they used to be which is managed by self- preservation while maintaining their residual selves and resisting self decay. Maintaining residual self is done by living in the past mostly driven by inertia while resisting self decay is a proactive and purposeful driven strategy.

It is a complex issue to do fall risk assessments and planning fall preventive action where the individual’s entire life situation has to be taken into consideration.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2014. p. 85
Series
Örebro Studies in Care Sciences, ISSN 1652-1153 ; 56
Keywords
elderly, experience, falls, independently living, perceived vision, performance-based vision, visual impairment
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-32749 (URN)978-91-7529-018-8 (ISBN)
Public defence
2014-05-30, Haldasalen, Högskolan Halmstad, Halmstad, 11:25 (English)
Opponent
Supervisors
Note

Medicine doktorsexamen

Available from: 2017-01-10 Created: 2016-12-19 Last updated: 2017-01-10Bibliographically approved

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Källstrand-Ericson, JeanetteHildingh, Cathrine

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