The experiences of older adults with cognitive impairment in using falls prevention alarms in hospital: A qualitative descriptive study

IF 1.6 4区医学 Q2 REHABILITATION

Australian Occupational Therapy Journal Pub Date : 2023-11-28 DOI:10.1111/1440-1630.12917

Kelly Stephen, Alison Campbell

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引用次数: 0

Abstract

Introduction

Bed and chair sensor alarms are commonly used for falls prevention in hospitals, despite questionable efficacy. Research analysing older adults' experiences of alarms is scarce, and adults with cognitive impairment are consistently excluded.

Aim

The aim of this study was to explore how older adults with cognitive impairment perceive and experience falls prevention alarms in hospital.

Method

A qualitative descriptive design investigated older adults' experiences of alarms in a Geriatric Evaluation and Management ward in Melbourne. Patients were included if they had been provided an alarm. Semi-structured interviews were the primary method of data collection with two observation sessions and medical record analyses completed to enable triangulation of findings. Data were subjected to thematic analysis, and the Person-Environment-Occupation framework was chosen to add insight into the complexities of older adults' experiences of alarms.

Findings

All 11 participants had a level of cognitive impairment with delirium, confusion, or impulsiveness recorded in their medical file. Two overarching themes were identified: communication and collaboration with staff and rationalisation of alarm use. Participants' perceived staff were focussed on falls prevention but experienced a lack of communication about the purpose of alarms. Participants wanted an individualised approach to alarms. Some were comforted with the thought of alarms alerting staff, making them feel well cared for and believed alarms were a useful ‘back-up’. Others found alarms uncomfortable, frustrating, and restricting. Application of the Person-Environment-Occupation framework provided insight into how enabling and restrictive factors can impact whether the alarm is experienced positively or negatively. Seven unwitnessed falls occurred during the participants' admissions. Thirty-four per cent of alarm triggers observed were considered false alerts.

Conclusion

Older adults commonly reported negative experiences using bed/chair sensor alarms. Occupational therapists have the training to collaborate with people with cognitive impairment and assess the usefulness of alarms in reducing falls, based on how they interact with the older adult's unique person, environment, and occupation domains.

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查看原文本刊更多论文

认知障碍老年人在医院使用防跌倒警报器的经验:一项定性描述性研究。

导读:床和椅子传感器报警器通常用于医院预防跌倒，尽管其有效性值得怀疑。分析老年人警报经历的研究很少，而且有认知障碍的成年人一直被排除在外。目的:本研究的目的是探讨有认知障碍的老年人如何感知和体验医院的跌倒预防警报。方法:采用定性描述设计调查墨尔本老年评估和管理病房的老年人对警报的体验。如果给病人提供了警报，他们也被包括在内。半结构化访谈是收集数据的主要方法，其中有两次观察期和完成的医疗记录分析，以便对结果进行三角测量。数据进行了专题分析，并选择了“人-环境-职业”框架，以深入了解老年人警报体验的复杂性。研究结果:所有11名参与者都有一定程度的认知障碍，包括精神错乱、精神错乱或冲动，这些都记录在他们的医疗档案中。确定了两个总体主题:与工作人员的沟通和协作以及使警报使用合理化。参与者认为工作人员专注于预防跌倒，但缺乏关于警报目的的沟通。参与者想要一种个性化的警报方法。一些人对警报器提醒员工感到欣慰，让他们感到受到了很好的照顾，并相信警报器是有用的“后备”。另一些人则觉得警报让人不舒服、沮丧和受限。人-环境-职业框架的应用提供了对使能因素和限制因素如何影响警报是积极的还是消极的见解。在参与者入院期间发生了七次无人目击的跌倒。观察到的34%的警报触发被认为是假警报。结论:老年人普遍报告使用床/椅子传感器报警器的负面经历。职业治疗师接受过与认知障碍患者合作的培训，并根据他们如何与老年人独特的人、环境和职业领域相互作用来评估警报器在减少跌倒方面的有用性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Australian Occupational Therapy Journal 医学-康复医学

CiteScore

2.80

自引率

16.70%

发文量

审稿时长

6-12 weeks

期刊介绍： The Australian Occupational Therapy Journal is a leading international peer reviewed publication presenting influential, high quality innovative scholarship and research relevant to occupational therapy. The aim of the journal is to be a leader in the dissemination of scholarship and evidence to substantiate, influence and shape policy and occupational therapy practice locally and globally. The journal publishes empirical studies, theoretical papers, and reviews. Preference will be given to manuscripts that have a sound theoretical basis, methodological rigour with sufficient scope and scale to make important new contributions to the occupational therapy body of knowledge. AOTJ does not publish protocols for any study design The journal will consider multidisciplinary or interprofessional studies that include occupational therapy, occupational therapists or occupational therapy students, so long as ‘key points’ highlight the specific implications for occupational therapy, occupational therapists and/or occupational therapy students and/or consumers.