Longitudinal Trajectories and Determinants of Fear of Falling in Post-Stroke Patients

IF 3.9 3区医学 Q1 NURSING

Journal of Nursing Scholarship Pub Date : 2026-07-13 DOI:10.1111/jnu.70115

Xiaomeng Han, Mingming Zhong, Wenxiu Niu, Fei Zheng, Yuhan Sha, Xin Feng, Ruiyuan Yin, Panpan Li, Fangli Ma, Ying Ren, Zhigang Zhang

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引用次数: 0

Abstract

Objective

Fear of falling is a common and serious psychological challenge after stroke, yet its longitudinal patterns remain poorly understood. Current evidence often fails to capture individual heterogeneity in recovery trajectories. This study aimed to identify distinct longitudinal trajectories of fear of falling and explore associated factors to inform targeted rehabilitation strategies in post-stroke patients.

Design

A prospective longitudinal study.

Methods

From August 2023 to December 2024, we enrolled 166 stroke patients from the neurology wards of two hospitals in Lanzhou, China, forming a hospital-based sample within an urban healthcare setting. Fear of falling was assessed using a single-item question and the Short Falls Efficacy Scale-International at four time points: 2 weeks, 1 month, 3 months, and 6 months post-stroke. Data were analyzed using latent class growth modeling in Mplus 8.0.

Results

The prevalence of fear of falling was 48.8%, 49.4%, 45.8%, and 34.3% at 2 weeks, 1 month, 3 months, and 6 months, respectively. Mean Short Falls Efficacy Scale-International scores were 11.30 (±4.74), 9.84 (±3.40), 9.61 (±3.13), and 8.00 (±1.22) at these time points. Three distinct fear of falling trajectories were identified: high-level continuous decline (20.48%), medium-level steady decline (26.51%), and low-level fear (53.01%). Age, anxiety levels, and depression levels were significant factors associated with these trajectories.

Conclusion

Fear of falling after stroke demonstrates heterogeneous longitudinal trajectories that are significantly influenced by age, anxiety, and depression. These findings highlight the importance of individualized assessment and targeted psychological support during stroke rehabilitation.

Clinical Relevance

Fear of falling is a dynamic psychological challenge during stroke recovery. Routine screening for fear of falling, anxiety, and depression may help nurses identify patients at risk for persistent fear trajectories. Tailored rehabilitation and psychological interventions may improve rehabilitation participation and recovery outcomes.

Patient or Public Contribution

No patient or public engagement.

查看原文本刊更多论文

脑卒中后患者对跌倒恐惧的纵向轨迹和决定因素。

目的：害怕跌倒是中风后常见且严重的心理挑战，但其纵向模式尚不清楚。目前的证据往往无法捕捉到恢复轨迹中的个体异质性。本研究旨在确定不同的跌倒恐惧的纵向轨迹，并探讨相关因素，为卒中后患者提供有针对性的康复策略。设计：前瞻性纵向研究。方法：从2023年8月至2024年12月，我们从中国兰州两家医院的神经内科病房招募了166名脑卒中患者，形成了一个以医院为基础的城市医疗机构样本。在中风后2周、1个月、3个月和6个月四个时间点，使用单项问题和短跌倒疗效量表（Short Falls Efficacy Scale-International）评估对跌倒的恐惧。数据分析采用Mplus 8.0的潜在类生长模型。结果：2周、1个月、3个月、6个月时的跌倒恐惧患病率分别为48.8%、49.4%、45.8%、34.3%。在这些时间点，平均短跌倒疗效量表-国际评分分别为11.30（±4.74）、9.84（±3.40）、9.61（±3.13）和8.00（±1.22）。对下降轨迹的三种不同的恐惧：高水平持续下降（20.48%），中等水平稳定下降（26.51%）和低水平恐惧（53.01%）。年龄、焦虑水平和抑郁水平是与这些轨迹相关的重要因素。结论：脑卒中后跌倒恐惧表现出异质性的纵向轨迹，显著受年龄、焦虑和抑郁的影响。这些发现强调了在脑卒中康复过程中进行个性化评估和有针对性的心理支持的重要性。临床相关性：害怕跌倒是中风恢复过程中一个动态的心理挑战。对害怕跌倒、焦虑和抑郁的常规筛查可以帮助护士识别有持续恐惧轨迹风险的患者。量身定制的康复和心理干预可以改善康复参与和康复结果。患者或公众贡献：没有患者或公众参与。

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

Journal of Nursing Scholarship 医学-护理

CiteScore

6.30

自引率

5.90%

发文量

审稿时长

6-12 weeks

期刊介绍： This widely read and respected journal features peer-reviewed, thought-provoking articles representing research by some of the world’s leading nurse researchers. Reaching health professionals, faculty and students in 103 countries, the Journal of Nursing Scholarship is focused on health of people throughout the world. It is the official journal of Sigma Theta Tau International and it reflects the society’s dedication to providing the tools necessary to improve nursing care around the world.