Adherence to Recommendations of Home Modification for Falls Prevention in Stroke Patients
Date Issued
2010
Date
2010
Author(s)
Tsai, Lan-Shiang
Abstract
Home modification was prpoposed as an important strategy to prevent falls among older people who are at increased risk of falling. Previous studies suggested that adherence seems to be a crucial issue with respect to the effectiveness of the home modification. This study examined the adherence of home modification recommendations given by an occupational therapist and attempted to identify correlated factors of the adherence among stroke patients.
An experienced occupational therapist visited the homes of 14 stroke patients, who had recently discharged from the rehabilitation ward, identified the environmental hazards, and made recommendations for falls prevention. Other data related to the adherence including the socio-demographic details, housing characteristics, family status, past medical history, modification characteristics, health status, and health belief of home modification of caregiver were collected before the discharge of rehabilitation ward. One month later, a telephone survey was conducted to assess the adherence to each recommendation. Descriptive statistics were calculated for the dependent variable and all independent variables for the sample. Mann-Whitney U test, Kruskal-Wallis test and Spearman’s correlation were used to analyze the correlations between the adherence of home modification and each of the correlated factors.
The results showed that there were about 3 to 24 environmental hazards (median 9.5 hazards) presented in each home. The bathroom, entrance and stairs, and bedroom were the commonest sites with environmental hazards, especially the bathroom. An average of 8.7 modification recommendations was made by the occupational therapist. At follow up, the caregivers of the 14 stroke patients reported complying 74.0% of the recommendations given by the occupational therapist. Adherence to specific recommendations varied from a high of 100% adherence, such as behavior modification. However, the recommendation of removing or lowering the stopovers was not adhered at all (0% adherence). Bivariate analysis found that participants’ adherence to home modification was significant correlated to their level of belief that home modification are beneficial, their level of perceived susceptibility to falling, and their incomes.
The results showed that behavior modification rather than changing the physical environment was more acceptable for stroke patients. Future educational programs emphasizing the necessity of home modification for preventing fall should be organized in clinics as an effort to improve the adherence of home modification. Besides, policy-maker may consider increasing the reimbursement of home modification to motivate people to make home modification for preventing fall.
Subjects
stroke
home modifications
adherence
accidental falls
File(s)![Thumbnail Image]()
Loading...
Name
ntu-99-R96429001-1.pdf
Size
23.32 KB
Format
Adobe PDF
Checksum
(MD5):fce207ba32b75b4080dab4346e798013