Falls as a global public health concern: a modified Delphi study to determine the functional activities during which near-falls occur

Judith Lane, Joanna Long, Yazeed Qashwa, Chee-Wee Tan
Purpose:

Our study aimed to establish the relevance and comprehensiveness of the functional activities in the BRCS for adults aged 50 and over living independently in the UK.

Methods:

We used the modified Delphi consensus development method, designing the survey using Jisc Online Surveys© software. Using purposive sampling, we recruited expert panellists who were independently living UK community-dwelling adults aged 50 years and over or UK-based healthcare professionals (HCPs) with at least three years of experience in falls management. The experts scored each of the 19 BRCS activities using a one (‘lowest relevance’) to nine (‘highest relevance’) RAND scale. The survey included a text box to suggest other relevant activities during which people may experience near falls. We analysed qualitative data using Erlingsson and Brysiewicz’s (2017) content analysis method.

Results:

We recruited 80 experts, comprising 25 community-dwelling adults (mean age=66; females=15; males= 10) and 55 HCPs with a total of 720 years’ experience amongst them (Physiotherapists=29; Nurses=14; Physicians=6; Occupational Therapists=6). Participants rated 13 (68%) of the 19 BRCS activities as ‘high relevance’ (median scores=7-9), five (26%) as ‘moderate relevance’ (median scores=4-6) and only one (5%) as ‘low relevance’ (median scores=1-3). Futhermore, 44 experts suggested 128 additional activities, which following condensation, removal of duplicates and categorisation resulted in a final list of 27 activities conducted during standing, walking, stepping, climbing, pushing and pulling.

Conclusion(s):

Our study developed consensus on the functional activities that community-dwelling adults aged 50 and over and HCPs in the UK perceive as relevant to independent living and during which near falls may occur. The findings established that most (95%) of the current BRCS activities are relevant for a UK context. However, the new functional activities the experts proposed would need to be considered in any future development work to ensure the comprehensiveness of the BRCS for the UK population.

Implications:

The experts in our study distilled a list of functional activities they perceived as essential for the independent living of the UK's ageing population. This list is valuable for all healthcare practitioners in falls prevention and management. Furthermore, our findings establish a foundation for the future development of the UK's first patient-reported outcome measure to assess balance recovery confidence.

Funding acknowledgements:
This study was conducted as part of a fully funded PhD bursary from Queen Margaret University, Scotland, United Kingdom.
Keywords:
Near-falls
Balance recovery confidence
Patient-reported outcome measure
Primary topic:
Health promotion and wellbeing/healthy ageing/physical activity
Second topic:
Older people
Third topic:
Community based rehabilitation
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
Ethical approval was granted by Queen Margaret University’s School of Health Sciences Research Ethics Committee on 27 September 2023.
Provide the ethics approval number:
REP0296
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
Yes

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