Obi PC1, Nwankwo H2, Diemeta E3, Adandom I2, Obenebo MI4, Arinole Y5, Kalu M6
1Peak Wellness Centre, Physiotherapy, Abuja, Nigeria, 2Centre for Research on Ageing,University of Southampton, Gerontology, Southampton, United Kingdom, 3Humanity Hospital Limited, Physiotherapy, Warri, Nigeria, 4General Hospital Ekwulobia, Physiotherapy, Ekwulobia, Nigeria, 5University of Manitoba, Department of Applied Health Science, Manitoba, Canada, 6McMaster University Hamilton, School of Rehabilitation Science, Ontario, Canada
Background: Falling is a major health concern that has contributed significantly to older people's injury and loss of life worldwide, warranting the development of fall prevention strategies. The success of these strategies has been attributed to the knowledge about risk factors and practice of fall prevention in older adults among physiotherapists and other healthcare professionals. While this has been extensively studied among physiotherapists practicing in the developed nations, little is known about the experiences of physiotherapist practicing fall prevention in developing nations.
Purpose: To determine the self-reported levels of knowledge on risk factors and experience gained by physiotherapists in Nigeria when practicing of fall prevention in older adults.
Methods: We adopted a multi-method approach in this study. First, physiotherapists (n=273) randomly recruited from the six geopolitical zones of Nigeria complete a three-part structured questionnaire that asked questions about risk factors for fall and common practices for fall prevention using a 5-point rated Likert. Subsequently, we purposefully selected and conducted face to face interviews with twelve physiotherapists who have treated at least one older adult who reported falling two or three times within last six months. Data were analyzed using chi-square/Kruskal- Wallis test and thematic analysis for quantitative and qualitative data respectively.
Results: Among physiotherapists in Nigeria, 89% rated their level of knowledge about preventing falls among older adults as high, and 64% of them rated their level of practice on this topic as high. Among the individual items that measure knowledge, knowledge, 40% of the participants reported a moderate level of knowledge about multiple medications as a risk factor for falls. Fifty percent of the participants reported a low level of practice of referral to other health care professionals, whereas 40% and 41% reported a moderate level of practice on documenting risk factors and treatment plans, respectively. Surprisingly, a high percentage (80%) of the participants reported not being aware of the WHO fall prevention strategies or any other fall prevention guidelines. Four themes emerged from our participants: characteristics of recurrent fallers; fall prevention practices, hindrances to fall prevention and strategies to promote fall prevention practices. In practice, understanding the characteristic (risk factors) of older adults with the history of recurrent falls is important for effective fall prevention practices among physiotherapists. Among other characteristics, our participants believed that older adults who have patronized “traditional bone setters/healer” are at the higher risk of having multiple falls.
Conclusion(s): Although physiotherapists in Nigeria generally showed high levels of knowledge and practice about fall prevention in older adults, there is room for improvement in their knowledge and practice with respect to standardized, multidisciplinary approaches to fall prevention, and the importance of case note documentation.
Implications: Knowledge translation strategies are needed such as updating standards of practice, creating clinical practice guidelines, and then using methods of reminder, audit, and feedback to ensure that practice patterns are appropriately changed to reflect best practice. However, the high level of knowledge implies that fall‐prevention strategies could be sustainably implemented in most physiotherapy clinical practice settings in Nigeria.
Keywords: Accidental Falls, Elderly People, Physical Therapist
Funding acknowledgements: The research was not funded
Purpose: To determine the self-reported levels of knowledge on risk factors and experience gained by physiotherapists in Nigeria when practicing of fall prevention in older adults.
Methods: We adopted a multi-method approach in this study. First, physiotherapists (n=273) randomly recruited from the six geopolitical zones of Nigeria complete a three-part structured questionnaire that asked questions about risk factors for fall and common practices for fall prevention using a 5-point rated Likert. Subsequently, we purposefully selected and conducted face to face interviews with twelve physiotherapists who have treated at least one older adult who reported falling two or three times within last six months. Data were analyzed using chi-square/Kruskal- Wallis test and thematic analysis for quantitative and qualitative data respectively.
Results: Among physiotherapists in Nigeria, 89% rated their level of knowledge about preventing falls among older adults as high, and 64% of them rated their level of practice on this topic as high. Among the individual items that measure knowledge, knowledge, 40% of the participants reported a moderate level of knowledge about multiple medications as a risk factor for falls. Fifty percent of the participants reported a low level of practice of referral to other health care professionals, whereas 40% and 41% reported a moderate level of practice on documenting risk factors and treatment plans, respectively. Surprisingly, a high percentage (80%) of the participants reported not being aware of the WHO fall prevention strategies or any other fall prevention guidelines. Four themes emerged from our participants: characteristics of recurrent fallers; fall prevention practices, hindrances to fall prevention and strategies to promote fall prevention practices. In practice, understanding the characteristic (risk factors) of older adults with the history of recurrent falls is important for effective fall prevention practices among physiotherapists. Among other characteristics, our participants believed that older adults who have patronized “traditional bone setters/healer” are at the higher risk of having multiple falls.
Conclusion(s): Although physiotherapists in Nigeria generally showed high levels of knowledge and practice about fall prevention in older adults, there is room for improvement in their knowledge and practice with respect to standardized, multidisciplinary approaches to fall prevention, and the importance of case note documentation.
Implications: Knowledge translation strategies are needed such as updating standards of practice, creating clinical practice guidelines, and then using methods of reminder, audit, and feedback to ensure that practice patterns are appropriately changed to reflect best practice. However, the high level of knowledge implies that fall‐prevention strategies could be sustainably implemented in most physiotherapy clinical practice settings in Nigeria.
Keywords: Accidental Falls, Elderly People, Physical Therapist
Funding acknowledgements: The research was not funded
Topic: Older people; Health promotion & wellbeing/healthy ageing; Education: clinical
Ethics approval required: Yes
Institution: University of Southampton
Ethics committee: Ethis and Research Goverance of University of Southamption
Ethics number: 14692.2812
All authors, affiliations and abstracts have been published as submitted.
