"Be ready to learn": a qualitative study of the patient perspective of falls and fall prevention following discharge from a spinal injuries unit

Disabil Rehabil. 2023 Aug 9:1-8. doi: 10.1080/09638288.2023.2245755. Online ahead of print.

Abstract

Purpose: Falls following a spinal cord injury (SCI) can have physical and psychological consequences, although some risk of falls may be acceptable to enable participation in meaningful activity. The study aimed to explore the patients' perspective of falls and fall prevention after discharge from a inpatient spinal injuries unit.

Methods: An interpretive descriptive approach guided the study. Semi structured interviews were conducted in the 6-12 months post discharge period. Thematic analysis was used to analyze the data and identify themes.

Results: Fifteen individuals with SCI, with a mean age of 57 years and varied fall experiences were included. Three themes were identified including: 1. Expectation of falling; 2. Learning from my own experience and the experience of others' and 3. How to prevent falls. Learning from their own experience and the experience of others was highly valued by persons with SCI and influenced expectations of falls. A variety of strategies were used to prevent falls.

Conclusions: Strategies that include learning from others, include activities that are individual and provide skills in self-reflection may aid to make fall prevention meaningful.Implications for RehabilitationPatients want to learn from practical experience and the experience of others with spinal cord injury (SCI).Clinicians need to consider patients' readiness to receive education and could benefit from the inclusion of peers in the delivery of information/education provided.A shift of focus for clinicians providing fall prevention education to skills in risk assessment, self-reflection and ability to formulate fall management plans may be beneficial to patients with SCI.Patients appreciate demonstration of skills. Clinicians are encouraged to learn wheelchair skills when performing functional tasks and demonstrate them to add credibility to their fall prevention education.

Keywords: Spinal cord injury; community living; falls; patient perspective; rehabilitation; self-management.