Authors: (including presenting author): :
Lau MW(1), Chan DYC(2), Li RSM(1), Lam SYS(2), Tam BHT(2), Cheng HKY(2), Chan FM(1), Leung KKL(2)
Affiliation: :
(1)Department of Psychiatry, (2)Physiotherapy Department, Kowloon Hospital
Keyword 2: :
Fall efficacy
Keyword 4: :
Hospitalized seniors
Keyword 6: :
Self-management
Introduction: :
Falls represent the most common incident in Hospital Authority. Cognitive decline, psychological symptoms, and hospitalized-associated physical deterioration trigger a vicious cycle causing higher fall risk, reduced independence, and prolonged hospitalization. More-mobile psychiatric hospitalized seniors experienced fall despite universal fall precautions precipitated by discordance between assumed and actual fall risk. Multifactorial management on enhancing fall efficacy in terms of individual's perceived ability on managing potential threats of fall, enclosing 4-domains:“Balance self-efficacy”, “Balance recovery self-efficacy”, “Self-landing self-efficacy”, and “Post fall recovery self-efficacy”, is therefore crucial to minimize specific fall risk factors for these patients.
Objectives: :
To investigate the effectiveness of enhanced fall efficacy program on psychosocial outcomes and fall efficacy among more-mobile psychiatric hospitalized seniors.
Methodology: :
A quasi-experimental single-group pretest-posttest study was conducted in a female psychogeriatric and long-stay ward for independent/supervised walkers in 07-12/2025. The nurse-physiotherapist collaborative program included daily video exercise training, twice-a-week face-to-face Taichi class and patient empowerment talk. Outcomes assessed included cognitive functioning(Hong Kong Brief Cognitive Test,HKBC), mood and social engagement(Geriatric Depression Scale,GDS), sleep quality and wakening pattern(Sleep Chart,SC), in-patient medication history, and confidence on managing fall(Fall Efficacy Survey).
Result & Outcome: :
28 patients were recruited(mean age:65.89±4.84). No falls occurred during study until discharge. Significant improvements showed in cognition(HKBC:19.88±5.06 to 22.00±4.72(p< 0.001)), and mood/social engagement(GDS:4.36±2.73 to 2.56±2.18(p=0.007)). Better sleeping quality and daytime arousal were credited with significance in longer deep-sleep duration(37.8±3.27hr to 39.68±0.82hr(p=0.001)), less insomnia interval(1.45±2.31hr to 0.14±0.52hr(p=0.001)), reduced daytime sleepiness(1.71±4.85hr to 0.00±0.00hr(p=0.027)), and trend of improvement in broken sleep(0.75±1.6hr to 0.18±0.67hr(p=0.066)). 5 participants(17.86%) achieved psychiatric medication simplification post-program. This anticipated further treatment regime optimization can be achieved with longer program adherence, emerging less pharmacological dependence. 27 participants(96.4%) reported confidence across all fall efficacy domains. To conclude, the program demonstrated significant improvement in psychosocial outcomes among more-mobile psychiatric hospitalized seniors. Benefits on psychological symptoms and social engagement aligned with global initiatives and World Health Organization’s recommendations. Adequate energy arousal supports active lifestyle and physical reconditioning, therefore enhanced fall efficacy. Medication optimization reinforces effective self-management, empowers ownership on treatment compliance, thereby potentially reducing healthcare dependence and hospital length of stay.
