Application Research Of Intervention Mapping Program In Improving Self-management Abilities For Fall Prevention In Elderly Patients

Objectives:1.To acquaint the general situation of elderly patients and the current situation of self-management behavior for falling prevention,and to determine the direction of intervention of self-management health education program in elderly patients.2.To construct the self-management intervention mapping program for falling prevention in elderly patients through application of intervention mapping method.3.To examine the efficiency of self-management intervention mapping program in order to improve the level of self-management behavior for falling prevention in elderly patients through the experimental study design method.Methods:1.We select 163 inpatients from geriatrics department in a first-class hospital at Grade 3 in Apr.2016,the self-designed questionnaire was used to analyze the current situation ofself-management behavior for fall prevention in elderly patients,so as to understand the needs of patients,and to provide the basis for the construction of self-management health education program for elderly patients.2.Using the 6 steps of intervention mapping to construct a health education program for fall prevention in elderly patients.3.Using the experimental study design method,the 258 inpatients from geriatrics department in a first-class hospital at Grade 3 from Jun.till Aug.2016 were randomly divided into intervention group and control group with 129 cases in each group.The patients of two groups were given falling prevention health education guidance,The intervention group add implementation of self-management intervention mapping program for falling prevention,to assess self-management behavior of the patients through questionnaire before and after intervention for 6 months.Results:1.The overall score of self-management behavior is good for falling prevention in elderly patients among the 163 investigated patients.The percentage of good scores of self-management behavior for falling prevention in each dimension from high to low is Environmental Management(98.16%),Self-protection / Falling self-help(87.73%),Daily life management(87.11%),Dangerous behavior(79.14%),Health belief(78.52%),Chronic disease management(74.23%),Drug management(47.24%).The average score of the last 8 items from low to high is to acquire and avoid the side effects of the medication(1.84±1.39),to acquire the medication may lead to fallings,and to acquire the prevention methods(2.48±1.67);not to wear slippers to walk at home(3.14±2.00),to deal with affairs by seeking assistance(3.34±1.66),to acquire the drug name(3.34±1.53);to improve the activity gradually to the usual level after the recovery of acute disease(3.38±0.85),to acquire the medication effect(3.40±1.53);to participate in social activities regularly for keeping physically active(3.54±1.19).The patients acquire knowledge of falling prevention mainly from medical staff,accounting for 55.1%.2.Before the intervention,there was no statistical significance between the intervention group and the control group in the scores of self-management behaviors for falling prevention(P> 0.05).After 6-months-intervention the scores of self-management behaviors in the intervention group are higher than those before intervention.There is significance statistical difference(P<0.001).Conclusions:1.The inferior 4 items in the evaluation of the total 42 items of self-management behavior for falling prevention in elderly patients are the followings;Drug management,Monitoring of dangerous behavior,Chronic disease management and Health belief.It is necessary to carry out the health education to get the professional knowledge for falling prevention in elderly patients,especially for the inferior items and carry out the targeted nursing intervention.As the main source of health education knowledge,the nursing staff need to strengthen the education of popularity,scientificalness and professional guidance for the falling prevention management behavior.2.In this study,the self-management intervention mapping program is effectively improved the self-management behavior for falling prevention in elderly patients,thus to achieve the desired research objectives.The intervention mapping program is designed to improve the self-management behavior ability for falling prevention so as to achieve the nursing aim.Through the implementation of interventions of self-management from video education,family involvement,patient discussion,the establishment of behavioral objectives and the implementation of behavior training,telephone follow-up etc.We help patients to participate actively in self-management for falling prevention and improve the cognition of risk of fallings,the self-monitoring and self-restraint of dangerous / neglect behavior,and establish and maintain healthy behavior...