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首页> 外文期刊>International journal of older people nursing >'Balancing risk' after fall-induced hip fracture: The older person's need for information
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'Balancing risk' after fall-induced hip fracture: The older person's need for information

机译：跌倒诱发的髋部骨折后的“平衡风险”：老年人对信息的需求

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Background: Hip fracture is a significant cause of morbidity and mortality in older people. Healthcare professionals have a role to identify and respond to challenges and concerns that older people face as they strive to manage risk of future falls and rebuild confidence and independence after discharge. Aims and objectives: This study aimed to explore the postdischarge concerns of older people after fall-induced hip fracture. Method: Glaser's approach to the grounded theory method guided qualitative interviews conducted with 19 older people in their own homes up to 3 months post discharge, in two health authority areas. Results: A theory of 'taking control' was generated. 'Balancing risk' emerged as a key strategy that older people employed to help them to take control after discharge home. Older people attempted to control or 'balance' their risk of future falls and dependence by implementing two further strategies: 'protective guarding' and 'following orders'. The instinctive strategy of protective guarding and the learned strategy of following orders were implemented simultaneously and were characterised by older people aiming to pace their progress and balance risk safely and appropriately. To apply these strategies, older people required information from healthcare professionals. In circumstances where older people did not receive or did not understand the information provided, they were left 'grasping to understand' and were more likely to miscalculate risk. This leads to damaged confidence and in some cases further falls. Conclusions: The concept of balancing risk aims to help healthcare professionals understand the older person's perspective of hip fracture and to recognise the efforts that people make to guard against further injury and dependence in the early postdischarge period. Implications for practice: Our study suggests that engaging older people and their relatives in discussions to acknowledge their perceptions of future risk and to provide appropriate information on managing risk is crucial, as this will enable older people to balance risk safely and ultimately rebuild independence.
机译：背景：髋部骨折是老年人发病和死亡的重要原因。在老年人努力管理未来跌倒的风险并在出院后重建信心和独立性方面，医疗保健专业人员可以识别并应对老年人所面临的挑战和担忧。目的和目的：本研究旨在探讨老年人跌倒诱发的髋部骨折后出院后的担忧。方法：格拉瑟（Glaser）采用扎根理论方法的方法指导了在出院后三个月内在两个卫生当局区域对19位老年人在家中进行的定性访谈。结果：产生了“采取控制”的理论。平衡风险已成为老年人用来帮助他们出院后控制的一项关键策略。老年人试图通过实施两个进一步的策略来控制或“平衡”他们未来跌倒和依赖的风险：“保护性保护”和“遵从命令”。同步实施保护性保护的本能策略和遵循命令的学习策略，其特点是老年人旨在加快自己的进度并安全适当地平衡风险。要应用这些策略，老年人需要医疗保健专业人员的信息。在老年人没有收到或不理解所提供信息的情况下，他们被“抓着理解”，并且更有可能误算风险。这会导致信心受损，并且在某些情况下会进一步下降。结论：平衡风险的概念旨在帮助医疗保健专业人员了解老年人对髋部骨折的看法，并认识到人们在出院后早期为防止进一步的伤害和依赖性所做的努力。对实践的影响：我们的研究表明，让老年人及其亲属参与讨论以确认他们对未来风险的认识并提供有关风险管理的适当信息至关重要，因为这将使老年人能够安全地平衡风险并最终重建独立性。

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