Validation of the nursing diagnosis risk for falls in elderly

Abstract

Background Falls and their consequences are critical for for elderly well-being quality of life, for caregivers, and for health care providers [1]. The nursing diagnosis risk for falls is listed in NANDA International since 2000 [2]. This diagnosis seems particularly important in planning effective nursing care for the community-dwelling elderly. Objective To validate the nursing diagnosis risk for falls in a sample of elderly. Methods Observational, cross-sectional and quantitative study conducted in three phases. The first phase, corresponded to a systematic literature review to identify the risk factors of risk for falls [3]. The second phase consisted of the translation, linguistic and cultural adaptation of the nursing diagnosis for European Portuguese language. The third, was the clinical validation of the diagnosis using the clinical validation model of Richard Fehring [4], in a sample of elderly and counting on the collaboration of registered nurses and rehabilitation nurses to collect the data and fill the questionnaires, which comprised demographic data, the risk factors and falls efficacy scale international [5]. The study was approved by the ethical committee of SESARAM. E.P.E (Madeira Island Healthcare System). Results A total of 50 risk factors of risk for falls have been identified in the systematic literature review. A European Portuguese version was obtained and submitted to the clinical validation in a sample of 126 elderly, whose average age was 73.86 years, mostly female, with the primary school, in a situation of retirement, widowed and with history of falls. The prevalence of risk for falls was 68.3% in the expert's opinion and 63.5% in the opinion of the elderly. All risk factors have been validated. The most sensitive risk factor was history of falls, comorbidities, feminine gender, polymedication, difficulty with gait, and drugs.Conclusions This study found the main risk factors for falls in a sample of community-dwelling elderly. The identification of the most sensitive risk factors may support nurses’ clinical reasoning and interventions for effective fall prevention.