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Development and Validation for Use With Older Adults
Falling is a significant cause of disability and death among older adults. A recent U. S. Centers for Disease Control and Prevention report listed fall-related injuries as the leading cause of injury- related morbidity and mortality in elderly individuals (2006). Approximately 30% of community-dwelling older adults fall each year, of whom 50% fall more than once (Tinetti & Speechley, 1989; Tinetti, Speechley, & Ginter, 1988). Up to 10% of falls result in serious soft tissue injuries, including hematomas, sprains, and joint dislocations (Tinetti & Speechley, 1989). An additional 5% result in bone fractures of the humerus, wrist, pelvis, and hip (Tinetti & Speechley, 1989).
Length of hospital stay has been found to be twice as high for elderly patients hospitalized after a fall compared to elderly persons hospitalized for other reasons (Scott & Gallagher, 1999). Falls not only lead to increased use of health-care resources for acute treatment (Alexander, Rivara, & Wolf, 1992; Rizzo, Baker, McAvay, & Tinetti, 1996), but elderly individuals who sustain an injury from a fall are more likely to use health care services such as nursing care in the ensuing year (Wilkins, 1999).
Falls also affect the confidence, independence, and quality of life of older persons (Tinetti, Mendes de Leon, Doucette, & Baker, 1994). Between 40% and 73% of community- dwelling older adults say they have a fear of falling (Arfken, Lach, Birge, & Miller, 1994; Tinetti, Mendes de Leon, et al., 1994), and many restrict their activities as a result (Arfken et al., 1994; Tinetti & Williams, 1998).
A significant amount of research has been conducted to describe the risk factors for falls in older populations, and physical, behavioral, environmental, and medication-related risk factors for falling are well-documented (Grisso et al., 1991; Leipzig, Cumming, & Tinetti, 1999a, 1999b; Nevitt, Cummings, Kidd, & Black, 1989; Tinetti et al., 1988). However, there is a relative paucity of information about older adults' awareness of or opinions about risks for falling (Braun, 1998).
Braun (1998) made an initial attempt at identifying knowledge and perception of risks for falls in older adults. A self-administered questionnaire was completed by 120 community-dwelling older adults. The study concluded older adults perceived falls as preventable and understood risks for falling...