Analysis and prevention of falls among community-dwelling older adults in southern Thailand

Abstract

Aim: To analyse fall prevalence, risk factors and perceptions among Thai older adults to design a prevention model.

Design: Quantitative and qualitative data were collected using a convergent parallel mixed-methods design.

Methods: A cross-sectional analysis was conducted using secondary data from health screenings of older adults in 20 subdistrict hospitals in southern Thailand from January 2018 to September 2019 (n = 12,130). In-depth interviews (IDIs) and focus group discussions (FGDs) were conducted with purposively sampled participants who were representatives of older adults and stakeholders (n = 50).

Results: The quantitative analysis showed that the prevalence of falls was 12.1%. The independent risk factors were female gender, employment status, cognitive impairment, semi-dependent functional ability, balance problems, vision impairment, hearing difficulties, use of medications, reliance on assistive devices and access to outdoor toilets. The qualitative analysis revealed misconceptions on falls and fall prevention measures among older adults and community stakeholders. In Thailand, healthcare providers and community nurses play a crucial role in providing primary advice and conducting interventions, yet they encounter obstacles due to lack of personnel, time constraints, limited resources, inadequate support and unclear policies. Stakeholders stress the urgency of improving practice guidelines, developing evidence-based strategies and aligning with government policies.

Conclusions: Fall risk factors and prevention challenges among older adults were identified. Effective fall prevention programmes are needed.

Impact: The identified fall events may guide public health agencies and local administrations in planning fall prevention programmes. For implementation in Thai communities, teamwork among leaders and stakeholders is key.

Patient or public contribution: IDIs and FGDs were conducted with older adults, village health volunteers, nurses, healthcare providers, local organization administrators and village headmen.

Keywords: Thai older adults; fall prevention measure; nursing; perception of falls.