Developing a falls prevention program for community-dwelling stroke survivors in Singapore: client and caregiver perspectives

Tianma Xu, Kate O’Loughlin, Lindy Clemson, Natasha A. Lannin, Catherine Dean, Gerald Koh

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Purpose: Drawing on the perspectives of stroke survivors, family members and domestic helpers, this study explores participants’ experiences of self-perceived fall risk factors after stroke, common fall prevention strategies used, and challenges to community participation after a fall. Methods: Semi-structured interviews were conducted in Singapore with community-dwelling stroke survivors with a previous fall (n = 9), family caregivers (n = 4), and domestic helpers (n = 4) who have cared for a stroke survivor with a previous fall. Purposive sampling was used for recruitment; all interviews were audio-recorded with permission and transcribed. Thematic analysis was conducted using NVivo (v10) software. Results: All participants shared their self-perceived intrinsic and extrinsic fall risk factors and main challenges after a fall. For stroke participants and family caregivers, motivational factors in developing safety strategies after a previous fall(s) include social connectedness, independent living and community participation. For family caregivers and domestic helpers, the stroke survivor’s safety is their top priority, however this can also lead to over-protective behavior outside of the rehabilitation process. Conclusions: Reducing the risk of falls in community-dwelling stroke survivors seems to be more important than promoting community participation among caregivers. The study findings highlight that a structured and client-centered fall prevention program targeting stroke survivors and caregivers is needed in Singapore. 

Implications for rehabilitation: Falls after stroke can lead to functional decline in gait and mobility and restricted self-care activities. 

Community-dwelling stroke survivors develop adaptive safety strategies after a fall and want to be socially connected. However, caregivers see the safety of the stroke survivors as their top priority and demonstrate over-protective behaviors. 

Fall prevention programs for community-dwelling stroke survivors should target both stroke survivors and their caregivers. 

A structured and client-centered fall prevention program targeting at multiple risk factors post-stroke is needed for community-living stroke survivors.

LanguageEnglish
Pages1044-1054
Number of pages11
JournalDisability and Rehabilitation
Volume41
Issue number9
Early online date25 Dec 2017
DOIs
Publication statusPublished - 24 Apr 2019

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Independent Living
Singapore
Caregivers
Survivors
Stroke
Safety
Rehabilitation
Interviews
Self Care

Cite this

Xu, Tianma ; O’Loughlin, Kate ; Clemson, Lindy ; Lannin, Natasha A. ; Dean, Catherine ; Koh, Gerald. / Developing a falls prevention program for community-dwelling stroke survivors in Singapore : client and caregiver perspectives. In: Disability and Rehabilitation. 2019 ; Vol. 41, No. 9. pp. 1044-1054.
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abstract = "Purpose: Drawing on the perspectives of stroke survivors, family members and domestic helpers, this study explores participants’ experiences of self-perceived fall risk factors after stroke, common fall prevention strategies used, and challenges to community participation after a fall. Methods: Semi-structured interviews were conducted in Singapore with community-dwelling stroke survivors with a previous fall (n = 9), family caregivers (n = 4), and domestic helpers (n = 4) who have cared for a stroke survivor with a previous fall. Purposive sampling was used for recruitment; all interviews were audio-recorded with permission and transcribed. Thematic analysis was conducted using NVivo (v10) software. Results: All participants shared their self-perceived intrinsic and extrinsic fall risk factors and main challenges after a fall. For stroke participants and family caregivers, motivational factors in developing safety strategies after a previous fall(s) include social connectedness, independent living and community participation. For family caregivers and domestic helpers, the stroke survivor’s safety is their top priority, however this can also lead to over-protective behavior outside of the rehabilitation process. Conclusions: Reducing the risk of falls in community-dwelling stroke survivors seems to be more important than promoting community participation among caregivers. The study findings highlight that a structured and client-centered fall prevention program targeting stroke survivors and caregivers is needed in Singapore. Implications for rehabilitation: Falls after stroke can lead to functional decline in gait and mobility and restricted self-care activities. Community-dwelling stroke survivors develop adaptive safety strategies after a fall and want to be socially connected. However, caregivers see the safety of the stroke survivors as their top priority and demonstrate over-protective behaviors. Fall prevention programs for community-dwelling stroke survivors should target both stroke survivors and their caregivers. A structured and client-centered fall prevention program targeting at multiple risk factors post-stroke is needed for community-living stroke survivors.",
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Developing a falls prevention program for community-dwelling stroke survivors in Singapore : client and caregiver perspectives. / Xu, Tianma; O’Loughlin, Kate; Clemson, Lindy; Lannin, Natasha A.; Dean, Catherine; Koh, Gerald.

In: Disability and Rehabilitation, Vol. 41, No. 9, 24.04.2019, p. 1044-1054.

Research output: Contribution to journalArticleResearchpeer-review

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