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Feasibility of a cognitive behavioural group intervention to reduce fear of falling and associated avoidance of activity in community-living older people: a process evaluation.

van Haastregt JC, Zijlstra GA, van Rossum E, van Eijk JT, de Witte LP, Kempen GI - BMC Health Serv Res (2007)

Bottom Line: Minor refinement of the intervention, however, is warranted to further improve intervention effectiveness and efficiency.Based on these positive findings, we recommend implementing a refined version of this effective and feasible intervention in regular care.ISRCTN43792817.

View Article: PubMed Central - HTML - PubMed

Affiliation: Maastricht University, Faculty of Health, Medicine and Life Sciences, School for Public Health and Primary Care, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. j.vanhaastregt@zw.unimaas.nl

ABSTRACT

Background: Fear of falling and associated avoidance of activity are common among older people and may have negative consequences in terms of functional decline, quality of life and institutionalisation. We evaluated the effects of a cognitive behavioural group intervention to reduce fear of falling and associated avoidance of activity among older persons. This intervention showed favourable effects on fear of falling, avoidance of activity, daily activity, and several secondary outcomes. The aim of the present study is to assess the feasibility of this cognitive behavioural group intervention for participants and facilitators.

Methods: The intervention consisted of eight weekly group sessions lasting two hours each and a booster session after six months. Self-administered questionnaires, registration forms and interviews were used to collect data from participants (n = 168) and facilitators (n = 6) on the extent to which the intervention was performed according to protocol, participant attendance, participant adherence, and participants' and facilitators' opinion of the intervention. Quantitative data from the questionnaires and registration forms were analysed by means of descriptive statistics. Qualitative data were categorised based on matching contents of the answers.

Results: Facilitators reported no major protocol deviations. Twenty-six percent of the participants withdrew before the start of the programme. Of the persons who started the programme, 84% actually completed it. The participants reported their adherence as good, but facilitators had a less favourable opinion of this. The majority of participants still reported substantial benefits from the programme after six and twelve months of follow-up (71% and 61% respectively). Both participants and facilitators provided suggestions for improvement of the intervention.

Conclusion: Results of this study show that the current cognitive behavioural group intervention is feasible for both participants and facilitators and fits in well with regular care. Minor refinement of the intervention, however, is warranted to further improve intervention effectiveness and efficiency. Based on these positive findings, we recommend implementing a refined version of this effective and feasible intervention in regular care.

Trial registration: ISRCTN43792817.

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Related in: MedlinePlus

Flow chart process evaluation participants.
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Figure 1: Flow chart process evaluation participants.

Mentions: A total of 174 persons (74%) had completed the programme and received the first evaluation questionnaire immediately after the programme (Figure 1). Six questionnaires were not returned, resulting in a response of 97% (n = 168). Of the 161 persons who did not withdraw in the period between the end of the programme and the booster session after six months, 159 (99%) filled in the second questionnaire at FU2 and 151 (94%), the third at FU3. Table 3 shows the characteristics of the 174 persons who completed the intervention and the characteristics of the 106 persons who did not complete the intervention. Overall the persons completing the intervention seem to be less frail, less afraid of falling and less avoidant than the persons who did not complete the intervention.


Feasibility of a cognitive behavioural group intervention to reduce fear of falling and associated avoidance of activity in community-living older people: a process evaluation.

van Haastregt JC, Zijlstra GA, van Rossum E, van Eijk JT, de Witte LP, Kempen GI - BMC Health Serv Res (2007)

Flow chart process evaluation participants.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2194766&req=5

Figure 1: Flow chart process evaluation participants.
Mentions: A total of 174 persons (74%) had completed the programme and received the first evaluation questionnaire immediately after the programme (Figure 1). Six questionnaires were not returned, resulting in a response of 97% (n = 168). Of the 161 persons who did not withdraw in the period between the end of the programme and the booster session after six months, 159 (99%) filled in the second questionnaire at FU2 and 151 (94%), the third at FU3. Table 3 shows the characteristics of the 174 persons who completed the intervention and the characteristics of the 106 persons who did not complete the intervention. Overall the persons completing the intervention seem to be less frail, less afraid of falling and less avoidant than the persons who did not complete the intervention.

Bottom Line: Minor refinement of the intervention, however, is warranted to further improve intervention effectiveness and efficiency.Based on these positive findings, we recommend implementing a refined version of this effective and feasible intervention in regular care.ISRCTN43792817.

View Article: PubMed Central - HTML - PubMed

Affiliation: Maastricht University, Faculty of Health, Medicine and Life Sciences, School for Public Health and Primary Care, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. j.vanhaastregt@zw.unimaas.nl

ABSTRACT

Background: Fear of falling and associated avoidance of activity are common among older people and may have negative consequences in terms of functional decline, quality of life and institutionalisation. We evaluated the effects of a cognitive behavioural group intervention to reduce fear of falling and associated avoidance of activity among older persons. This intervention showed favourable effects on fear of falling, avoidance of activity, daily activity, and several secondary outcomes. The aim of the present study is to assess the feasibility of this cognitive behavioural group intervention for participants and facilitators.

Methods: The intervention consisted of eight weekly group sessions lasting two hours each and a booster session after six months. Self-administered questionnaires, registration forms and interviews were used to collect data from participants (n = 168) and facilitators (n = 6) on the extent to which the intervention was performed according to protocol, participant attendance, participant adherence, and participants' and facilitators' opinion of the intervention. Quantitative data from the questionnaires and registration forms were analysed by means of descriptive statistics. Qualitative data were categorised based on matching contents of the answers.

Results: Facilitators reported no major protocol deviations. Twenty-six percent of the participants withdrew before the start of the programme. Of the persons who started the programme, 84% actually completed it. The participants reported their adherence as good, but facilitators had a less favourable opinion of this. The majority of participants still reported substantial benefits from the programme after six and twelve months of follow-up (71% and 61% respectively). Both participants and facilitators provided suggestions for improvement of the intervention.

Conclusion: Results of this study show that the current cognitive behavioural group intervention is feasible for both participants and facilitators and fits in well with regular care. Minor refinement of the intervention, however, is warranted to further improve intervention effectiveness and efficiency. Based on these positive findings, we recommend implementing a refined version of this effective and feasible intervention in regular care.

Trial registration: ISRCTN43792817.

Show MeSH
Related in: MedlinePlus