Perceived barriers and facilitators for the use of external hip protectors
T. Bulat, G. Powell-Cope, A. Nelson, L.Z. Rubenstein
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AbstractBackground. Hip protectors have been found to be effective in preventing hip fractures; unfortunately adherence with their use seems to be poor, especially long-term. We wanted to identify key barriers and facilitators influencing their use in long-term care from staff’s perspective and patient-perceived barriers and facilitators among elderly outpatients. Methods. A series of focus groups and individual interviews were conducted with nursing home staff and outpatients seen in a falls clinic and deemed to be high risk for falls and fall-related injuries. Forty-one nursing home staff members and 38 outpatients (3 months after receiving a multidisciplinary fall evaluation during which external hip protectors were provided) participated. Using content analysis, responses were grouped into categories. Results. In the long-term care setting, the main perceived advantage was improvement in quality of care, particularly the prevention of hip fractures. Perceived barriers were categorized into administrative constraints (cost, availability), characteristics of hip protectors, and patient and staff concerns. Facilitators were supportive managers and administrators, families and co-workers. In the outpatient setting, adherence with hip protector use was poor (34%) at 3 months despite substantial encouragement and education from the providers. All respondents gave multiple reasons for not using protectors, most commonly related to comfort and difficulty in taking them on and off. The majority of outpatients was not willing to wear them. Conclusion. Important barriers to the use of hip protectors exist from both patient and provider perspectives. Knowledge of these barriers will be used to design and evaluate targeted implementation strategies to better integrate these highly effective devices into clinical practice.Keywords: hip protectors; adherence; barriers; facilitators
T. Bulat, G. Powell-Cope, A. Nelson, L.Z. Rubenstein (2004). Perceived barriers and facilitators for the use of external hip protectors. Gerontechnology, 3(1), 5-15
https://doi.org/10.4017/gt.2004.03.01.003.00