The main objectives of this study are: 1. an effect evaluation of an in-home multicomponent cognitive behavioural program on concerns about falling and related avoidance of activity (primary outcomes), as well as disability, fall incidents (secondary outcomes) and several additional outcomes in frail community-dwelling older people, 2. a process evaluation of the feasibility of the program, with the following main outcomes: population reached, performance according to protocol, exposure and engagement, opinion on the program of participants and facilitators, perceived benefit or achievement, and experienced barriers and potential solutions, and 3. an economical evaluation on the impact of the program on healthcare utilization and related costs.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
389
The in-home cognitive behavioral program aims to learn older persons, living in the community, how to deal with concerns about falling and to increase physical, social and functional activity. The principles of cognitive restructuring are used for shifting maladaptive in adaptive attitudes with respect to falling as well as increasing self efficacy beliefs and feelings of control. The following themes are discussed during the program: concerns about falling, thoughts about falling, physical exercise, assert oneself, overcome personal barriers, recognizing fall-ty habits and managing concerns about falling. Duration of the program is 10 weeks with 7 individual sessions (3 home visits (60, 60 and 75 minutes, respectively) \& 4 telephone contacts (35 minutes each). The program is facilitated by trained nurses qualified in the field of geriatrics and working for home care agencies.
Maastricht University
Maastricht, Netherlands
concerns about falling
Falls Efficacy Scale International (FES-I)
Time frame: baseline, 5 months and 12 months
avoidance of activities due concerns about falling
Falls Efficacy Scale International Avoidance Behaviour (FES-IAB)
Time frame: baseline, 5 months and 12 months
disability
Groningen Activity Restriction Scale (GARS)
Time frame: baseline, 5 months and 12 months
number of falls
Fall calendar
Time frame: continuous registration during the course of the trial for a period of 1 year
catastrophic beliefs about falling
Catastrophic beliefs about falling (CAFS)
Time frame: baseline, 5 months and 12 months
perceived consequences of falling
CoF - loss of functional independence subscale and damage to identity subscale
Time frame: baseline, 5 months and 12 months
perceived control over falling
Perceived control over falling (PCOF)
Time frame: baseline, 5 months and 12 months
mastery
Personal Mastery Scale
Time frame: baseline, 5 months and 12 months
feelings of anxiety
Subscale of the Hospital Anxiety and Depression Scale (HADS-A)
Time frame: baseline, 5 months and 12 months
symptoms of depression
Subscale of the Hospital Anxiety and Depression Scale (HADS-D)
Time frame: baseline, 5 months and 12 months
social support interactions
Social support interactions (SSL 12-I)
Time frame: baseline, 5 months and 12 months
health-related quality of life
SF-12 Health Survey
Time frame: baseline, 5 months and 12 months
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