Fear of falling in patients with hip fractures: prevalence and related psychological factors

Abstract

Objective: To determine the prevalence of fear of falling (FoF) in patients after a hip fracture, to investigate the relation with time after fracture, and to assess associations between FoF and other psychological factors.

Design: Cross-sectional study performed between September 2010 and March 2011 in elderly patients after a hip fracture.

Setting: Ten postacute geriatric rehabilitation wards in Dutch nursing homes.

Participants: A total of 100 patients aged ≥65 years with a hip fracture admitted to a geriatric rehabilitation ward.

Measurements: FoF and related concepts such as falls-related self-efficacy, depression, and anxiety were measured by means of self-assessment instruments.

Results: Of all patients, 36% had a little FoF and 27% had quite a bit or very much FoF. Scores on the Falls Efficacy Scale-International were 30.6 in the first 4 weeks after hip fracture, 35.6 in the second 4 weeks, and 29.4 in the period ≥8 weeks after fracture. In these 3 periods, the prevalence rates of FoF were 62%, 68%, and 59%, respectively. Significant correlations were found between FoF and anxiety (P < .001), and self-efficacy (P < .001).

Conclusion: In these patients with a hip fracture, FoF is common and is correlated with anxiety and falls-related self-efficacy. During rehabilitation, FoF is greatest in the second 4 weeks after hip fracture. More studies are needed to explore the determinants of FoF and develop interventions to reduce FoF and improve outcome after rehabilitation.