Qualitative study on falling experience and coping style of stroke home patients: a Meta synthesis_West China Medical Journal

Authors：

HU Linxue ¹ , LI Siqin ² , WU Xiaoyan ³ , DENG Zhiqiang ⁴ ,  YANG Rong ⁴

1. West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Division of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
4. Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

YANG Rong, Email: hxyangrong2004@126.com

Keywords：

Stroke; home patient; falling experience; psychological disorder; coping style; Meta synthesis

DOI：

10.7507/1002-0179.202205052

Video：

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Objective To integrate the falling experience and coping styles of stroke home patients with falls through Meta synthesis, summarize existing problems based on the integration results, and propose suggestions. Methods We searched databases including PubMed, Medline, Embase, Web of Science, etc., from database establishment to January 2023, to collect qualitative studies on stroke patients’ falling experience at home. The quality of included studies was evaluated by “JBI Australian Evidence-based Health Care Centre (2008) Qualitative Research Quality Assessment Criteria”. The results were integrated by integrating methods. Results A total of 6 references were included, and 18 clear research results were extracted. Similar results were summarized and combined to form 6 new categories, and integrated into 3 main themes. The integration results showed that stroke patients with falls had severe psychological problems, poor coping styles, and unmet needs for fall prevention, resulting in reduced social participation and exercise. Conclusions It is necessary to improve the content of fall assessment and provide corresponding fall prevention health education based on the assessment results. It helps stroke patients and caregivers at home to establish correct coping strategies, thereby avoiding the occurrence of falls.

Citation： HU Linxue, LI Siqin, WU Xiaoyan, DENG Zhiqiang, YANG Rong. Qualitative study on falling experience and coping style of stroke home patients: a Meta synthesis. West China Medical Journal, 2023, 38(5): 710-717. doi: 10.7507/1002-0179.202205052 Copy

1.	Bhatt T, Dusane S, Patel P. Does severity of motor impairment affect reactive adaptation and fall-risk in chronic stroke survivors?. J Neuroeng Rehabil, 2019, 16(1): 43.
2.	Tarvonen-Schröder S, Niemi T, Hurme S, et al. Fall assessment in subacute inpatient stroke rehabilitation using clinical characteristics and the most preferred stroke severity and outcome measures. Eur J Physiother, 2023, 25(2): 60-72.
3.	Walsh ME, Sorensen J, Galvin R, et al. First year post-stroke healthcare costs and fall-status among those discharged to the community. Eur Stroke J, 2018, 3(3): 254-262.
4.	Kerse N, Parag V, Feigin VL, et al. Falls after stroke: results from the Auckland Regional Community Stroke (ARCOS) Study, 2002 to 2003. Stroke, 2008, 39(6): 1890-1893.
5.	Schmid AA, Yaggi HK, Burrus N, et al. Circumstances and consequences of falls among people with chronic stroke. J Rehabil Res Dev, 2014, 50(9): 1277-1286.
6.	Belgen B, Beninato M, Sullivan PE, et al. The association of balance capacity and falls self-efficacy with history of falling in community-dwelling people with chronic stroke. Arch Phys Med Rehabil, 2006, 87(4): 554-561.
7.	Ahmed N, Greenberg P. Early risk stratification of in hospital mortality following a ground level fall in geriatric patients with normal physiological parameters. Am J Emerg Med, 2020, 38(12): 2531-2535.
8.	Batchelor FA, Mackintosh SF, Said CM, et al. Falls after stroke. Int J Stroke, 2012, 7(6): 482-490.
9.	Friedman SM, Munoz B, West SK, et al. Falls and fear of falling: which comes first? A longitudinal prediction model suggests strategies for primary and secondary prevention. J Am Geriatr Soc, 2002, 50(8): 1329-1335.
10.	Batchelor FA, Hill KD, Mackintosh SF, et al. Effects of a multifactorial falls prevention program for people with stroke returning home after rehabilitation: a randomised controlled trial. Arch Phys Med Rehabil, 2012, 93(9): 1648-1655.
11.	Dean CM, Rissel C, Sherrington C, et al. Exercise to enhance mobility and prevent falls after stroke: the community stroke club randomised controlled trial. Neurorehabil Neural Repair, 2012, 26(9): 1046-1057.
12.	Wei WE, De Silva DA, Chang HM, et al. Post-stroke patients with moderate function have the greatest risk of falls: a National Cohort Study. BMC Geriatr, 2019, 19(1): 373.
13.	Chittrakul J, Siviroj P, Sungkarat S, et al. Multi-system physical exercise intervention for fall prevention and quality of life in pre-frail older adults: a randomized controlled trial. Int J Environ Res Public Health, 2020, 17(9): 3102.
14.	孙皓, 时景璞. 循证医学中 PICO 模型的扩展及其在定性研究中的应用. 中国循证医学杂志, 2014, 14(5): 505-508.
15.	Cooke A, Smith D, Booth A. Beyond PICO: the SPIDER tool for qualitative evidence synthesis. Qual Health Res, 2012, 22 (10): 1435-1443.
16.	陈向明. 质的研究方法与社会科学研究. 北京: 教育科学出版社, 2000: 12.
17.	胡娇娇, 王建宁, 詹梦梅, 等. 肠造口患者居家护理需求质性研究的 Meta 整合. 中华护理杂志, 2023, 58(3): 357-365.
18.	Lockwood C, Munn Z, Porritt K. Qualitative research synthesis: methodological guidance for systematic reviewers utilizing Meta-aggregation. Int J Evid Based Healthc, 2015, 13(3): 179-187.
19.	Macaitis K. The systematic review of evidence generated by qualitative research, narrative and text. Adelaide: the Joanna Briggs Institute, 2009: 1-81.
20.	Munford D, Gunn H. What are the perceptions and experiences of falls amongst people with stroke who live in the cmmunity?. Disabil Rehabil, 2018, 42(5): 722-729.
21.	Schmid AA, Rittman M. Consequences of poststroke falls: activity limitation, increased dependence, and the development of fear of falling. Am J Occup Ther, 2009, 63(3): 310-316.
22.	Kelley CP, Graham C, Christy JB, et al. Falling and mobility experiences of stroke survivors and spousal caregivers. Phys Occup Ther Geriatr, 2010, 28(3): 235-248.
23.	Da Silva CP, Carlegis M, Suchma K, et al. Falling, balance confidence, and fear of falling after chronic stroke. Phys Occup Ther Geriatr, 2014, 32(4): 353-367.
24.	Walsh ME, Galvin R, Williams DJP, et al. The experience of recurrent fallers in the first year after stroke. Disabil Rehabil, 2019, 41(2): 142-149.
25.	Schmid AA, Rittman M. Fear of falling: an emerging issue after stroke. Top Stroke Rehabil, 2007, 14(5): 46-55.
26.	Morris, Reg C. Psychological and emotional issues after stroke//Munshi SK, Harwood R. Stroke in the older person. Oxford Medicine Online, 2020: 399.
27.	Henrique PPB, Colussi EL, De Marchi ACB. Effects of exergame on patients’ balance and upper limb motor function after stroke: a randomized controlled trial. J Stroke Cerebrovasc Dis, 2019, 28(8): 2351-2357.
28.	Yardley L, Donovan-Hall M, Francis K, et al. Older people’s views of advice about falls prevention: a qualitative study. Health Educ Res, 2005, 21(4): 508-517.
29.	Laufer Y. The use of walking aids in the rehabilitation of stroke patients. Rev Clin Gerontol, 2004, 14: 137-144.
30.	Tilson JK, Wu SS, Cen SY, et al. Characterizing and identifying risk for falls in the LEAPS study: a randomized clinical trial of interventions to improve walking poststroke. Stroke, 2012, 43(2): 446-452.
31.	Finlayson ML, Peterson EW, Asano M. A cross-sectional study examining multiple mobility device use and fall status among middle-aged and older adults with multiple sclerosis. Disabil Rehabil Assist Technol, 2014, 9(1): 12-16.
32.	Shibata M, Isoda A, Ogasawara T, et al. Verification of the causes of and countermeasures for falls using fall assessment score sheets in a municipal hospital. J Gerontol Geriat, 2022, 70(1): 40-49.
33.	Chidume T. Promoting older adult fall prevention education and awareness in a community setting: a nurse-led intervention. Appl Nurs Res, 2021, 57: 151392.
34.	Clark L, Thoreson S, Goss CW, et al. Understanding fall meaning and context in marketing balance classes to older adults. J Appl Gerontol, 2013, 32(1): 96-119.
35.	Itzhaki M, Hildesheimer G, Barnoy S, et al. Family involvemen in medical decision-making: perceptions of nursing and psy chology students. Nurse Educ Today, 2016, 40: 181-187.
36.	Graffigna G, Barello S, Riva G, et al. Patient engagement: the key to redesign the exchange between the demand and supply fo healthcare in the era of active ageing. Stud Health Techno Inform, 2014, 203: 85-95.
37.	胡恒瑜, 张亚英, 陈羽双, 等. 患者参与医疗保健及其影响因素的研究进展. 中华护理杂志, 2017, 52(6): 740-745.
38.	Graffigna G, Barello S, Triberti S. Giving (back) a role to patient in the delivery of healthcare services: theoretical roots of patient engagement//Graffigna G, Barello S, Triberti S. Patient engagement: a consumer-centered model to innovate healthcare. De Gruyter Open Poland, 2015: 13-26.
39.	Buetow SA, Martínez-Martín P, McCormack B. Falling upward with Parkinson’s disease. NPJ Parkinson’s Dis, 2017, 3: 29.

1. Bhatt T, Dusane S, Patel P. Does severity of motor impairment affect reactive adaptation and fall-risk in chronic stroke survivors?. J Neuroeng Rehabil, 2019, 16(1): 43.
2. Tarvonen-Schröder S, Niemi T, Hurme S, et al. Fall assessment in subacute inpatient stroke rehabilitation using clinical characteristics and the most preferred stroke severity and outcome measures. Eur J Physiother, 2023, 25(2): 60-72.
3. Walsh ME, Sorensen J, Galvin R, et al. First year post-stroke healthcare costs and fall-status among those discharged to the community. Eur Stroke J, 2018, 3(3): 254-262.
4. Kerse N, Parag V, Feigin VL, et al. Falls after stroke: results from the Auckland Regional Community Stroke (ARCOS) Study, 2002 to 2003. Stroke, 2008, 39(6): 1890-1893.
5. Schmid AA, Yaggi HK, Burrus N, et al. Circumstances and consequences of falls among people with chronic stroke. J Rehabil Res Dev, 2014, 50(9): 1277-1286.
6. Belgen B, Beninato M, Sullivan PE, et al. The association of balance capacity and falls self-efficacy with history of falling in community-dwelling people with chronic stroke. Arch Phys Med Rehabil, 2006, 87(4): 554-561.
7. Ahmed N, Greenberg P. Early risk stratification of in hospital mortality following a ground level fall in geriatric patients with normal physiological parameters. Am J Emerg Med, 2020, 38(12): 2531-2535.
8. Batchelor FA, Mackintosh SF, Said CM, et al. Falls after stroke. Int J Stroke, 2012, 7(6): 482-490.
9. Friedman SM, Munoz B, West SK, et al. Falls and fear of falling: which comes first? A longitudinal prediction model suggests strategies for primary and secondary prevention. J Am Geriatr Soc, 2002, 50(8): 1329-1335.
10. Batchelor FA, Hill KD, Mackintosh SF, et al. Effects of a multifactorial falls prevention program for people with stroke returning home after rehabilitation: a randomised controlled trial. Arch Phys Med Rehabil, 2012, 93(9): 1648-1655.
11. Dean CM, Rissel C, Sherrington C, et al. Exercise to enhance mobility and prevent falls after stroke: the community stroke club randomised controlled trial. Neurorehabil Neural Repair, 2012, 26(9): 1046-1057.
12. Wei WE, De Silva DA, Chang HM, et al. Post-stroke patients with moderate function have the greatest risk of falls: a National Cohort Study. BMC Geriatr, 2019, 19(1): 373.
13. Chittrakul J, Siviroj P, Sungkarat S, et al. Multi-system physical exercise intervention for fall prevention and quality of life in pre-frail older adults: a randomized controlled trial. Int J Environ Res Public Health, 2020, 17(9): 3102.
14. 孙皓, 时景璞. 循证医学中 PICO 模型的扩展及其在定性研究中的应用. 中国循证医学杂志, 2014, 14(5): 505-508.
15. Cooke A, Smith D, Booth A. Beyond PICO: the SPIDER tool for qualitative evidence synthesis. Qual Health Res, 2012, 22 (10): 1435-1443.
16. 陈向明. 质的研究方法与社会科学研究. 北京: 教育科学出版社, 2000: 12.
17. 胡娇娇, 王建宁, 詹梦梅, 等. 肠造口患者居家护理需求质性研究的 Meta 整合. 中华护理杂志, 2023, 58(3): 357-365.
18. Lockwood C, Munn Z, Porritt K. Qualitative research synthesis: methodological guidance for systematic reviewers utilizing Meta-aggregation. Int J Evid Based Healthc, 2015, 13(3): 179-187.
19. Macaitis K. The systematic review of evidence generated by qualitative research, narrative and text. Adelaide: the Joanna Briggs Institute, 2009: 1-81.
20. Munford D, Gunn H. What are the perceptions and experiences of falls amongst people with stroke who live in the cmmunity?. Disabil Rehabil, 2018, 42(5): 722-729.
21. Schmid AA, Rittman M. Consequences of poststroke falls: activity limitation, increased dependence, and the development of fear of falling. Am J Occup Ther, 2009, 63(3): 310-316.
22. Kelley CP, Graham C, Christy JB, et al. Falling and mobility experiences of stroke survivors and spousal caregivers. Phys Occup Ther Geriatr, 2010, 28(3): 235-248.
23. Da Silva CP, Carlegis M, Suchma K, et al. Falling, balance confidence, and fear of falling after chronic stroke. Phys Occup Ther Geriatr, 2014, 32(4): 353-367.
24. Walsh ME, Galvin R, Williams DJP, et al. The experience of recurrent fallers in the first year after stroke. Disabil Rehabil, 2019, 41(2): 142-149.
25. Schmid AA, Rittman M. Fear of falling: an emerging issue after stroke. Top Stroke Rehabil, 2007, 14(5): 46-55.
26. Morris, Reg C. Psychological and emotional issues after stroke//Munshi SK, Harwood R. Stroke in the older person. Oxford Medicine Online, 2020: 399.
27. Henrique PPB, Colussi EL, De Marchi ACB. Effects of exergame on patients’ balance and upper limb motor function after stroke: a randomized controlled trial. J Stroke Cerebrovasc Dis, 2019, 28(8): 2351-2357.
28. Yardley L, Donovan-Hall M, Francis K, et al. Older people’s views of advice about falls prevention: a qualitative study. Health Educ Res, 2005, 21(4): 508-517.
29. Laufer Y. The use of walking aids in the rehabilitation of stroke patients. Rev Clin Gerontol, 2004, 14: 137-144.
30. Tilson JK, Wu SS, Cen SY, et al. Characterizing and identifying risk for falls in the LEAPS study: a randomized clinical trial of interventions to improve walking poststroke. Stroke, 2012, 43(2): 446-452.
31. Finlayson ML, Peterson EW, Asano M. A cross-sectional study examining multiple mobility device use and fall status among middle-aged and older adults with multiple sclerosis. Disabil Rehabil Assist Technol, 2014, 9(1): 12-16.
32. Shibata M, Isoda A, Ogasawara T, et al. Verification of the causes of and countermeasures for falls using fall assessment score sheets in a municipal hospital. J Gerontol Geriat, 2022, 70(1): 40-49.
33. Chidume T. Promoting older adult fall prevention education and awareness in a community setting: a nurse-led intervention. Appl Nurs Res, 2021, 57: 151392.
34. Clark L, Thoreson S, Goss CW, et al. Understanding fall meaning and context in marketing balance classes to older adults. J Appl Gerontol, 2013, 32(1): 96-119.
35. Itzhaki M, Hildesheimer G, Barnoy S, et al. Family involvemen in medical decision-making: perceptions of nursing and psy chology students. Nurse Educ Today, 2016, 40: 181-187.
36. Graffigna G, Barello S, Riva G, et al. Patient engagement: the key to redesign the exchange between the demand and supply fo healthcare in the era of active ageing. Stud Health Techno Inform, 2014, 203: 85-95.
37. 胡恒瑜, 张亚英, 陈羽双, 等. 患者参与医疗保健及其影响因素的研究进展. 中华护理杂志, 2017, 52(6): 740-745.
38. Graffigna G, Barello S, Triberti S. Giving (back) a role to patient in the delivery of healthcare services: theoretical roots of patient engagement//Graffigna G, Barello S, Triberti S. Patient engagement: a consumer-centered model to innovate healthcare. De Gruyter Open Poland, 2015: 13-26.
39. Buetow SA, Martínez-Martín P, McCormack B. Falling upward with Parkinson’s disease. NPJ Parkinson’s Dis, 2017, 3: 29.

West China Medical Journal

Qualitative study on falling experience and coping style of stroke home patients: a Meta synthesis

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