introduction to nursing research
The nursing practice problem under analysis in this analytical essay is the high rates of falls in the community-dwelling elderly population. Research has shown that close to 25% to 36% of older adults affected by falls are situated in community dwellings, and hence the high rates of fall-related injuries and enormous healthcare costs (Cederbom et al., 2020). The main purpose of the paper is to examine how the core findings from the selected quantitative, peer-reviewed journal articles explored the topic on falls in community-dwelling older adults. Strong emphasis is placed on investigating how the adoption of exercise programs in comparison to usual care may contribute to a significant reduction in fall rates among non-frail elderly patients in the community-dwelling settings. The PICOT question is: are there evidence-based exercise programs that are effective in reducing the risk of falls in community-dwelling older adults in comparison to usual care when implemented over a one-year period?
Background of Studies
The peer-reviewed research article by El-Khoury et al. (2017) explored the emergence of geriatric falls as a pertinent public health problem experienced by community-dwelling older adults. The findings of the article reported that extent to which some of the key risk factors and effects of falls can be prevented through the design and implementation of evidence-based exercise programs. Similar sentiments are shared by Bjerk et al. (2017) who argued that the adoption of individualized exercise programs including balance training, physical therapy and others can contribute to positive improvements in the physical strength and stability of older adults, and hence a key intervention aimed at preventing or addressing this particular clinical issue. The main purpose of the quantitative study was to determine the effectiveness of evidence-based exercise programs and initiatives in the prevention of falls in aging community-dwellers. This purpose of the research was attained by quantitatively measuring and evaluating the rates of fall-induced injuries reported in the intervention group and the control group. The main research questions explored in this quantitative study included: 1) what are the effects of fall prevention exercise programs on fall-induced injuries? And 2) what are the effects of exercise on fall risk factors and overall quality of life of older adults in community-dwellings?
On the other hand, the quantitative study by Severance et al. (2022) attempted to investigate a range of exercise-related interventions that can be adopted to ensure the provision of person-centered and evidence-based programs to tackle the persistent issue of geriatric falls among both frail and non-frail older community dwellers. The main purpose of the study was to conduct an examination of the outcomes of genuine partnerships among the different stakeholders including education institutions, government agencies, emergency management services, community entities and individuals in the development and adoption of tailored falls-prevention training programs. The research question explored in the article was: can collaboration between the various partners and stakeholders help to improve the provision of falls prevention training to at-risk older adults?
How the two articles support the selected Nursing Practice Problem
The selected articles will be used to answer the identified PICOT question since they explored how exercise-based programs can be adopted as a preventive mechanism aimed at reducing falls among older adults. For example, El-Khoury et al. (2017) attempted to identify some of the primary physical exercise interventions that can be streamlined to meet the distinct needs and requirements of the community-dwelling older adults. The findings revealed that proper implementation of physical exercise programs can go ahead to promote fall prevention among older adults. The positioning of evidence-based exercise programs as preventive action against age-related conditions emerged as a key point of capital importance since it recognizes the centrality of promoting lifelong healthy behaviors and positive lifestyles (Worum et al., 2020). On the other hand, the findings presented by Severance et al. (2022) explored the role played by physical activity in the prevention of falls and stimulation of postural control and improvement in secondary outcomes including balance, strength and stability. The findings supported the argument that adoption of evidence-based exercise programs can act an effective non-pharmacological intervention aimed at preventing falls in older adults in community-dwellings.
Conducted in 20 centers across France, the study by El-Khoury et al. (2017) included an intervention group (352 participants) and the control group (354 participants). The findings indicated that the implementation of exercise programs contributed to a significant reduction in fall rates in the intervention group than in the control group. On the other hand, the study by Severance et al. (2022) sampled 354 community-dwelling adults residing in Tarrant County, Texas, and who had been recruited to participate in the University of Palermo Sports Lab. In comparison to those identified in the PICOT Question, the interventions and comparison groups in the two articles focused primarily on the elderly adults in the community-dwelling environment. A key distinction with those identified in the PICOT question is that whilst the intervention group will comprise community-dwelling adults included in the exercise program, the control group will be made up of community-dwelling adults currently receiving the usual care.
Method of Studies
The study by El-Khoury et al. (2017) applied statistical analysis to determine to what extent and whether fall prevention exercise interventions for older community-dwelling persons can be effective in the prevention of various types of fall-related injuries. On the other hand, the prospective study by Severance et al. (2022) employed descriptive statistics to examine the outcomes of partnerships among the various parties in the implementation of falls-prevention training initiative utilizing an Age-Friendly Health Systems approach. With regards to differences, whilst the statistical analysis method employed by El-Khoury et al. (2017) was mainly used for calculating the rate ratio of injurious falls among the target participants, the descriptive statistics employed by Severance et al. (2022) primarily focused on the participant demographic variables and program implementation.
Results of Studies
The studies revealed that the adoption of falls prevention exercise programs can lead to positive improvements in terms of reducing the severity, frequency and effects of geriatric falls among community-dwelling older people. Equally, the studies emphasized the importance of collaborative partnerships in key areas including training, resource mobilization, program implementation and evaluation to foster improvements in the efficacy, reliability and sustainability of evidence-based exercise programs aimed at preventing falls in older community-dwelling people (Severance et al., 2022; Patti et al., 2021; El-Khoury et al., 2017). The implications of the two studies is based on how they both emphases the centrality of exercise as a preventive action against falls in older adults.
The two ethical considerations included informed consent and beneficence. In both the studies, the researchers obtained informed consent from the participants in a voluntary and participatory manner. Equally, the studies sought to create a better understanding of how appropriate exercise programs can help to tackle falls as a serious clinical issue.
The findings presented in both articles supported the effectiveness of exercise programs when it comes to preventing falls in older adults in the community setting. Some of the key outcomes include: reduced incidence of falls, enhanced primary and secondary outcomes and subsequent improvement in quality of life. Therefore, implementation of evidence-based exercise programs over a given timeline may assist to significantly reduce falls rates, reduce healthcare costs, and prevent some of the consequences associated with geriatric falls.
Bjerk, M., Brovold, T., Skelton, D. A., & Bergland, A. (2017). A falls prevention programme to improve quality of life, physical function and falls efficacy in older people receiving home help services: Study protocol for a randomised controlled trial. BMC Health Services Research, 17(1). https://doi.org/10.1186/s12913-017-2516-5
Cederbom, S., Bjerk, M., & Bergland, A. (2020). A qualitative study exploring physical therapists’ views on the Otago exercise programme for fall prevention: A stepping stone to “age in place” and to give faith in the future. Physiotherapy Theory and Practice, 38(1), 132-140. https://doi.org/10.1080/09593985.2020.1731895
El-Khoury, F., Cassou, B., Charles, M., & Dargent-Molina, P. (2017). The effect of fall prevention exercise programmes on fall induced injuries in community dwelling older adults:. British Journal of Sports Medicine, 49(20), 1348-1348. https://doi.org/10.1136/bmj.f6234
Patti, A., Zangla, D., Sahin, F. N., Cataldi, S., Lavanco, G., Palma, A., & Fischietti, F. (2021). Physical exercise and prevention of falls. Effects of a Pilates training method compared with a general physical activity program. Medicine, 100(13), e25289. https://doi.org/10.1097/md.0000000000025289
Severance, J. J., Rivera, S., Cho, J., Hartos, J., Khan, A., & Knebl, J. (2022). A collaborative implementation strategy to increase falls prevention training using the age-friendly health systems approach. International Journal of Environmental Research and Public Health, 19(10), 5903. https://doi.org/10.3390/ijerph19105903
Worum, H., Lillekroken, D., Roaldsen, K. S., Ahlsen, B., & Bergland, A. (2020). Reflections of older people about their experience of fall prevention exercise in the community- a
In this assignment, you will write a critical appraisal that demonstrates comprehension of two quantitative research studies.
Use the practice problem and two quantitative, peer-reviewed research articles you identified in the Topic 1 assignment (or two new articles based on instructor feedback in Topic 1) to complete this assignment.
In a 1,000–1,250-word essay, summarize two quantitative studies.
Use the “Research Critique Guidelines – Part II” document to organize your essay.
You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.