Efectividad de las intervenciones enfermeras en la prevención de caídas en adultos mayores en la comunidad y en entornos sanitariosuna revisión sistemática y metaanálisis de ECA

  1. María Isabel Orts-Cortés 1
  2. María José Cabañero-Martínez 2
  3. Cristóbal Meseguer-Liza 3
  4. Claudia P. Arredondo-González 4
  5. Carmen de la Cuesta-Benjumea 5
  6. Eva Abad-Corpa 6
  1. 1 Department of Nursing, University of Alicante, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Nursing and Healthcare Research Unit (Investén-ISCIII), CIBER of Frailty and Healthy Aging (CIBERFES) Instituto de Salud Carlos III, Madrid, España
  2. 2 Department of Nursing, University of Alicante, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, España
  3. 3 Adjunct Professor of Nursing, University of Murcia, Nurse Murcia Health Service, Murcia, España
  4. 4 Lecturer, Department of Health Care, San Juan de Dios Foundation, University Pontificia Comillas, Madrid, España
  5. 5 Professor, University of Alicante, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, España
  6. 6 Professor, University of Murcia, Nurse, Murcia Health Service, IMIB-Arrixaca. Murcia, Nursing and Healthcare Research Unit (Investén-ISCIII), CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, España
Mostra les afiliacions +
Revista:
Enfermería clínica

ISSN: 1130-8621

Any de publicació: 2024

Volum: 34

Número: 1

Pàgines: 4-13

Tipus: Article

DOI: 10.1016/J.ENFCLI.2023.08.002 DIALNET GOOGLE SCHOLAR

Altres publicacions en: Enfermería clínica

Objectius de Desenvolupament Sostenible

Resum

Objective To estimate the effectiveness of fall prevention programs in people aged 65 years and older involving nursing professionals. Methods We included available full-text randomized clinical trials on nurse-led prevention of falls in the community in people over 65 years of age and reporting the incidence of such falls. An extensive search was performed in 14 databases covering the period 2016 to 2018 for publications in English, French, Portuguese and Spanish. The quality of the papers was assessed independently and blindly by reviewers working in pairs using the risk of bias dominios of the Cochrane Collaboration. The hazard ratio was used as a measure of the effect size of the incidence of falls. A random-effects model was assumed for statistical analyses. The influence of moderator variables of the studies on the effect sizes was performed using ANOVAs and its 95% CI for each moderator category. Results A total of 31 randomized clinical trials were selected with 25,551 participants. The most frequent type of intervention was education (57.1%), followed by multifactorial models (37.1%). The probability of falling was significantly reduced by 13% in the intervention groups compared to the control groups (RR +=0.87). Multifactorial (RR +=0.89) and education-based (RR=+0.84) interventions significantly reduced the probability of falls by 11% and 16%, respectively. Conclusions Discarding publication bias prevention programs carried out by nurses produce a significant 10% reduction in falls. Education-based and multifactorial interventions are the most effective when conducted by nurses.

Referències bibliogràfiques

  • Abellán García A, Aceituno Nieto P, Pérez Díaz J, Ramiro Fariñas D, Ayala García A, Pujol Rodríguez RA. Un perfil de las personas mayores en España, 2019. Indicadores estadísticos básicos [A profile of older people in Spain, 2019 Basic statistical indicators] [Internet] Madrid: CSIC,- Instituto de Economía, Geografía y Demografía (IEGD); 6 marzo 2019. Informes Envejecimiento en Red; número 22.
  • Fernández Morales I, Abellán García A, Ayala García A. Sentirse solo. Envejecimiento en red, 2018 [Internet]. Madrid: CSIC, 11 de mayo. [Consultado 21 Nov 2020]. Disponible en: http://hdl.handle.net/10261/164810
  • World Health Organization. World report on ageing and health [Internet]. Geneve: World Health Organization; 29 September 2015. Global Report. [Consultado 21 Nov 2020]. Disponible en: https://apps.who.int/iris/handle/10665/186463.
  • ADVANTAGE Joint Action. Layman report of the State-of-the-Art report on frailty prevention and management [Internet]. ADVANTAGE; 2018 April. 1. [Consultado 21 Nov 2020]. Disponible en: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.advantageja.eu/images/State-of-the-Art-ADVANTAGE-JA.pdf.
  • WHO. World Health Organization. Fallls 2021 [Internet]. Geneve: World Health Organization. [Consultado 2 Jun 2022].
  • P. Abizanda, J. Espinosa, R. Juárez, A. López, I. Martín, M.J. Megido, et al. Consensus document on frailty and falls prevention in the elderly. Strategy for Health Promotion and Prevention in the Spanish NHS [Internet] Ministerio de Sanidad, Servicios Sociales e Igualdad (2014)
  • Registered Nurses’ Association of Ontario. Preventing Falls and Reducing Injury from Falls. [Internet]. Toronto: RNAO; September 2017. 4th ed.
  • Prevention of Falls Network Europe project (ProFANE). Manual for the fall prevention classification system Version 1 [Internet]. 2007
  • D.S. Thompson, C.A. Estabrooks, S. Scott-Findlay, K. Moore, L. Wallin Interventions aimed at increasing research use in nursing: A systematic review Implement Sci., 2 (2007), pp. 2-16
  • World Health Organization. Preventing injuries and violence: A guide for ministries of health [Internet]. Geneva. World Health Organization; 2007. [Consultado 5 May 2018]. Disponible en: https://apps.who.int/iris/handle/10665/43628.
  • C. De la Cuesta-Benjumea, M.A. Henriques, E. Abad-Corpa, B. Roe, M.I. Orts-Cortés, B. Lidón-Cerezuela, et al. Falls prevention among older people and care providers: Protocol for an integrative review J Adv Nurs., 73 (2017), pp. 1722-1734
  • C. De La Cuesta-Benjumea, B. Lidón-Cerezuela, E. Abad-Corpa, C. Meseguer-Liza, C.P. Arredondo-González Managing and keeping control: A qualitative synthesis of nursing and care staff strategies to prevent older people from falling J Adv Nurs., 77 (2021), pp. 3008-3019
  • C. De la Cuesta-Benjumea, C.P. Arredondo-González, B. Lidón-Cerezuela, E. Abad-Corpa Fall prevention in older people and their families: A qualitative synthesis Gac Sanit., 35 (2021), pp. 186-192, 10.1016/j.gaceta.2019.10.004
  • J.A.C. Sterne, J. Savović, M.J. Page, R.G. Elbers, N.S. Blencowe, I. Boutron, et al. RoB 2: A revised tool for assessing risk of bias in randomised trials BMJ., 366 (2019), p. l4898
  • G.D. Egger Smith, D.G.M. Altman Systematic reviews in health care: Meta-analysis in context (2nd ed.), BMJ Publishing Group, Londres (2007)
  • L.V. Borenstein Hedges, J.P.T. Higgins, H.R.M. Rothstein Introduction to meta-analysis Wiley, Chichester (2009)
  • L.V. Cooper Hedges, J.C. Valentine The handbook of research synthesis and meta-analysis Russell Sage Foundation, New York (2019)
  • J. Botella Ausina, J. Sánchez Meca Meta-analysis in social and health sciences Síntesis;, Madrid (2015)
  • W. Viechtbauer, J.A. López-López, J. Sánchez-Meca, F. Marín-Martínez A comparison of procedures to test for moderators in mixed-effects meta-regression models Psychol methods., 20 (2015), pp. 360-374
  • J.A. López-López, F. Marín-Martínez, J. Sánchez-Meca, W. Van den Noortgate, W. Viechtbauer Estimation of the predictive power of the model in mixed-effects meta-regression: A simulation study Br J Stat Psychol., 67 (2014), pp. 30-48
  • M. Borenstein, L.V. Hedges, J.P.T. Higgins, H.R. Rothstein Introduction to meta-analysis Wiley, Chichester (2009)
  • I.D. Cameron, S.M. Dyer, C.E. Panagoda, G.R. Murray, K.D. Hill, R.G. Cumming, et al. Interventions for preventing falls in older people in care facilities and hospitals Cochrane Database Syst Rev., 9 (2018), p. CD005465, 10.1002/14651858.CD005465.pub4
  • A.J. Campbell, M.C. Robertson Rethinking individual and community fall prevention strategies: A meta-regression comparing single and multifactorial interventions Age Ageing., 36 (2007), pp. 656-662
  • P. Cheng, L. Tan, P. Ning, L. Li, Y. Gao, Y. Wu, et al. Comparative effectiveness of published interventions for elderly fall prevention: A systematic review and network meta-analysis Int J Environ Res Public Health., 15 (2018), p. 498
  • L.D. Gillespie, M.C. Robertson, W.J. Gillespie, C. Sherrington, S. Gates, L. Clemson, et al. Interventions for preventing falls in older people living in the community Cochrane Database Syst Rev., 2012 (2012), p. CD007146, 10.1002/14651858.CD007146.pub3
  • E.E. Hill-Westmoreland, K. Soeken, A.M. Spellbring A meta-analysis of fall prevention programs for the elderly Nurs Res., 51 (2002), pp. 1-8
  • K.D. Hill, P. Suttanon, S.I. Lin, W.W.N. Tsang, A. Ashari, T.A.A. Hamid, et al. What works in falls prevention in Asia: A systematic review and meta-analysis of randomized controlled trials BMC Geriatr., 18 (2018), p. 3
  • R.T. Morello, S.E. Soh, K. Behm, A. Egan, D. Ayton, K. Hill, et al. Multifactorial falls prevention programmes for older adults presenting to the emergency department with a fall: Systematic review and meta-analysis Inj Prev., 25 (2019), pp. 557-564
  • A.C. Tricco, S.M. Thomas, A.A. Veroniki, J.S. Hamid, E. Cogo, L. Strifler, et al. Comparisons of Interventions for preventing falls in older adults JAMA., 7 (2017), p. 1687
  • E. Vlaeyen, J. Coussement, G. Leysens, E. van der Elst, K. Delbaere, D. Cambier, et al. Characteristics and effectiveness of fall prevention programs in nursing homes: A systematic review and meta-analysis of randomized controlled trials J Am Geriatr Soc., 63 (2015), pp. 211-221
  • P. Hill Suttanon, S.I. Lin, W.W.N. Tsang, A. Ashari, T.A.A.A. Hamid, E.K.D. Burton What works in falls prevention in Asia: A systematic review and meta-analysis of randomized controlled trials BMC Geriatr., 18 (2018), p. 3
Fuente de los datos: Dialnet