Burns and Grove (2011), define qualitative research is a standardized, personal way used to define life experiences and grant them meaning. A qualitative study must establish a dilemma or research problem, does not contain a hypotheses, and the research questions, which evolve as the study progresses are usually very broad. As a result, the person conducting the study looks for data to form impressions; this type of research cannot be measured. This qualitative research critique will analyze the problem statement, purpose and research questions, literature review and conceptual framework of Qualitative Study on the Impact of Falling in Frail Older Persons and Family Caregivers: Foundations for an Intervention to Prevent Falls.
Among adults 65 years of age and older, falls are the main purpose of injury death and the most typical reason for nonfatal injuries and trauma related hospital admissions. In 2010, approximately two million nonfatal fall injuries in older adults were cared for in emergency departments with costs totally approximately $30 billion (Centers for Disease Control and Prevention, 2012). Injuries sustained from falls include fractures (hip, spine, forearm, leg, ankle, pelvis, hand), lacerations, and head traumas. Often times after a fall, an individual will become disabled, lose their independence, or develop a fear of falling again causing them to decrease their activity level. Decreased activity level results in decreased mobility and muscle mass, loss of being physically fit, and actually increases an elderly person’s chances of falling. In addition to the physical injuries from falls, patients also suffer emotionally and socially, as do their caregivers from increased dependence on them.
Purpose and Research Questions
The objective of the study was to review the impacts of falls in older adults, some of whom had cognitive impairments and the impacts on their primary caregivers who were family members. The subjects taking part in the study all had recently experienced a fall. The other purpose of the study was to make recommendations for a fall prevention program. While the researchers did not provide the questions they used, based on the information given they were questions such as: What are the consequences you fear from falling (physical, emotional, social)? What caused the fall? How did you cope with the fall? What do you expect from a fall prevention program?
The qualitative method of the grounded theory: a constant comparative analysis to identify common themes and issues was used to answer the authors’ research questions. Qualitative research is a methodical, personal way used to illustrate personal experiences and give them meaning. In a qualitative study, participants are chosen by those conducting the study to participate because of their knowledge, views, or experiences related to the study rather than by chance (Burns & Grove, 2011). In this study, the purpose and research questions used were related to the study about falls in the elderly and the impact it has on both them and their caregivers.
The authors of the article researched both qualitative and quantitative studies relevant to the focus of their study on falls. The study used references from 1988 through 2009 and approximately half of them were greater than five years old and the other half were less than five years old. Protocols for qualitative research were followed with regard to purposive sampling and triangulation, the sampling and data analysis reached saturation, and the manuscripts of the interviews were tested with interviewees (Faes et al., 2010). Some weaknesses of the study were the small sample size and the fact that the results were not statistically valid for other populations. The literature review presented valid evidence and information to support the authors’ argument for the need for a fall prevention program to discuss and educate people on ways to reduce the consequences of falling and provide information on safety to prevent falls.
Frame of Reference
When conducting this study, the grounded theory guided the authors who interviewed 10 caregivers and 10 patients. Three patients were cognitively unimpaired, four had mild cognitive impairments and the remaining three were dementia patients. All patients had experienced a recent fall and both them and their caregivers were used as the authors’ frame of reference. After the study, a framework was developed from the study findings that consisted of two tables that presented the socio-demographic and health characteristics of patients and the socio-demographic and health characteristics of caregivers and their care recipients. Interview responses were also categorized into the following categories: emotions, social consequences, attributions, coping, burden and rewards of care giving, and fall prevention program. This framework was used by the authors to determine the need for a fall prevention program.
Falls impact the elderly physically, emotionally and socially as well as contribute to added stress amongst their caregivers. Therefore, the authors of this study suggested that a fall prevention program involving both patients and caregivers should be implemented. The fall prevention program should target reducing the consequences of falling, provide advice on walking and standing more safely, promote self-efficacy and activity, and discuss the cause of falls (Faes et al., 2010). Caregivers should also be properly educated on ways to prevent falls and on how to supervise cognitively impaired patients.
Burns, N. & Grove, S.K. (2011). Understanding nursing research: Building an evidence-
based practice. Retrieved from
http://pageburstls.elsevier.com/#/books/978-1-4377-0750-2/pages/52532283 Centers for Disease Control and Prevention. (2012). Falls among older adults: An overview.
Retrieved from http://www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html Faes, M., Reelick, M., Joosten-Weyn Banningh, L., Gier, M., Esselink, R., & Olde Rikkert, M. (2010). Qualitative study on the impact of falling in frail older persons and family caregivers: Foundations for an
intervention to prevent falls. Aging & Mental Health, 14(7), 834-842. doi:10.1080/13607861003781825