Background Falls are an increasing health problem and are more frequent in females. Beliefs and behaviour are known to influence the health status.
Objectives To evaluate the influence of beliefs on health-related quality of life (HRQL) in women aged ≥65 years who had suffered falls in the previous 6 months.
Methods Observational study. Sociodemographic and clinical variables were collected. Beliefs were determined using the Falls Efficacy Scale-International (FES-I), which evaluates the fear of falling, and a question on self-efficacy with respect to health: “Do you believe that your behaviour can influence your health status?” This was measured on a 5-point Likert scale: 1) Totally agree: 2) Quite agree; 3) Don't know; 4) Quite disagree; 5) Totally disagree. HRQL was measured using the SF-36 and WOMAC questionnaires. Gait and balance was evaluated using the Tinetti test. Statistical analysis: Correlations between HRQL and beliefs were calculated. Linear multiple regression was used to evaluate the association between significant independent variables and the physical component of the SF-36 (PC) and the total WOMAC score (TW).
Results 46 women (mean age 75.4 years (SD 6.8), BMI 30.3 (5.7), number of comorbidities 6.1 (SD 2.4), of which 75% were taking ≥4 medications (mean 6.1 [SD 2.4]) were included. Mean Tinetti score was 23.1 points (SD14.6), mean FES-I was 29.9 points (SD 20.6): 69.6% of patients believed their behaviour influenced their health, PC 34.2 points (SD 8.1) and TW 45.3 points (SD 24.7).
Significant correlations were found between the fear of falling (FES-I) and HRQL. Correlations were 61% (p<0.001) with the PC, 58% (p<0.001) with the TW, and 45% (p=0.006) with the Tinetti test. Patients who agreed their behaviour could influence their health had significantly better HRQL (TW score [40.4 vs 56.5 p=0.029] and the Tinetti score [23.39 vs 11.36 p=0.002]). Regression analysis showed that 36% of the variability in the PC was explained by the fear of falling. The variability in the TW was explained by the fear of falling (35%) and the BMI (11%). Age, number of comorbidities and number of medications had no influence on the two models.
Conclusions Patients who believed their behaviour influenced their health had a better HRQL and a lower risk of suffering falls than those who did not. Health professionals should take patients' beliefs into account when planning and introducing interventions to prevent falls and improve HRQL.
World Health Organization. Falls 2012. http://www.who.int/mediacentre/factsheets/fs344/en/
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Acknowledgements The FATE project has been funded by CIPICT-PSP-2011-5 297178
Disclosure of Interest None declared
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