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Qualitative Descriptions of Patient Perceptions about Fall Risks, Prevention Strategies, and Self-Identity: Analysis of Fall Prevention Motivational Interviewing conversations.

BACKGROUND
Older adults are often reluctant to engage in fall prevention activities.


OBJECTIVES
To understand how older adults respond to fall prevention and identify attributes that affect their responses to fall prevention.


METHODS
Qualitative content analysis of Fall Prevention Motivational Interviewing conversations that were conducted as an intervention for a fall prevention study in the United States. We report the methods, results, and discussions using the COnsolidated criteria for REporting Qualitative research checklist.


RESULTS
Conversations from 30 participants were analyzed. Participants showed various responses to fall prevention from acceptance and engagement to ambivalence to denial or giving up. Three attributes affecting how they responded to fall prevention were: (a) their perception of fall risks, (b) their perception about fall prevention strategies, and (c) self-identity. If participants perceived that their fall risks were temporary or modifiable, they were more likely to engage in fall prevention. If participants perceived that their fall risks were permanent or unmodifiable, they seemed to have difficulty accepting fall risks or gave up engaging in fall prevention strategies. Participants were more willing to adopt fall prevention strategies that involved minor adjustments but expressed more resistance to adopting strategies that required major adjustments. Further, their response to accepting or not accepting fall prevention was influenced by their perception of whether the fall risks and fall prevention strategies aligned with their self-identity.


CONCLUSION
Findings underscore the importance of understanding older adults' self-identify and perceptions about fall prevention.


RELEVANCE TO CLINICAL PRACTICE
Exploring older adults' self-identity and perceptions about fall prevention can be useful to support their engagement in fall prevention.