Effectiveness of an educational video in older adults’ perception about falling risks: a randomized clinical trial

Sá, Guilherme Guarino de Moura; Santos, Ana Maria Ribeiro dos; Carvalho, Khelyane Mesquita de; Galindo Neto, Nelson Miguel; Gouveia, Márcia Teles de Oliveira; Andrade, Elaine Maria Leite Rangel

doi:10.1590/1980-220X-REEUSP-2021-0417

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ORIGINAL ARTICLE • Rev. esc. enferm. USP 56 • 2022 • https://doi.org/10.1590/1980-220X-REEUSP-2021-0417 copy

Effectiveness of an educational video in older adults’ perception about falling risks: a randomized clinical trial^* * Extracte from the thesis “Efetividade de vídeo educativo e orientações verbais de enfermagem na percepção de idosos sobre os riscos de queda: ensaio clínico randomizado”, Universidade Federal do Piauí, Programa de Pós-Graduação em Enfermagem, 2020.

Efectividad de un video educativo en la percepción de los ancianos sobre el riesgo de caída: un ensayo clínico aleatorizado

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to assess the effectiveness of using an educational video in comparison with verbal nursing guidelines in increasing older adults’ perception of falling risks.

Method:

this is a randomized clinical trial in a cluster, with 138 community older adults, randomized into an intervention group, which watched an educational video, and a control group, which received verbal instructions. The perception of falling risks was assessed by FRAQ-Brazil in the pre-test and after a 30-day follow-up. Student’s t-test was used for dependent samples to compare intragroup means and for independent samples to compare intergroup means. The effect size was determined by Cohen’s d.

Results:

in the intragroup analysis, intervention and control groups had an increase in perception, with a statistically significant difference between pre-and post-tests. In the intergroup analysis, the control group showed a greater increase in the perception of falling risks in relation to the intervention group (p = 0.013), with Cohen’s d of small effect.

Conclusion:

the use of an educational video and verbal instructions increased older adults’ perception of falling risks, with better results in the control group. However, the effect size was small. RBR-8nfggd.

DESCRIPTORS
Aged; Accidental Falls; Health Education; Instructional Film and Video; Geriatric Nursing; Clinical Trial

Categorical variables	Intervention group (n = 69)	Control group (n = 69)	p
Categorical variables	n (%)	n (%)	p
Sex
Male	22 (31.9)	24 (34.8)	0.718*
Female	47 (68.1)	45 (65.2)	0.718*
Age group
65 to 79 years	55 (79.7)	58 (84.1)	0.507*
≥80 years	14 (20.3)	11 (15.9)	0.507*
Read and write
Yes	32 (46.4)	32 (46.4)	1.000*
No	37 (53.6)	37 (53.6)	1.000*
Physical exercise
Yes	37 (53.6)	40 (58.0)	0.607*
No	32 (46.4)	29 (42.0)	0.607*
Fall in the last year
Yes	22 (31.9%)	31 (44.9%)	0.115*
No	47 (68.1%)	38 (55.1%)	0.115*
Feel at risk of falling
Yes	45 (65.2%)	43 (62.3%)	0.723*
No	24 (34.8%)	26 (37.7%)	0.723*
Received information on fall risks
Yes	13 (18.8%)	10 (14.5%)	0.647*
No	56 (81.2%)	59 (85.5%)	0.647*
Numerical variables	Mean (SD⁺)	Mean (SD⁺)	p
Age (years)	73.6 (6.4)	73.5 (6.2)	0.871^‡
	Median (IR^§)	Median (IR^§)	p
Education (years)	0 (0–4)	1 (0–3)	0.817^\|\|
Family composition	2 (1–4)	2 (1–3.5)	0.821^\|\|
Family income	1996 (998–1996)	1996 (998–1996)	0.244^\|\|

Group	Pre-test		Post-test		p^‡	Difference
Group	Mean (SD*)	95%^† CI	Mean (SD*)	95%^† CI	p^‡	Mean (SD*)	95%^† CI
Intervention group	19.2 (3.5)	18.3–20.0	21.7 (2.7)	21.0–22.4	0.001	2.5 (3.6)	1.7–3.4
Control group	18.8 (3.7)	17.9–19.7	22.8 (2.5)	22.2–23.4	<0.001	4.0 (4.3)	3.0–5.0
p^§	0.559		0.013			0.030
d^\|\|	0.10		0.43			0.38

Items	Pre-test		p	Post-test		p
	Intervention group	Control group		Intervention group	Control group
	n (%)	n (%)		n (%)	n (%)
1. People aged 65 and over are more likely to fall than younger adults	57 (82.6)	64 (92.8)	0.070*	69 (100.0)	66 (95.7)	0.245^†
2. Older people can change their activities to prevent falls	62 (89.9)	53 (76.8)	0.040*	65 (94.2)	65 (94.2)	1.000^†
3. Most falls result in no effect	1 (1.4)	0 (0.0)	1.000^†	3 (4.3)	11 (15.9)	0.024*
4. Falls make older adults less confident to move around	63 (91.3)	63 (91.3)	1.000*	65 (94.2)	69 (100.0)	0.120^†
5. Falls are more likely to happen at home	34 (49.3)	36 (52.2)	0.733*	44 (63.8)	46 (66.7)	0.721*
6. Older age increases falling risks	65 (94.2)	63 (91.3)	0.511*	66 (95.7)	67 (97.1)	1.000^†
7. Using a correct walker does not increase the chance of falling	53 (76.8)	38 (55.1)	0.007*	57 (82.6)	62 (89.9)	0.217*
8. The safest type of footwear is tennis	17 (24.6)	24 (34.8)	0.192*	32 (46.4)	31 (44.9)	0.864*
9. There is a higher risk of falling when entering and exiting the shower	34 (49.3)	32 (46.4)	0.733*	36 (52.2)	47 (68.1)	0.056*
10. Lower risk of falling if living with a family	49 (71.0)	59 (85.5)	0.039*	54 (78.3)	61 (88.4)	0.110*
11. Alzheimer’s affects chances of falling	59 (85.5)	58 (84.1)	0.813*	64 (92.8)	67 (97.1)	0.441^†
12. Brain stroke affects chances of falling	67 (97.1)	64 (92.8)	0.441^†	69 (100.0)	69 (100.0)	–^§
13. Deafness increases chances of falling	42 (60.9)	43 (62.3)	0.861*	54 (78.3)	58 (84.1)	0.384*
14. Ear problems affect chances of falling	61 (88.4)	56 (81.2)	0.236*	64 (92.8)	69 (100.0)	0.058*
15. Eating salty fries does not cause falls	28 (40.6)	47 (68.1)	0.001*	34 (49.3)	39 (56.5)	0.495^†
16. Use of alcohol increases falling risks	69 (100.0)	68 (98.6)	1.000^†	69 (100.0)	69 (100.0)	–^§
17. Medications for anxiety worry or stress may increase chances of falling	14 (20.3)	23 (33.3)	0.084*	31 (44.9)	30 (43.5)	0.864*
18. Sleeping pills may increase chances of falling	27 (39.1)	21 (30.4)	0.284*	30 (43.5)	47 (68.1)	0.004*
19. Mood stabilizers may increase chances of falling	13 (18.8)	9 (13.0)	0.352*	21 (30.4)	17 (24.6)	0.446*
20. Tranquillizers that control symptoms such as hallucination can increase chances of falling	12 (17.4)	15 (21.7)	0.520*	19 (27.5)	19 (27.5)	1.000*
21. Blood pressure medications may increase chances of falling	22 (31.9)	19 (27.5)	0.576*	27 (39.1)	24 (34.8)	0.597*
22. Pain killers may increase chances of falling	10 (14.5)	8 (11.6)	0.613*	12 (17.4)	10 (14.5)	0.642*
23. Morphine pain medications may increase chances of falling	17 (24.6)	12 (17.4)	0.296*	22 (31.9)	25 (36.2)	0.590*
24. Heart medications may increase chances of falling	21 (30.4)	11 (15.9)	0.044*	25 (36.2)	22 (31.9)	0.590*
25. Older adults who take several medications have a greater chance of falling than those who take only one medication	49 (71.0)	45 (65.2)	0.465*	57 (82.6)	55 (79.7)	0.663*
26. Staying physically active decreases chances of falling	53 (76.8)	59 (85.5)	0.191*	57 (82.6)	59 (85.5)	0.642*
27. Getting up at night to go to the bathroom can lead to falls	61 (88.4)	50 (72.5)	0.018*	65 (94.2)	65 (94.2)	1.000*
28. Sitting on the edge of the bed for a minute is the best way to get out of bed	64 (92.8)	59 (85.5)	0.171*	68 (98.6)	67 (97.1)	1.000*
29. Women aged 65 and over have a greater chance of falling	16 (23.2)	28 (40.6)	0.028*	28 (40.6)	42 (60.9)	0.027^†
30. There is a greater chance of being injured when having weak or brittle bones	67 (97.1)	68 (98.6)	1.000^†	69 (100.0)	68 (98.6)	1.000*
31. Fear of falling increases chances of falling	55 (79.7)	49 (71.0)	0.236*	58 (84.1)	60 (87.0)	0.629*
32. Having an active dog at home contributes to falls	61 (88.4)	54 (78.3)	0.110*	64 (92.8)	69 (100.0)	0.058^†

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author:

Guilherme Guarino de Moura Sá

Avenida Sebastião Rodrigues da Costa São Pedro

55145-065 – Belo Jardim, PE, Brazil
guilherme_mourasa@hotmail.com