ORCID

0000-0002-0127-210X

Keywords

fear of falling, fall risk appraisal, community-dwelling, older adult, falls

Abstract

This study employed both quantitative and qualitative approaches to investigate the fear of falling (FOF) and irrational fall risk appraisal (FRA) in community-dwelling, low-income older adults. Guided by the National Institute on Aging Health Disparities Framework, the research included an integrated literature review, quantitative analysis, and a qualitative study. The literature review identified key gaps, including a limited understanding of changes in fall risk factors over time, particularly regarding those with irrational FRA, and few using both quantitative and qualitative methods. A quantitative, prospective, observational, repeated-measures study was employed to achieve aims 1 and 2, and data from 100 community-dwelling older adults (aged 60 years or older) were analyzed. Measures included the Falls Efficacy Scale-International (FES-I), CDC STEADI fall risk checklist, BTrackS balance testing, handgrip strength, PHQ-9 for depression, and GAI-SF for anxiety. Fall Risk Appraisal (FRA) categories were calculated using FOF and balance scores. Wilcoxon signed-rank tests and Spearman correlations were used to assess changes and associations; multiple regression identified predictors of FOF. Significant associations were found between FOF and fall risk (CDC STEADI; p< .001), balance (p=.060), depression (p=.710), and handgrip strength (p=.021). Handgrip strength improved significantly over time (p=.005), but FOF and most psychological factors, including depression, remained stable. FRA categories shifted positively over time, though not significantly. A qualitative descriptive study for aim 3 explored the daily experiences of older adults with irrational FRA. Most participants experienced a fall but lacked awareness of FOF and its impact. Reflections emphasized physical injury over psychological effects, and no interventions were offered to address psychological effects. Fall risk is multifactorial, with physical and psychological components influencing FOF. These findings suggest that education and awareness, even without formal intervention, may positively influence fall risk perception and behavior. Integrating physical and psychological assessments can guide tailored fall prevention strategies and education of older adults in community settings.

Completion Date

2025

Semester

Fall

Committee Chair

Ladda Thiamwong

Degree

Doctor of Philosophy (Ph.D.)

College

College of Nursing

Department

Nursing

Format

PDF

Language

English

Release Date

12-15-2027

Document Type

Dissertation

Campus Location

UCF Online

Subjects

Falls (Accidents) in old age--Research; Falls (Accidents) in old age--Evaluation; Frail older people--Psychology; Older people--Health risk assessment; Falls (Accidents)--Prevention

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Available for download on Wednesday, December 15, 2027

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