A Predictive Model of Fall Prevention Behaviors in Postmenopausal Women

Hyun-Jung Jang; Sukhee Ahn

doi:10.4040/jkan.2014.44.5.525

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Jang and Ahn: A Predictive Model of Fall Prevention Behaviors in Postmenopausal Women

Original Article

J Korean Acad Nurs 2014;44(5):525-533.

Published online: 15 October 2014

DOI: https://doi.org/10.4040/jkan.2014.44.5.525

A Predictive Model of Fall Prevention Behaviors in Postmenopausal Women

Hyun-Jung Jang¹, Sukhee Ahn^2,

¹Department of Nursing, Kkottongnae University, Chungju

²College of Nursing, Chungnam National University, Daejeon, Korea

Address reprint requests to : Ahn, Sukhee College of Nursing, Chungnam National University, 266 Munwha-ro, Jung-gu, Daejeon 301-747, Korea Tel: +82-42-580-8324 Fax: +82-42-580-8309 E-mail: sukheeahn@cnu.ac.kr

Received 2 June 2014 Revised 19 June 2014 Accepted 18 August 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

Abstract

Purpose

This study was done to propose and test a predictive model that would explain and predict fall prevention behaviors in postmenopausal women. The health belief model was the theoretical basis to aid development of a nursing intervention fall prevention program.

Methods

Data for 421 postmenopausal women were selected from an original data set using a survey design. The structural equation model was tested for 3 constructs: modifying factors, expectation factors, and threat factors. Expectation factors were measured as relative perceived benefit (perceived benefit minus perceived barrier), self-efficacy, and health motivation; threat factors, as perceived susceptibility (fear of falling) and perceived severity (avoiding activity for fear of falling); and modifying factors: level of education and knowledge about fall prevention. Data were analyzed using SPSS Windows and AMOS program.

Results

Mean age was 55.7 years (range 45-64), and 19.7% had experienced a fall within the past year. Fall prevention behaviors were explained by expectation and threat factors indicating significant direct effects. Mediating effect of health beliefs was significant in the relationship between modifying factors and fall prevention behaviors. The proposed model explained 33% of the variance.

Conclusion

Results indicate that fall prevention education should include knowledge, expectation, and threat factors based on health belief model.

Keywords: Falls, Fracture, Prevention, Menopause, Health behavior

References

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Figure 1.

Theoretical framework for this study.

Figure 2.

Standardized estimates and explained variances in model for fall prevention behaviors.

Table 1.

Descriptive Statistics and Relationships among Study Variables for Fall Prevention Behaviors (N=421)

Variables	Categories (Range)	n (%) or M±SD	x1	x2	x3	y1	y2	y3	y4	y5
Variables	Categories (Range)	n (%) or M±SD	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)
x1	≤High school	262 (62.2)	1
x1	≥College	159 (37.8)
x2	(6-24)	18.16±3.90	.12 (.013)	1
x3	Yes	83 (19.7)	.04	.06	1
x3	No	338 (80.3)
y1	(-11-16)	2.53±4.72	.10 (.041)	.27 (<.001)	.07	1
y2	(7-35)	26.43±4.73	.06	.39	.04	.37	1
y2				(<.001)		(<.001)
y3	(6-30)	20.00±4.07	.18	.26	−.01	.33	.33	1
y3			(<.001)	(<.001)		(<.001)	(<.001)
y4	(1-4)	1.96±0.71	−.06	−.03	.09	−.04	−.10	−.01	1
y4							(.044)
y5	(11-34)	15.40±5.17	−.17	−.18	.10	−.15	−.28	−.07	.32	1
y5			(<.001)	(<.001)	(.044)	(.002)	(<.001)		(<.001)
y6	(7-28)	15.66±4.51	.06	.25	.12	.46	.16	.29	.10	.04
y6				(<.001)	(.018)	(<.001)	(.001)	(<.001)	(.036)

x1=Level of education (1=college and above); x2=Knowledge about fall prevention; x3=History of falls (1=yes); y1=Perceived benefits-barriers; y2=Perceived self-efficacy; y3=Health motivation; y4=Perceived susceptibility; y5=Perceived severity; y6=Fall prevention behaviors.

Table 2.

Effects of Explanatory Variables on Fall Prevention Behaviors (N=421)

Endogenous variables	Exogenous variables	Direct effect	Indirect effect	Total effect	SMC
Endogenous variables	Exogenous variables	ß (p)	ß (p)	ß (p)	SMC
Expectation factors	Modifying factors	.86 (<.001)	−	.86	.73
Threat factors	Modifying factors	−.38 (<.001)	−	−.38	.14
Fall prevention behaviors	Modifying factors	−	.43 (.022)	.43	.33
	Expectation factors	.61 (<.001)	−	.63
	Threat factors	.25 (<.001)	−	.26

ß=Standardized coefficients; SMC=Squared multiple correlation.

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