Perspectives of Inpatients With Cancer on Engagement in Fall Prevention

PURPOSE To explore perspectives of hospitalized adults with cancer regarding engagement in fall prevention plans. The primary aim was to discover new knowledge about patients' perspectives and improve the design of fall prevention strategies. A secondary aim was to compare fall-related perspectives of patients who had and who had not fallen. PARTICIPANTS A SETTING 30 inpatients with cancer at a teaching hospital in a statewide academic health system in the midwestern United States. METHODOLOGIC APPROACH A descriptive exploratory approach framed qualitative data collection through interviews with inpatients. Data were analyzed thematically. FINDINGS Themes reflected six perspectives related to engagement in fall prevention. A need to go to the bathroom triggered a two-step process in which participants decided whether to ask staff for assistance to mobilize and to wait for assistance to arrive. If necessary, participants would disengage from fall prevention plans and move to the bathroom without assistance to avoid incontinence, preserve privacy, and maintain independence in toileting. Factors influencing decisions were assessments of mobilization capacity and views of nurses' behaviors. IMPLICATIONS FOR NURSING Nurses can foster patient engagement in fall prevention by developing trusting, authentic relationships with at-risk patients, involving patients in assessing their own fall risk, and tailoring toileting plans to ensure continence.