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Falls self-efficacy and falls incidence in community-dwelling older people: the mediating role of coping

  • Christine C. Loft (a1), Fergal W. Jones (a2) and Ian I. Kneebone (a3)

Abstract

Background:

A cognitive behavioral model predicts that coping responses mediate the relationship between falls related psychological concerns and falls incidence, in community-dwelling older people. If empirical support could be found for this pathway then interventions could be developed to reduce falls risk by targeting coping strategies. Therefore, this study aimed to begin the process of testing whether coping responses mediate the association between falls self-efficacy (a principal element of falls related psychological concerns) and falls incidence, in community-dwelling older people.

Method:

In a cross-sectional design, 160 community-dwelling older people (31 male, 129 female; mean age 83.47 years) completed the Falls Efficacy Scale–International, the Revised-Ways of Coping Questionnaire, the Turning to Religion subscale of the COPE, and a falls questionnaire. Data were analyzed via mediation analysis using a bootstrapping approach.

Results:

Lower falls self-efficacy was associated with higher falls incidence, and more self-controlling coping was found to be a partial mediator of this association, with a confidence interval for the indirect effect of (0.003, 0.021) and an effect size of κ2 = 0.035. The association was not mediated by the other measured coping responses; namely, turning to religion, distancing, seeking social support, accepting responsibility, escape-avoidance, planful problem-solving, and positive reappraisal.

Conclusions:

Self-controlling coping may mediate the association between falls self-efficacy and falling. If longitudinal studies confirm this finding then coping could be targeted in interventions to reduce falls.

Copyright

Corresponding author

Correspondence should be addressed to: Fergal W. Jones, Salomons Centre for Applied Psychology, Canterbury Christ Church University, 1 Meadow Road, Tunbridge Wells, Kent TN1 2YG, UK. Phone: +44 (0) 1227 927110. Email: fergal.jones@canterbury.ac.uk.

References

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Anderson, J. C. and Gerbing, D. W. (1988). An updated paradigm for scale development incorporating unidimensionality and its assessment. Journal of Marketing Research, 25, 186192. doi:10.2307/3172650.
Carver, C. S., Scheier, M. F. and Weintraub, J. K. (1989). Assessing coping strategies: a theoretically based approach. Journal of Personality & Social Psychology, 56, 267283. doi:10.1037/0022-3514.56.2.267.
Catanzaro, S. J., Horaney, F. and Creasey, G. (1995). Hassles, coping and depressive symptoms in an elderly community sample: the role of mood regulation expectancies. Journal of Counseling Psychology, 42, 259265. doi:10.1037/0022-0167.42.3.259.
Chou, L. W., Chi, I. and Chiu, A. Y. (2005). Incidence and predictors of falls in the Chinese elderly. Annal: Academy of Medicine, 34, 6072.
Delbaere, K., Close, J. C., Mikolaizak, A. S., Sachdev, P. S., Brodaty, H. and Lord, S. R. (2010). The falls efficacy scale international (FES-I). A comprehensive longitudinal validation study. Age and Ageing, 39, 210216. doi: 10.1093/ageing/afp225.
Department of Health (2001). National Service Framework for Older People. London: Stationary Office.
Filiatrault, J. and Desrosiers, J. (2011). Coping strategies used by seniors going through the normal aging process: does fear of falling matter? Gerontology, 57, 228236. doi:10.1159/000314529.
Fisher, B. M., Segal, D. I. and Coolidge, F. L. (2003). Assessment of coping in cognitively impaired older adults: a preliminary study. Clinical Gerontologist, 26, 312.
Folkman, S. and Lazarus, R. S. (1989). Ways of Coping Questionnaire: Manual. California: Mind Garden.
Folkman, S., Lazarus, R. S., Dunkel-Schetter, C., DeLongis, A. and Gruen, R. J. (1986). Dynamics of a stressful encounter: cognitive appraisal, coping, and encounter outcomes. Journal of Personality and Social Psychology, 50, 9921003. doi:10.1037/0022-3514.50.5.992.
Fritz, M. S. and MacKinnon, D. P. (2007). Required sample size to detect the mediated effect. Psychological Science, 18, 233239. doi:10.1111/j.1467-9280.2007.01882.x.
Ganz, D. A., Higashi, T. and Rubenstein, L. (2005). Monitoring falls in cohort studies of community-dwelling older people: effect of the recall interval. Journal of the American Geriatrics Society, 53, 21902194. doi:10.1111/j.1532-5415.2005.00509.x.
Gillespie, L. D., Gillespie, W. J., Robertson, M. C., Lamb, S. E., Cumming, R. G. and Rowe, B. H. (2003). Interventions for preventing falls in elderly people. Cochrane Database of Systemic Review, 4, CD000340. doi:10.1002/14651858.CD000340.
Hauer, K., Lamb, S. E., Jorstad, E. C., Todd, C. and Becker, C. (2006). Systematic review of definitions and methods of measuring falls in randomised controlled fall prevention trials. Age and Ageing, 35, 510. doi: 10.1093/ageing/afi218.
Hayes, A. F. (2013). Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach. New York: Guilford.
Hsu, H. and Tung, H. (2011). Coping strategies and adaptation for the disabled elderly in Taiwan. Geriatric Gerontology International. 11, 488495. doi:10.1111/j.1447-0594.2011.00701.x.
Hughes, C. C., Kneebone, I., Jones, F. W. and Brady, B. (2015). A theoretical and empirical review of psychological factors associated with falls related psychological concerns in community dwelling older people. International Psychogeriatrics, 27, 10711087. doi:10.1017/S1041610214002701.
Hull, S. and Kneebone, I. I. (2007). Revision and assessment of the evidence for a revised cognitive-behavioural model for fear of falling. Paper Presented to the World Congress of Behavioral and Cognitive Therapies, Barcelona, Spain.
Jung, D., Lee, J. and Lee, S. (2009). A meta-analysis of fear of falling treatment programs for the elderly. Western Journal of Nursing Research, 31, 616. doi:10.1177/0193945908320466.
Koenig, H. G., George, L. K. and Peterson, B. L. (1998). Religiosity and remission of depression in medically ill older patients. American Journal of Psychiatry, 155, 536542. doi:10.1176/ajp.155.4.536.
Lamb, S. E., Jorstad-Stein, E. C., Hauer, C. and Becker, C. (2005). Development of a common outcome data set for fall injury prevention trials: the prevention of falls network Europe consensus. Journal of the American Geriatrics Society, 53, 16181622. doi:10.1111/j.1532-5415.2005.53455.x.
Lazarus, R. S. and Folkman, S. (1984). Stress, Appraisals and Coping. New York: Springer Publishing Company.
Lincoln, N. B., Kneebone, I. I., Macniven, J. and Morris, R. (2012). Psychological Management of Stroke. Chichester, UK: Wiley.
Moore, D. S. and Ellis, R. (2008). Measurement of fall-related psychological constructs among independent-living older adults: a review of the research literature. Aging and Mental Health, 12, 684699. doi:10.1080/13607860802148855.
Oliver, D., Daly, F., Martin, F. C. and McMurdo, M. E. (2004). Risk factors and risk assessment tools for falls in hospital in-patients: a systematic review. Age and Ageing, 33, 122130. doi: 10.1093/ageing/afh017.
Powell, L. E. and Myers, A. M. (1995). The activities-specific balance confidence (ABC) Scale. Journals of Gerontology Series A-Biological Sciences & Medical Sciences A, 50, M28M34. doi:10.1093/gerona/50A.1.M28.
Schwarzer, R. and Christine Schwarzer, C. (1996). A critical survey of coping instruments. In Zeidner, M. and Morris, N. S. (eds.), Handbook of Coping. New York: Wiley.
Shumway-Cook, A., Ciol, M. A., Hoffman, J., Dudgeon, B. J., Yorkston, J. and Chan, L. (2009). Falls in the medicare population: incidence, associated factors, and impact on health care. Journal of Physical Therapy, 89, 324332. doi:10.2522/ptj.20070107.
Tanner, D. (2007). Starting with lives: supporting older people's strategies and ways of coping. Journal of Social Work, 7, 730. doi: 10.1177/1468017307075987.
Tinetti, M. and Speechly, M. (1989). Prevention of falls among the elderly. New England Journal of Medicine, 320, 10551059. doi:10.1056/NEJM198904203201606.
Tinetti, M., Richmond, D. and Powell, L. (1990). Falls efficacy as a measure of fear of falling. Journals of Gerontology, 45, 239243. doi: 10.1093/geronj/45.6.P239.
Vitaliano, P. P., Russo, J., Carr, J. E., Maiuro, R. D. and Becker, J. (1985). The ways of coping checklist: revision and psychometric properties. Multivariate Behavioral Research, 20, 326.
Ward-Griffin, C., Hobson, S., Melles, P., Kloseck, M., Vandervoort, A. and Crilly, R. (2004). Falls and fear of falling among community-dwelling seniors: the dynamic tension between exercising precaution and striving for independence. Canadian Journal on Aging-Revue Canadienne Du Vieillissement, 23, 307318. doi:10.1353/cja.2005.0028.
Yardley, L. and Smith, H. (2002). A prospective study of the relationship between feared consequences of falling and avoidance of activity in community-living older people. Gerontologist, 42, 1723. doi:10.1093/geront/42.1.17.
Yardley, L., Beyer, N., Hauer, K., Kempen, G., Piot-Ziegler, C. and Todd, C. (2005). Development and initial validation of the falls efficacy scale-international (FES-I). Age and Ageing, 34, 614619. doi:10.1093/ageing/afi196.
Zijlstra, G. A. R., van Haastregt, J. C. M., van Eijk, J. T. M., van Rossum, E., Stalenhoef, P. A. and Kempen, G. I. J. M. (2007). Prevalence and correlates of fear of falling, and associated avoidance of activity in the general population of community-living older people. Age and Ageing, 36, 304309. doi:10.1093/ageing/afm021.
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International Psychogeriatrics
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