Dissertation
Socioenvironmental factors in fall-related injury: a hospital registry study
Doctor of Nursing Practice (D.N.P.), Drexel University
Jun 2017
DOI:
https://doi.org/10.17918/etd-7421
Abstract
Accidental falls remain a significant public health problem as injury rates are increasing despite aggressive prevention efforts. This study hypothesized that prevention programs are ineffective due to a generic focus on the elderly, and an unrecognition of place-related effects involved in the etiology of injurious falls. A social epidemiological framework to fall-related injury assessment was applied as it would address socioenvironmental factors lacking in traditional patient-centered models. Utilizing a state-wide hospital registry, a retrospective, ecological population-based cohort study was conducted to explore how fall-related injuries vary based on the level of urbanization and socioeconomic deprivation. Study objectives were to estimate the incidence of fall-related injury by age, gender, and geographic unit for an entire state over five years, and to assess place-related effects. Descriptive statistical results were similar to those nationally reported, with injury rates highest in younger and older populations. Multivariate regression demonstrated that population size and density had a curvilinear relationship with fall injury, with injury rates higher in less populated towns. Moreover, socioeconomic deprivation had a strongly positive association with fall injury. The combined net effect of its interaction with age, gender, and population size showed a significant increase in injury rates among young males, as well as young and middle-aged adults residing in towns with high socioeconomic deprivation. Conventional risk factors associated with physical development and aging may be stronger determinates for fall-related injury in the youngest and oldest populations whereas socioenvironmental factors may increase injury risks in younger and middle-aged adults through different mechanisms.
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Details
- Title
- Socioenvironmental factors in fall-related injury
- Creators
- Kathleen M. Devine - DU
- Contributors
- Jaime C. Slaughter-Acey (Advisor) - Drexel University (1970-)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Nursing Practice (D.N.P.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Doctoral Nursing; Nursing (Graduate); College of Nursing and Health Professions; Drexel University
- Other Identifier
- 7421; 991014632583604721