A model used in the management of falls in institutionalized older people: an action-research study

Authors

DOI:

https://doi.org/10.12957/reuerj.2026.94139

Keywords:

Accidental Falls, Homes for the Aged, Accident Prevention

Abstract

Objective: to analyze the model used in managing fall risk among institutionalized older individuals. Method: action research study. The participants were older individuals, family members, formal caregivers, and healthcare staff. Data were collected through observation, interviews, and consultation of documentation, and analyzed using qualitative analysis software. Protocol approved by an Ethics Committee. Results: the model in use focuses on the biomedical approach, emphasizing physical risk and targeted intervention aimed at restricting activity. Formal caregivers decide on preventive measures after identifying risks, and they are aware of and utilize the institution's resources for prevention, but these practices are not always maintained. Fear of falling influences the decisions, practices, and behaviors of both older adults and professionals. Final considerations: it is necessary to prepare for institutionalization, assess the risk, and implement strategies to prevent functional decline.

Author Biographies

Ana Rita Pedrosa, Escola Superior de Enfermagem da Universidade de Lisboa

Guest Assistant. Master's degree in Rehabilitation Nursing. Nursing Research Innovation and Development Centre of Lisbon (CIDNUR), School of Nursing, Universidade de Lisboa. Lisbon. Portugal

Inês Agostinho, Escola Superior de Enfermagem de Lisboa

Nurse Bachelor's degree in Nursing. Lisbon School of Nursing. Lisbon, Portugal.

Larissa Chaves Pedreira, Universidade Federal da Bahia

Associate Professor. PhD in Nursing Permanent professor in the Graduate Program in Nursing and Health at the Federal University of Bahia. Salvador, BA, Brazil, 2021.

Marcelle Miranda da Silva, Universidade Federal do Rio de Janeiro

PhD in Nursing Associate Professor at the Federal University of Rio de Janeiro. Rio de Janeiro, RJ, Brazil.

Luis Sousa, Universidade Atlantica

PhD in Nursing Coordinating Professor at the School of Health Sciences of the Universidade Atlântica. Barcarena, Oeiras, Portugal. RISE – Health Research Network, Porto, Portugal Comprehensive Health Research Centre (CHRC), Évora, Portugal.

Rogerio Ferreira, Instituto Politecnico de Beja

Doctor of Science in Education. Coordinating Professor at the Polytechnic Institute of Beja. Beja. Portugal. Comprehensive Health Research Center (CHRC). Évora, Portugal.

Cristina Lavareda Baixinho, Escola Superior de Enfermagem da Universidade de Lisboa

PhD in Nursing Coordinating Professor at the Lisbon School of Nursing Nursing Research Innovation and Development Centre of Lisbon (CIDNUR), School of Nursing, Universidade de Lisboa. Lisbon. Portugal. ciTechCare - Center for Innovative Care and Health Technology. Leiria, Portugal.

References

1. Montero-Odasso M, van der Velde N, Martin FC, Petrovic M, Tan MP, Ryg Jet al. World guidelines for falls prevention and management for older adults: a global initiative. Age Ageing. 2022 [cited 2025 Aug 21]; 51(9):afac205. DOI: https://doi.org/10.1093/ageing/afac205.

2. Baixinho CRSL, Dixe MDACR, Henriques MAP. Falls in long-term care institutions for elderly people: protocol validation. Rev Bras Enferm. 2017 [cited 2025 Aug 21]; 70(4):740-6. DOI: https://doi.org/10.1590/0034-7167-2017-0109.

3. Adam CE, Fitzpatrick AL, Leary CS, Ilango SD, Phelan EA, Semmens EO. The impact of falls on activities of daily living in older adults: a retrospective cohort analysis. PLoS One. 2024 [cited 2025 Aug 21]; 19(1):e0294017. DOI: https://doi.org/10.1371/journal.pone.0294017.

4. Yang ZC, Lin H, Jiang GH, Chu YH, Gao JH, Tong ZJ, et al. Frailty is a risk factor for falls in the older adults: a systematic review and meta-analysis. J Nutr Health Aging. 2023 [cited 2025 Aug 21]; 27(6):487-595. DOI: https://doi.org/10.1007/s12603-023-1935-8.

5. Gürler H, Bayraktar N. The effectiveness of a recurrent fall prevention program applied to elderly people undergoing fracture treatment. Int J Orthop Trauma Nurs. 2021 [cited 2025 Aug 21]; 40:100820. DOI: https://doi.org/10.1016/j.ijotn.2020.100820.

6. Lavareda Baixinho C, Dixe MA. ¿Cuáles son las prácticas y comportamientos de los mayores institucionalizados para prevenir las caídas? Index Enferm. 2017 [cited 2025 Aug 28]; 26(4):255-9. Available from: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1132-12962017000300004&lng=es.

7. Trevisan C, Ripamonti E, Grande G, Triolo F, Ek S, Maggi Set al. The association between injurious falls and older adults' cognitive function: the role of depressive mood and physical performance. J Gerontol A Biol Sci Med Sci. 2021 [cited 2025 Aug 28]; 76(9):1699-706. DOI: https://doi.org/10.1093/gerona/glab061.

8. Shao L, Shi Y, Xie XY, Wang Z, Wang ZA, Zhang JE. Incidence and risk factors of falls among older people in nursing homes: systematic review and meta-analysis. J Am Med Dir Assoc. 2023 [cited 2025 Aug 28]; 24(11):1708-17. DOI: https://doi.org/10.1016/j.jamda.2023.06.002.

9. Miura T, Kanoya Y. Fall risk assessment and prevention strategies in nursing homes: a narrative review. Healthcare. 2025 [cited 2025 Aug 21]; 13(3):357. DOI: https://doi.org/10.3390/healthcare13040357.

10. Albasha N, Curtin C, McCullagh R, Cornally N, Timmons S. Staff's insights into fall prevention solutions in long-term care facilities: a cross-sectional study. BMC Geriatr. 2023 [cited 2025 Aug 21]; 23(1):738. DOI: https://doi.org/10.1186/s12877-023-04435-7.

11. Baixinho CL, Dixe MA. Team practices in fall prevention in institutionalized elderly people: Scale design and validation. Texto Contexto Enferm. 2017 [cited 2025 Aug 21]; 26:e2310016. DOI: https://doi.org/10.1590/0104-07072017002310016.

12. Silva EJC; Morais ER, Figueiredo MDLF, Tyrrell MAR. Pesquisa-ação: concepções e aplicabilidade nos estudos em enfermagem. Rev. Bras. Enferm. 2011 [cited 2025 Aug 28]; 64:592–5. DOI: https://doi.org/10.1590/S0034-71672011000300026.

13. Kuhne GW, Quigley BA. Understanding and using action research in practice settings. In: Kuhne GW, Quigley BA. Creating practical knowledge through action research: posing problems, solving problems, and improving daily practice. San Francisco, CA, USA: Jossey-Bass Publishers; 1997. pp. 23–40.

14. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007 [cited 2025 Aug 28]; 19(6):349-57. DOI: https://doi.org/10.1093/intqhc/mzm042.

15. Renz SM, Carrington JM, Badger TA. Two strategies for qualitative content analysis: an intramethod approach to triangulation. Qual Health Res. 2018 [cited 2025 Aug 21]; 28(5):824-31. DOI: https://doi.org/10.1177/1049732317753586.

16. Zhou J, Liu B, Qin MZ, Liu JP. A prospective cohort study of the risk factors for new falls and fragility fractures in self-caring elderly patients aged 80 years and over. BMC Geriatr. 2021 [cited 2025 Sep 1]; 21(1):116. DOI: https://doi.org/10.1186/s12877-021-02043-x.

17. Ramírez MH, Flores CAJ, Alvarado MRB, Delgado IL, Tarabay JAB. Valoración de la dependencia funcional en adultos mayores asociado a riesgo de caídas en el hogar. Horiz. Sanitário. 2020 [cited 2025 Sep 1]; 19(1):153-65. DOI: https://doi.org/10.19136/hs.a19n1.3546.

18. Bergen G, Stevens MR, Kakara R, Burns ER. Understanding modifiable and unmodifiable older adult fall risk factors to create effective prevention strategies. Am J Lifestyle Med. 2019 [cited 2025 Sep 1]; 15(6):580-9. DOI: https://doi.org/10.1177/1559827619880529.

19. Izadi-Avanji FS, Safa A, Abedzadeh-Kalahroudi M, Shaterian N. Fear of falling and its related factors in older adults following a fall in Kashan, Iran (2023-2024). BMC Geriatr. 2024 [cited 2025 Sep 1]; 24(1):965. DOI: https://doi.org/10.1186/s12877-024-05560-7.

20. Baixinho CL, Marques-Vieira C, Sousa L, Abrantes A, Conceição N, Martins A et al. Falls efficacy scale - formal caregivers: adaptation and validation in Portuguese nursing homes. Geriatr Nurs. 2025 [cited 2025 Sep 1]; 61:113-20. DOI: https://doi.org/10.1016/j.gerinurse.2024.10.060.

Downloads

Published

2026-04-29

How to Cite

1.
Pedrosa AR, Agostinho I, Pedreira LC, Silva MM da, Sousa L, Ferreira R, et al. A model used in the management of falls in institutionalized older people: an action-research study. Rev. enferm. UERJ [Internet]. 2026 Apr. 29 [cited 2026 Jun. 30];34(1):e94139. Available from: https://www.e-publicacoes.uerj.br/enfermagemuerj/article/view/27_04_2026

Issue

Vol. 34 (2026): In Progress

Section

Research Articles

License

Copyright (c) 2026 Ana Rita Pedrosa, Inês Agostinho, Larissa Chaves Pedreira, Marcelle Miranda da Silva, Luis Sousa, Rogerio Ferreira, Cristina Lavareda Baixinho

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

When publishing in Revista Enfermagem UERJ, the authors declare that the work is their exclusive authorship and therefore assume full responsibility for its content.

Authors retain copyright to their article and agree to license their work using a Creative Commons Attribution International Public License (CC BY), thereby accepting the terms and conditions of this license (https://creativecommons.org/licenses/by/4.0/legalcode.en), which allows material created by the author to be distributed, copied and displayed by third parties. The original work must be cited and present a link to the article available on the website of the journal in which it was published.

The Copyright of the articles published in Revista Enfermagem UERJ belongs to their respective author(s), with the rights of first publication assigned to Revista Enfermagem UERJ, with the work simultaneously licensed under a Creative Commons License CC BY, which allows sharing of work with recognition of authorship and initial publication in this journal.

The authors grant Revista Enfermagem UERJ the right of first publication, to identify themselves as the original publisher of the work and grant the magazine a license of non-exclusive rights to use the work in the following ways:

  1. Sell and/or distribute the work in printed copies and/or electronic format;
  2. Distribute parts and/or the work as a whole with the aim of promoting the magazine through the internet and other digital and printed media;
  3. Record and playback work in any format, including digital media.

In line with the journal's policies, each published article will be assigned a Creative Commons Attribution (CC BY) license.

Crossref
Scopus
Google Scholar
Europe PMC

Most read articles by the same author(s)