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Objective: Partnering with patients and staff to develop and evaluate falls prevention education could better enable patient learning and engagement. This study aimed to create a revised version of the Safe Recovery falls prevention education programme in partnership with older patients and hospital staff, to improve patient engagement in undertaking falls preventive strategies in hospital. Design: Two-phase sequential mixed methods participatory design. Setting: Hospital rehabilitation wards in Western Australia. Method: Phase 1--older patients (n = 10) and staff (n = 10) were surveyed before and after original programme delivery to ascertain their reaction and learning. Consumer-focused discussions were undertaken with staff and patients online to inform programme revision. A patient video and workbook were co-produced, and staff were trained to deliver the revised programme. Phase 2: older patients (n = 10) and staff (n = 10) were surveyed before and after receiving the revised programme to gain reactions and learning. Deductive content analysis and Wilcoxon signed-rank tests were used to analyse the qualitative and quantitative data. Results: Patients and staff perceived the original programme to be outdated and expressed low levels of satisfaction with the original resources. In contrast, both patients and staff were highly satisfied with the revised programme. Both original and revised Safe Recovery programme patient groups demonstrated significant improvements in knowledge and awareness to reduce their risk of falling after receiving the education (p = 0.008, p = 0.005, respectively). However, patients receiving the revised programme were significantly more likely to intend to take action (p = 0.024) and have a clear action plan (p = 0.010). Staff perceived that the revised resources showed significant improvements in aesthetic appeal (p = 0.007) and ability to engage patients in learning (p = 0.007). Conclusion: Patients and staff contributed to successfully revising the Safe Recovery programme with positive reactions to the co-produced resources. Participating in falls education significantly improved older patients' knowledge and attitudes regarding falls prevention.

Purpose: The purpose of this study was to co-design a falls prevention education programme with aged care home residents and staff and evaluate its feasibility. The intention of providing the education programme was to assist residents to stay safe and mobile whilst reducing their risk of falling. Design/methodology/approach: A two-phase mixed methods participatory design using a resident (n = 6) and care staff (n = 5) consumer engagement panel, pre- and post-programme resident (n = 35) survey and semi-structured care staff interviews (n = 8) was undertaken in two countries. Findings: A poster, brochure, video and staff education guide featuring 12 safety messages depicting fall prevention behaviours were co-designed. Residents, supported by staff, perceived the falls prevention education programme as enjoyable and informative, but there were no significant differences in capability, opportunity or motivation. However, several residents were observed enacting fall prevention behaviours such as "If I feel unwell, I'll ring the bell" and waiting for staff assistance. Challenges to programme demand, acceptability and implementation which may have impacted residents' exposure and engagement with the programme were identified, along with recommendations to improve feasibility. Practical implications: When developing falls prevention education programmes partnering with residents and staff, providing choices to meet personal and aesthetic preferences along with frequent, shorter duration learning opportunities are important for translating education messages into actions. Originality/value: The use of bespoke resources, novel rhymes, positive messages emphasising safety and co-designing with residents themselves was a welcomed point of programme difference.

Objective: Falls are a significant problem for many older patients after hospital discharge. The purpose of this study was to evaluate the fidelity and impact of a tailored patient fall prevention education programme from the perspective of the educators who delivered the programme. Design: Qualitative sequential design. Setting: Three rehabilitation hospitals in Western Australia. Method: Three experienced physiotherapists trained as 'educators' to deliver a tailored fall prevention education programme to 195 older patients prior to hospital discharge, together with monthly telephone follow-up for 3 months after discharge. Educator-patient interactions were recorded in a standardised educator diary. Post-intervention, educators participated in a mini-focus group, providing their perspectives regarding education delivery and its impact on patient abilities to engage in fall prevention strategies. Data were analysed using deductive content analysis. Results: Educators followed up 184 (94%) patients, identifying multiple barriers and enablers affecting patient engagement in planned fall prevention strategies. Key barriers included unresolved medical conditions, reluctance to accept assistance on discharge, delays in assistive service provision, patient beliefs and perceptions about falls and, in some cases, patients' absolving responsibility for recovery. Enablers were related to programme design, the completion of hospital discharge processes and support networks following discharge. Conclusion: Educators identified several barriers and enablers to programme delivery, receipt and enactment by older patients that contributed to the fidelity of the education programme. The consistent need for more patient support to enable improved enactment of plans and assist with safe recovery long after discharge warrants further attention at policy and health system levels.

Background: Providing older patients with an opportunity to participate in individualised falls preventive education, has been shown to reduce hospital falls. However, few studies have explored older peoples' perspectives of hospital falls prevention education. This study aimed to explore older people and their caregivers' knowledge and awareness about hospital falls prevention, including their reflections on the education they received when hospitalised. Methods: A qualitative, exploratory study with focus groups and semistructured interviews was conducted. Participants were a purposively selected sample of community‐dwelling older people (65+ years) admitted to a hospital in the past 5 years and caregivers of older people. Data were thematically analysed using deductive and inductive approaches, and a capability–opportunity–motivation–behaviour model was applied to understand key determinants of implementing falls education for hospitalised older people. Results: Participants' [n = 46 (older people n = 37, age range 60–89 years), caregivers n = 9] feedback identified five themes: distress and disempowerment if the participant did have a hospital fall or nearly fell, anxiety and uncertainty about what behaviour was required while in hospital, insufficient and inconsistent falls prevention education, inadequate communication and underlying attitudes of ageism. Applying a behaviour change model suggested that older people and their caregivers did not develop falls prevention knowledge, awareness or motivation to engage in falls prevention behaviour. Older people were also provided with limited opportunities to engage in falls preventive behaviour while in hospital. Conclusion: Older people in our study received sporadic education about falls prevention during their hospital admissions which did not raise their awareness and knowledge about the risk of falls or their capability to engage in safe falls preventive behaviour. Conflicting messages may result in older people feeling confused and anxious about staying safe in hospital. [ABSTRACT FROM AUTHOR]

This paper presents the research findings from a study reviewing graduates' opinions on completing online reflective journaling tasks during work integrated learning as an undergraduate. The study was divided into two parts with an initial focus group conducted with six physiotherapy graduates seven months following graduation. Findings from the focus group guided the development of a questionnaire sent to graduates nine months after course completion. Results from both the focus group and questionnaire (n = 25) highlighted the benefits of online, structured, assessed reflective writing tasks. Graduates provided specific examples of their personal and professional development and perceived benefits from undertaking reflective journaling during work integrated learning. These findings may have application across a wide variety of tertiary courses of study with work integrated learning incorporated into curriculum. [Papers included in this "Asia-Pacific Journal of Cooperative Education" ("APJCE") Special Issue stem from selected manuscripts from the Australian Collaborative Education Network Annual Conference 2012.]

Transition care programmes (TCP) provide older adults with goal-oriented rehabilitation after hospitalisation. However, limited research has focused on understanding older adults' experiences when undertaking TCP. Using a phenomenological approach, we explored the lived experience of older adults undertaking a TCP at a transition care facility in Australia. A purposive sample (N = 33 participants: 16 older adults, four family members and 13 staff) was recruited. Semi-structured interviews were undertaken at three time-points during admission and inductive thematic analysis was utilised. Older adults reflected on their TCP experiences through an emotional lens through which they deliberated, 'is my destination home?' Fear of losing independence and uncertainty about their discharge destination strongly influenced older adults' perspectives regarding their TCP experience. Emotional responses, both positive and negative, were influenced by expectations prior to admission, level of family support and staff behaviour. Staff and family concurred that many older adults were confused about their admission to the facility and initially were unprepared to engage in the rehabilitation provided. Older adults experienced TCP as a time of great uncertainty and feared the unknown when discharged from hospital to transition care. They expressed grief at the loss of existing life roles and anxiety about the possibility of being unable to return home. Health professionals need to inform and tailor rehabilitation for older adults to better support this transient time of life. [ABSTRACT FROM AUTHOR]

Objectives. There is limited evidence regarding the effectiveness of transition care programs (TCP) in improving health-related outcomes and discharge destination for older adults. This study aimed to (i) identify changes in health-related outcomes in older adults undergoing a facilitybased TCP between admission and discharge; and (ii) compare health-related outcomes between participants discharged home and those discharged to permanent residential care. Method. A prospective, observational study was conducted with older adults aged ≥60 years who participated in a facility-based TCP that provided short-term rehabilitation including mobility training, group exercise and cognitive activities. Physical, cognitive and social outcomes were measured at admission and discharge. Data were analysed using linear mixed modelling. Results. Of the 41 participants (mean age 80.1 (±8.9) years), 26 (63.4%) were discharged home compared with 14 (34.2%) to residential care. Participants showed statistically significantly improvement in performance of activities of daily living (ADL), mobility and health-related quality of life, with a statistically and clinically significant decline in performance of instrumental ADL. Participants discharged home had statistically and clinically significant greater improvement in mobility compared with those discharged to residential care (de Morton mobility index: home, 13.6 (95% CI: 9.8, 17.4) vs residential, 6.9 (95% CI: 1.7, 12.0), Pinteraction = 0.04) and statistically and clinically significant less decline in instrumental ADL (Lawton’s scale: home, −0.8 (95% CI: −1.3, −0.2) vs residential, −2.1 (95% CI: −2.9, −1.4), Pinteraction = 0.002). Conclusion. Older adults participating in a facility-based TCP had improvements in physical, cognitive and social functional abilities. However, those who returned home still had residual mobility deficits and decreased performance of instrumental ADL when compared with normative community level recommendations, which could impact on longer term community living. Further research investigating which program service components could be modified to further improve rehabilitation outcomes could benefit older adults in returning and remaining at home. [ABSTRACT FROM AUTHOR]

Falls prevention strategies can only be effective in reducing falls amongst older people if they are adopted and enacted in their daily lives. There is limited evidence identifying what older people in residential aged care (RAC) homes understand about falls and falls prevention, or what may limit or enable their adoption of strategies. This study was conducted in two countries and explored older people's knowledge and awareness of falls and their preferences, opportunities and motivation to undertake falls prevention strategies. A cross-sectional survey was administered to participants (N = 70) aged 65 years and over, living in six RAC homes in Perth, Australia and six RAC homes in Swansea, Wales, United Kingdom. Participants had limited knowledge about intrinsic falls risk factors and strategies to address these and frequently expressed self-blame regarding falling. Almost all (N = 67, 95.7%) participants felt highly motivated to maintain their current functional mobility and independence in everyday tasks. Key preferences for receiving falls prevention messages favoured a positive approach promoting wellness and independence (N = 41, 58.6%) via pictorial posters or brochures (N = 37, 52.9%) and small group discussions preferably with demonstrations (N = 18, 25.7%). Findings from this study may assist organisations and staff to more effectively engage with older people living in RAC about falls prevention and design targeted resources to address the motivations and preferences of this population. [ABSTRACT FROM AUTHOR]